Marilyn Rose

Kidneys, ureters, bladder, urethra Kidneys- retroperitoneal, bean-shaped Oblique orientation, paravertebral gutters along

posterior abdominal wall One on each side of spine at the

level of T12 – L4 Surrounded by perirenal fat, and Gerota’s fascia Composed of

outer cortex- functional subunit- nephrons- filter urine inner renal medulla- pyramids, Loops of Henle

Mass on CT recon ofHorseshoe Kidney

http://radiology.rsna.org/content/247/3/747/F2.large.jpg

Retroperitoneal, paired, suprarenal, y shaped Rt adrenal- posterior to IVC, medial to Rt

hepatic lobe, lateral to Rt crus of diaphragm. Lt adrenal- in “triangle” of the aorta,

pancreatic tail, and Lt kidney- borders Lt crus of diaphragm

Outer cortex- produce steroids Corticosteroids

glucocorticoids, mineralocorticoids and androgens Inner medulla

Hormones Epinephrine and norepinephrine- fight or flight

NeuroblastomaOf Lt adrenal gland

Adrenal Hemorrhage

Neuroblastoma

http://www.uhrad.com/pedsarc/peds063b2.jpg

Stomach- food reservoir and early digestion Located under Lt dome of diaphragm Superior portion- joins esophagus at cardiac

orifice (cardiac sphincter) Boder- lesser and greater curvature Inferior portion- pyloric antrum -> duodenum Anterior surface- contact with diaphragm,

anterio abdominal wall and Lt lobe of liver Lining of stomach = rugae Gastric juices= mucus, hydrochloric acid,

intrinsic factor and pepsinogen and lipase Very vascular organ

CT scan of chest & upper abdomen (coronal section); herniation of stomach & splenic flexure of colon, along with collapse of lung and mediastinal shifting

Small bowel between pylorus and ileocecal valve

6-7 meters in length Duodenum

Pylorus- head of panc- retroperitoneal 4 portions

First- superior-duodenal bulb Second- descend- ampulla of Vater Third- horizontal- L3- ant to SVC, AO Fourth- ascending- Lt of AO at L2 meets with Jejunum

jejunum– duodenojejunal flexure ligament of Treitz- suspensory lig-around celiac axis Entry of small bowel into peritoneal cavity Lt upper abdomen/ umbilical region- absorption occurs- folds??

Ileum Longest portion, RL abdomen- terminate at ileocecal valve-

CECUM Often this is the site of intussusception / inflammation and

WHAT?

Intestines

herniaIntussesseption

Inferior to stomach and liver Larger diameter, haustra and bands called

taenia coli The appendix attaches to posteromedial

surface of cecum Ascending-

retroperitoneal, cecum to liver- hepatic flexure Transverse

Peritoneal, horizontal, toward spleen, splenic flexure Descending

Retroperitoneal, Lt lat abd to sigmoid Sigmoid

Chains along branches of arteries of intestine and AO

Small, oblong, soft and difficult to visualize –unless ABNORMAL

Enlarged= greater than 1 cm in short axis and 2 cm in long axis.

Abdominoaortic nodal groups- surround AO/IVC Visceral –drain adjacent organs Lymph drains from abdominal cavity into

lumbar trunk, and intestinal in to intestinal trunk and both trunks join the thoracic duct and then the venous system

PTLD????

Diaphragm Quadratus lumborum

Lg portion of posterior abdominal wall Iliac crest- inferior 12th rib

Psoas Lateral surpaces of lumbar vertebrae Insert into greater trochanter of femur

Rectus abdominis Anterior surface of abd/pelvis

Linea alba Xiphoid- symphysis pubis- midline and

interlacing