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Anatomy PA > Additional abdomen > Flashcards

Additional abdomen Flashcards

1
Q

External oblique proximal and distal attachments`

A

proximal: lower ribs
distal: linea alba/pubic tubercle/iliac crest

flexion of trunk

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2
Q

internal oblique

A

proximal: iliac crest/inguinal ligament
distal: lower ribs/ linea alba/body of pubis

flexion of trunk

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3
Q

transversus abdominis

A

proximal: lower costal cartilages/iliac crest/ ingulinal ligament
distal: linea alba, pubic crest, pectineal line of pubis

flexion of trunk

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4
Q

rectus abdominis

A

proximal: pubic symphysis, pubic crest
distal: Xiphoid process, lower costal cartilages

flexion of trunk

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5
Q

cryptorchidism

A

testes undescended in 3% full term and 30% premature infants

90% occur unilaterally

increased risk of developing malignancy in the undescended testis

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6
Q

hydrocele

A

presence of excess fluid in a persistent processus vaginalis

may be associated with indirect inguinal hernia

congenital

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7
Q

torsion of the spermatic cord

A

surgical emergency because necrosis of the testis may occur

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8
Q

what is used to detect an inguinal mass

A

US

mass would not appear with typical hydrocele, rules out possibility of testicular tuomor, hernia, varicocele

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9
Q

what is a communicating hydrocele

A

most common in infants/children

results when proximal processus vaginalis remains open

peritoneal fluid enters scrotal sac

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10
Q

non communicating hydrocele

A

proximal processus vaginalis is closed

distal processus vaginalis is open

fluid is trapped in the open portion of the processus vaginalis

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11
Q

what is transillumination used for in hydrocele cases

A

bright light is applied to side of the scrotum, fluid in hydrocele is usually clear and light will outline the testes showing the presence of fluid in scrotum

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12
Q

varicocele

A

pampiniform plexus of veins may become dilated (varicose) and tortuous producing varicocele

visible when man is standing or straining

disappears when lies down

gravity empties veins

palpation feels like bag of worms

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13
Q

inguinal hernia

A

majority occur in the inguinal area

def: protrusion of parietal periotenum and viscera such as small intestine through a normal /abnormal opening from area they belong to area they do not belong

75% of abdominal hernias are inguinal hernias
both sexes have (86% males) because of spermatic cord passage through inguinal canal

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14
Q

how to clinically examine inguinal hernia

A

patient standing

examiner places finger at superficial inguinal ring

patient coughs

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15
Q

what is direct vs indirect with examination for inguinal hernia

A

direct: buldge felt against SIDE examiner finger
indirect: suspected if a buldge is felt at TIP of finger as the finger is directed toward the deep inguinal ring

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16
Q

inguinal lymph nodes

A

12-20 superficial inguinal nodes that parallel boarder of inguinal ligament

medially placed nodes receive lymph from external genitalia (except testis, epididymis, and spermatic cord), inferior anal canal, perianal region, uterus

laterally placed nodes received lymph from lateral gluteal region and lower anterior abdominal wall

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17
Q

lymphadenitis

A

infection (strep, staph, etc…) and subsequent enlargement of lymph nodes

swollen and painful

most common children

febrile

increased WBC

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18
Q

where in the body do you find serosae (serosa)

A

heart

lungs

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19
Q

funciton of serosae (serosa)

A

support organs within body cavity

mesothelial cells enrich fluid filtered from capillaries in underlying areolar connective tissue to create clear serous fluid

allow decreased friction

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20
Q

what is peritoneum

A

the serous membrane within the abdominopelvic cavity

invests the viscera

has two continuous layers

  1. parietal peritoneum (lines internal surfaces)
  2. visceral peritoneum (invests viscera)
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21
Q

ascites

A

accumulation of ascitic fluid (transudate - few nucleated cell or exudate with many nucleated cells=pus) in peritoneal cavity

peritoneal cavity= potential space between parietal and visceral peritoneal layers

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22
Q

how to treat ascites

A

drain fluid via paracentesis - surgical puncture of the peritoneal cavity to remove ascitic fluid via aspiration or drainage

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23
Q

what is done for when a pt hits renal failure and has waste products (urea) in blood/tissues accumulating to fatal levels

A

peritoneal dialysis

soluble substances and excess water removed from the system by transfer across peritoneum

usually employed only temporally

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24
Q

what does the superior mesenteric artery supply

A

midgut

distal duodenum
jejunum
ileum
cecum
appendix
ascending colon
proximal 2/3 transverse colon
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25
Q

what does the inferior mesenteric artery supply

A

hindgut

distal 1/3 transverse colon
descending colon
sigmoid colon 
rectum
superior portion of anal canal
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26
Q

where does all venous drainage go first for alimentary canal (stomach/intestines)

A

hepatic portal vein to liver
BEFORE
returning to general circulation

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27
Q

what innervates the esophagus

A

esophageal plexus (formed by vagal trunks and splanchnic nerves)

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28
Q

what occurs in lower esophageal sphincter (LES) during swallowing and what is timing of events

A
  1. at rest LES is contracted= no reflux
  2. peristaltic waves trigger simultaneous LES relaxtion
  3. pressure at LES equals atm pressure= LES opens
  4. bolus into stomach
  5. LES remains uopen until peristaltic wave reaches terminal end of esophagus
  6. LES relaxes is mediated by inhibitory neurons of vagus nerve and release vasoactive intestinal peptide and NO
29
Q

