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 of Horseshoe Kidney

 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

Neuroblastoma Of Lt adrenal gland

Adrenal Hemorrhage Neuroblastoma

 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 12 th 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