5b. Abdomen HAL - Worksheet

Question 1

the kidneys are located where in relation to peritoneum

Answer 1

retroperitoneum

Question 2

what are the kidneys encased in in terms of fat

Answer 2

peri and pararenal fat pads

Question 3

where are the kidneys located in relation to psoas major muscle and what other muscle is near it

Answer 3

located anterior to the psoas maj and quadratus lumborum muscles

Question 4

what is noticeable about the perirenal fat pads around the kidney and their relation to each other and the IVC and Abdominal aorta

Answer 4

they are continuous across the midline

Question 5

what might you expect to see in a case of trauma where one kidney has ruptured since the perirenal fat pads are continuous along the midline

Answer 5

blood in the retroperitoneum contained within the boundaries of the renal fascia, potentially crossing the midline

Question 6

the hila of the kidney lie on what plane

Answer 6

L1 trans-pyloric plane

Question 7

what key structures enter and exit the kidney at the hilum

Answer 7

renal artery enters, renal vein and renal pelvis exit

Question 8

why is it difficult to attain a complete view of the renal vessels in the coronal plane

Answer 8

the aorta and IVC are relatively more anterior than the renal hila

Question 9

why is it difficult to attain a complete view of the renal vessels in the axial plane

Answer 9

the renal vessels may descend slightly to the kidneys relative to their origin

left kidney is located higher than the right so not on same horizontal plane

Question 10

which kidney is typically positioned more inferior, why?

Answer 10

right due to position and size of liver

Question 11

what are the 3 main places that a kidney stone is likely to get stuck

Answer 11

pelvis ureteric junction (where ureters leave the renal pelvis)
pelvic brim/bifurcation of common iliac artery
vesico-ureteric junction (where ureters enter bladder)

Question 12

which muscles do the ureters descend upon as they course from kidney to bladder

Answer 12

psoas major

Question 13

the ureters are roughly in line with what parts of the lumbar spine

Answer 13

transverse processes (specifically the tips)

Question 14

the psoas muscles fills what on either side of the transverse processes

Answer 14

paravertebral gutter on either side

Question 15

what aspect of the bladder do the ureters enter at

Answer 15

posterior aspect

Question 16

is the small bowel intra/retroperitoneal

Answer 16

intra

Question 17

what parts of the large colon are intraperitoneal and which parts are retroperitoneal

Answer 17

ascending and descending are retroperitoneal

transverse and sigmoid colon are intraperitoneal

Question 18

the large intestine starts around what region of the abdomen

Answer 18

right groin

Question 19

in what region of the abdomen does the ileum transition into the caecum

Answer 19

right groin

Question 20

what region of the abdomen is the appendix

Answer 20

right groin

Question 21

what region of the abdomen is the ascending colon

Answer 21

right flank

Question 22

what region of the abdomen is the hepatic flexure

Answer 22

right hypochondrium

Question 23

what region of the abdomen is the transverse colon

Answer 23

epigastric

Question 24

what region of the abdomen is the splenic flexure

Answer 24

left hypochondrium

Question 25

what region of the abdomen is the descending colon

Answer 25

left flank

Question 26

what region of the abdomen is the sigmoid colon

Answer 26

left groin

Question 27

what region of the abdomen is the rectum

Answer 27

pubic

Question 28

where do you expect to find the ascending and descending colon

Answer 28

located relatively posteriorly within the abdominal cavity behind the peritoneum

Question 29

what is the alrge intestine filled with during life that helps to identify it on CT/MR

Answer 29

gas and faeces but gas is more identifiable as a density

Question 30

where is the small intestine jejunum to ileum situated in the abdomenn

Answer 30

situated relatively anterior and centrally within the abdomen and inferior to the transverse colon

Question 31

what is the GI tract composed of

Answer 31

stomach and duodenum

Question 32

how would you describe the location of the stomach in the abdomen

Answer 32

anterior and left in epigastric region

Question 33

where do you expect to see bowel gas within the stomach on a cross sectional image

Answer 33

top of the screen within structure anterior of patient as gas has risen to top CT and MR typically taken laying supine

Question 34

the duodenum is what shaped

Answer 34

C or G shaped

Question 35

what direction does the duodenum travel in

Answer 35

traverses to right (superior portion), descends and then traverses to the left (inferior portion) and then ascends before becoming the jejunum