Achalasia

A

impaired peristalsis in lower 2/3 esophagus (involves primarily smooth muscle dysfunction)

bolus not moved properly down esophagus

loss of inhibitory neurons innervating LES

LES fials to relax

30
Q

Corkscrew esophagus

A

type of achalasia

31
Q

what happens if parietal cells in stomach do not secrete intrinisc factor

A

pernicious anemia

pernicious anemia= inability to utilize Vit B12, most common cause is lack of intrinsic factor

intrinsic factor= essential to absorbing Vit B12. Vit B12 is essential in development of RBCs

32
Q

what happens if someone takes antacids all the time

A

pepsinogen cannot be converted into pepsin (active proteolytic enzyme)

requires HCL to be made into active form
pepsinogen + HCL-> pepsin (active form)

33
Q

what secretes gastrin in stomach

what stimulates this

what does gastrin do

A

G cells secrete in response to food in stomach

gastrin stimulates HCL production by parietal cells

34
Q

What is the stomach derived from

A

foregut

35
Q

what is the foregut innervated by

A

thoracic splanchnic nerves and parasympathetic innervation (T6-T9)

36
Q

what is esophagus derived from

A

foregut

37
Q

how is pain percieved by stomach

A

visceral afferents (vagus and sympathetic nerves)

pain receptor carried by sympathetic nerves stomach pain is referred to dermatomes T6-T9

38
Q

lacteal

A

special lymph capillaries in small intestine

transport lipids from digestive tract

39
Q

where does large intestine begin and end

A

cecum to anal canal

40
Q

tenia coli

A

three distinct longitudinal bands of smooth muscle on colon

when they contract entire intestine gets shorter= fecal mater can move to rectum

41
Q

epiploic (omental) appendices

A

small pouches of peritoneum filled with fat situated along colon
absent in rectum

42
Q

goblet cells in large intestine

A

mucous to protect from bacteria in feces

43
Q

what does the ileocolic artery supply

A

branch of superior messenteric artery

supplies the ileum, cecum, and part of the ascending colon

44
Q

what does the appendicular branch of the ileocolic artery supply

A

appendix

45
Q

what does the middle colic artery supply

A

transverse colon

46
Q

what does the left colic artery supply

and what artery give rise to the left colic artery

A

left colic artery is a branch of the inferior mesenteric artery

it supplies the descending colon

47
Q

what is the marginal artery

A

an anastomotic arches (arcades) of right and left colic arteries

continues along boarder of large intestine

48
Q

what is the vasa recta of large intestine

A

small, straight arteries that branch/radiate off the marginal artery to pentertate into the large intestine wall to supply large intestine

branches of marginal artery??

49
Q

which parts of the large intestine become retroperitoneal

A

ascending and descending colon

50
Q

what ribs are associated with the spleen

A

ribs 9-12

51
Q

what is the blood flow from the abdominal aorta to the spleen

A

abdominal aorta
celiac trunk
splenic artery

52
Q

what are the different types of splenomegaly

A

infective
congestive (portal HTN or CHF)
hyperplastic (sickle cell anemia)
infiltration (lymphoma)

53
Q

what serum enzymes are diagnostic in pancreatitis when above the normal range

A

serum amylase and serum lipase

approx 85% of pts with pancreatitis will have 3-fold increase in concentration of enzymes above normal range

54
Q

what supplies the liver with blood

A

80% of blood supply to liver is via hepatic portal system (hepatic portal vein)

20% comes from arterial supply (hepatic artery proper)

55
Q

what is the blood flow from abdominal aorta to liver arterial wise

A

abdominal aorta
celiac trunk
common hepatic artery

56
Q

what contributes to the hepatic portal vein

A
  1. superior mesenteric vein-> hepatic portal vein

2. inferior mesenteric vein-> splenic vein-> hepatic portal vein

57
Q

what is the route takes from liver to IVC

A

right, intermediate and left hepatic veins to inferior vena cava

58
Q

liver cirrhosis

A

liver completely disrupted by bands of connective tissue

chronic inflammatory cells mainly lymphocytes and other mononuclear cells in connective tissue

some proliferation of bile ductules

AKA fibrosis of the liver

59
Q

what innervates the gall bladder

A

sensory through right phrenic nerve

sympathetic motor: greater splanchnic nerve via celiac plexus

parasympathetic right vagus nerve

60
Q

what nerve roots give rise to the visceral pain sensation from the gall bladder and biliary system

A

T6-T9

61
Q

pain impulses from the gall bladder can also be transmitted via the phrenic nerve

what are the dermatomes associated with the phrenic nerve

A

C3-C5

62
Q

what is choluria

A

bile in the urine

63
Q

what is steatorrhea

A

presence of fat in stool

bile is important in fat digestion of lipids because it emulsifies lipids, thus making lipids soluble in aqueous solution

64
Q

what is cholelithiasis

A

gall stones

65
Q

how is pain involving the pancreas similar / different to that of the gall bladder / biliary system

A

pancreas is bilateral

?????

66
Q

signs and symptoms of pancreas dysfunction

A

??

67
Q

signs and symptoms of gall bladder dysfunction

A

??

68
Q

what does the following lab results rule out?

normal serum albumin
normal serum alkaline phosphatase
normal serum amylase
normal serum lipase

A

pancreatitis is rules out

Anatomy PA (12 decks)

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