Retroperitoneum

between the posterior parietal peritoneum and the posterior abdominal wall muscles
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Terms in this set (43)
between the posterior parietal peritoneum and the posterior abdominal wall muscles
Where is the retroperitoneum located?
from the diaphragm to the pelvis
From where to where does the retro extend?
1. anterior pararenal space
2. perirenal space
3. posterior pararenal space
what three spaces is the retro divided into?
surrounds kidney, adrenal gland, and perirenal fat
What 3 things does the parirenal space surround?
1. duodenum
2. pancreas
3. ascending colon
4. transverse colon
What is in the anterior pararenal space? 4
1. Iliopsoas muscle
2. ureter
3. branches of the IVC
4. Aorta
5. Lymphatics
What is in the posterior pararenal space? 5
Gerota's Fascia
What surrounds the perirenal space?
Small size, medial location, and surrounding perirenal fat
Why are the adrenal glands difficult to visualize on ultrasound? 3
size of patient, amount of perirenal fat, bowel gas, and ability to move patient position
What does adrenal gland visualization depend on? 4
adrenal is 1/3 size of the kidney
At birth, how big is the adrenal gland in relation to the kidney?
adult adrenal gland is 1/13 size of kidneyHow big is an adult adrenal gland in relation to kidney?triangularshape of RT adrenal glandsemilunarshape of LT adrenal glandnocan the cortex and medulla be distinguished on ultrasound?-caps superior pole of rt kidney -medial portion is immediately posterior to ivc (above the level of the PV) -lateral to the crus of the diaphragm -lateral portion is posterior and medial to right lobe of liverlocation of rt adrenal gland in relation to: -rt kid -ivc -crus of diaphragm -RT lobe of liver-extends along medial border of left kidney (superior pole to hilum) -lateral or slightly posteriolateral to aorta -superior portion is posterior to stomach -inferior portion is posterior to the pancreasLocation of LT adrenal gland in relation to: -LT kid -aorta -stomach -pancreasNo, they are paired endocrine organsDo the adrenal glands work separately from each other?smaller than 3cmUsual size of adrenal glandenclosed in gerota's fascia and surrounded by fatwhat encloses the adrenal gland and what surrounds it?outer cortex and inner medulla2 parts of the endocrine glandcortex produces steroids -corticoids, mineralocorticoids, and glucocorticoids --aldosterone, cortisol and sex hormonesWhat does the outer cortex produce? 1/3/3adrenocorticotropic hormone (ACTH) from the pituitary glandWhat controls the cortex of the adrenal gland?1. regulate electrolyte metabolism; aldosterone is a principal mineral corticoid 2. regulatory effect on mineral ions in body fluids and therefore tissue water content 3. insufficiency leads to increased excretion of sodium and chloride ions, and waterWhat do mineralocorticoids do? 31. principal role in carbohydrate metabolism 2. promotes deposition of liver glycogen from proteins and inhibits use of glucose by cells 3. this increases blood sugar levelsWhat do Glucocorticoids do?3cortisone and hydrocortisone -they diminish allergic responses; particularly Rheumatoid arthritis and rheumatic fever2 primary glucocorticoids and what do they do?male: androgens female: estrogen -adrenal glands secrete both regardless of gender and only a very small amountMale and female sex hormonesmedullaWhat is the core of the adrenal gland called?epinephrine and norepinephrine (known as catecholamines)What 2 things does the medulla secrete? What are they known as?4x as much epinephrineHow much more epinephrine is secreted than nor?they promote glycogenolysis -breakdown of liver glycogen to glucose which increases blood sugar concentrationWhat do epi and norepinephrine together promote? and what does this do?NOIs the medulla essential for life?1. iliac and hypogastric nodes within pelvis 2. para-aortic group in upper retroperitoneum - Chain follows course of thoracic aorta, abdominal aorta, and iliac arteries Called Para-aortic lymph nodes!What are the two major lymph node bearing areas in the retroperitoneal cavity? and what course do they follow?normally less than 1cm and not seen on US. but can be 1-3cm or larger if enlarged by infection or tumor -this would cause the aorta,ivc, or kidney to be displacedNormal size of para-aortic lymph nodesRegion between internal surface of iliac wings, from crest to iliopectineal lineWhere is the iliac fossa located?false pelvisAnother name for iliac fossaureter and major branches of distal/proximal great vessels, and lymphaticswhat does the iliac fossa contain?pancreas, kidneys(most common), bladder, parabolica gutters, and great vesselsWhat is included in a scan of the retroperitoneum?from the diaphragm to the iliac crestWhen scanning the retroperitoneum, from where to where can the scan be done?1. right crus of diaphragm 2. duodenum 3. gastroesophageal junciton 4. lobulations of spleen 5. splenic vasculature 6. bodytail region of pancreas 7. tortuous great vesselsWhat are 7 sonographic pitfalls of scanning the retroperitoneum?Anterior perirenal space1Retroperitoneal space2Posterior perirenal space3Perirenal space4