Week 6-Retroperitoneal structures

Question 1

What does retroperitoneal mean?

Answer 1

A structure that lies posterior to the parietal peritoneum (the parietal peritoneum only covers one side).

Question 2

What is a primary retroperitoneal structure?

Give some examples of these?

Answer 2

It developed retroperitoneal and stays retroperitoneal.

Kidney, suprarenal glands, vessels and nerves are examples of this.

Question 3

What is a secondary retroperitoneal structure?

Give some examples of these?

Answer 3

Become covered in peritoneum by the end of development and are seen that way in an adult.
Examples of this include most of the duodenum, pancreas, ascending colon, descending colon and upper 2/3rds of the rectum.

Question 4

What forms the urinary tract?

Answer 4

The kidneys, ureter, bladder and urethra.

Question 5

How big are the kidneys?

At what spinal level may they be found?

Answer 5

10-12cm long by 6-8cm wide

Found at L1 level.

Question 6

What may be found posterior to the right kidney?

Answer 6

Diaphragm, 12th rib, psoas, quadratus lumborum, transversus abdominus, subcostal nerve.

Question 7

What may be found posterior to the left kidney?

Answer 7

The diaphragm, 11th and 12th ribs, psoas, quadratus lumborum, transversus abdominus, subcostal nerve.

Question 8

What structures may be found in the renal hilum?

Answer 8

Renal artery, renal vein and ureter.

Question 9

Describe the arrangement of the renal hilum?

Answer 9

Renal artery superior
Renal vein inferior
Ureter posterior

Question 10

Describe the drainage of the kidney from the loop of Henle to the ureter?

Answer 10

Loop of Henle allows fluid in the minor calyx. Each minor calyx comes together in the centre of the kidney to form the major calxyx. The major calyx drains to the renal pelvis which is then continuous with the ureter at the renal hilum.

Question 11

At what level do the renal arteries come off the aorta?

Answer 11

At L1.

Question 12

How do the renal arteries enter the hilum (are they branched or is it just the one)?

Answer 12

The renal arteries exit the aorta at L1 and branch into anterior and posterior branches and then into segmental branches at the hilum.

Question 13

In relation to the IVC, where would you find the right renal artery?

Answer 13

Posterior to the IVC.

Question 14

Inside the kidneys, what branches of the arteries may be found?

Answer 14

Lobar arteries, interlobar arteries, arcuate arteries, afferent glomerular arteries inside the kidneys.

Question 15

Where do the renal veins drain to?

Answer 15

Directly into the IVC.

Question 16

Where does lymph from the kidneys drain to?

Answer 16

Drains to the lateral (para-aortic) nodes.

Question 17

What is the autonomic nerve supply to the kidneys?

Where do the afferent fibres enter the spinal cord at?

Answer 17

They come from the renal sympathetic plexus.

Enter at T10-12.

Question 18

Describe the differences in the left and right renal veins?

Answer 18

The left renal vein is three times the length of the right. It passes behind the splenic vein and body of the pancreas.

Question 19

What other veins join the left renal vein?

Answer 19

The left gonadal vein and left suprarenal vein join it.

Question 20

Where does the right renal vein pass behind?

Answer 20

Directly behind descending duodenum.

Question 21

Describe the path of the ureters?

Answer 21

They pass vertically down from the renal hilum on the surface of psoas. It crosses the bifurcation of the common iliac artery anterior to the sacroiliac joint. It then follows the lateral wall of the pelvis towards the ischial spine. It enters the inferior surface of the bladder at the trigone.

Question 22

How is urine propelled within the ureter?

Answer 22

Propelled by contractions of the ureter wall and filtration pressure from the glomeruli.

Question 23

There are 3 constrictions in the ureter, describe the position of these and why they occur?

Answer 23

One occurs at the junction of the ureters and the renal pelvis.
Another where the ureters cross the pelvic brim
Another as they enter the wall of the bladder.

Question 24

Why does the blood supply, nerve supply and lymph drainage of the ureter change as it descends?

Answer 24

This is due to the ureter crossing from the abdomen into the pelvis.

Question 25

What is the arterial supply to the ureter (several arteries)

Answer 25

Superiorly- renal artery
Middle- Testicular or Ovarian artery
Inferiorly- Superior vesicular artery.

Question 26

What is the venous drainage of the ureter? (Several veins)

Answer 26

Superiorly- renal vein
Middle- Testicular or Ovarian Vein
Inferiorly- Superior vesicular vein

Question 27

What is the lymph drainage of the ureter?

Answer 27

Either to lateral aortic or iliac nodes.

Question 28

What is the nerve supply to the ureter?

Answer 28

Either from renal, testicular or hypogastric plexuses.

Afferent fibres to L1 L2.

Question 29

What are the adrenal glands also known as?

Answer 29

Suprarenal glands

Question 30

What does the adrenal cortex release (in terms of hormones)?

Answer 30

Corticoids

Glucocorticoids

Question 31

What does the adrenal medulla release?

Answer 31

epinephrine and nor-epinephrine (adrenaline and nor-adrenaline)

Question 32

Describe the shape of the right and left adrenal gland?

Answer 32

Right- pyramidal and sits behind right lobe of liver

Left- cresenteric- behind the pancreas, stomach and lesser sac.

Question 33

Describe the arterial supply to the suprarenal glands?

Answer 33

Suprarenal branch of inferior phrenic, suprarenal branch of aorta and suprarenal branch of renal.

Question 34

Describe the venous drainage to the suprarenal glands?

Answer 34

Single vein on each side.

On the right-drains directly to IVC, L drains to the renal vein.

Question 35

Where does lymph from the suprarenal glands go?

Answer 35

To the lateral aortic nodes.

Question 36

What is the nerve supply to the suprarenal glands?

Answer 36

Pre-ganglionic sympathetic from splanchnic nerves.