Question 36

what does the inferior portion of the duodenum pass over (which vessel)

Answer 36

aorta

Question 37

in which plane do you expect to see the full length of the descending/ascending duodenum

Answer 37

coronal and/or sagittal

Question 38

in which plane do you expect to see the full length of the superior/inferior duodenum

Answer 38

axial and maybe coronal

Question 39

in the axial slice, what organ do you expect to see immediately to the left of the descending duodenum

Answer 39

head of pancreas

Question 40

the liver is located under what

Answer 40

right dome of diaphragm

Question 41

the anatomic system of dividing the liver into lobes produces what 2 lobes

Answer 41

right and left lobes

Question 42

what divides the liver into the right and left anatomic lobes

Answer 42

falciform ligament

Question 43

how many physiological lobes of the liver are there

Answer 43

8

Question 44

what divides the physiological lobes of the liver

Answer 44

venous architecture divides it into 4 columns

Question 45

what venous structure divides the physiological lobes of the liver into 4 columns

Answer 45

via 3 main hepatic veins

Question 46

what are the 3 hepatic veins

Answer 46

left, central and right

Question 47

what divides the left and right physiological lobes in cantlies line

Answer 47

central hepatic vein

Question 48

what vessel divides the liver into a superior and inferior half

Answer 48

2 main branches of the portal vein

Question 49

the caudate lobe is what segment and what does it drain into

Answer 49

segment 1 drains into the IVC

Question 50

the segment 4 gets split into what parts and where are they located in relation to which vessels

Answer 50

part A and B either side of left portal vein branch

Question 51

the gall bladder is located where in relation to the liver

Answer 51

pinned to and hangs from the postero-inferior surface of the liver

Question 52

what way does the gall bladder slope

Answer 52

slopes to the anterior

Question 53

what can be used to estimate cantlies line

Answer 53

gall bladder and IVC

Question 54

what is the difference between imaging and diagrams depicting the gall bladder and IVC relation

Answer 54

gall bladder is located anteriorly and to the right of the IVC but diagrams depict them as line antero-posteriorly

Question 55

the gall bladder drains into what structure

Answer 55

bile duct

Question 56

what 3 structures form the portal triad

Answer 56

hepatic artery and portal vein plus bile duct

Question 57

where is the portal vein in relation to the IVC

Answer 57

anterior

Question 58

what bit of the large bowel can you see inferior to the right lobe

Answer 58

hepatic flexure

Question 59

what other major solid organ is also closely attributed to the right lobe

Answer 59

right kidney

Question 60

what is the clinical significance of the livers relationship with the right kidney

Answer 60

hepatorenal pouch of Morrison is the most dependent part of the abdomen when supine and therefore is where the blood/fluids will collect and can be seen on imaging

Question 61

what is the difference between the IVC and the aorta that can help you differentiate them on the images

Answer 61

aorta is always more circular in axial cross section due to thick elastic muscular walls IVC is often more ellipsoid nd flattened due to weaker walls and lower blood pressure

Question 62

the spleen is on what side of the abdomen

Answer 62

left side

Question 63

the 3 impressions on the visceral/internal surface of the spleen correlate to what 3 organs

Answer 63

stomach = ant and right of spleen kidney = post and inf of spleen splenic flexure = ant and inf of spleen

Question 64

what is the difference between the splenic artery and splenic vein in terms of structure how does this relate to visualising them in images

Answer 64

splenic artery is very tortuous and is unlikely to get all in single slice splenic vein is straight and therefore more likely see more

Question 65

what organ does the splenic vein course behind

Answer 65

pancreas

Question 66

what are the 5 sections of the pancreas

Answer 66

head, neck, body, tail and uncinate process

Question 67

what is a key anatomical relation to the uncinate of the pancreas to other organs around it in terms of location

Answer 67

posterior to the SMA and SMV

Question 68

what is a key anatomical relation to the head of the pancreas to other organs around it in terms of location

Answer 68

left of descending duodenum

Question 69

what is a key anatomical relation to the neck of the pancreas to other organs around it in terms of location

Answer 69

anterior to SMA and portal vein origin

Question 70

what is a key anatomical relation to the body of the pancreas to other organs around it in terms of location

Answer 70

anterior to splenic vein

Question 71

what is a key anatomical relation to the tail of the pancreas to other organs around it in terms of location

Answer 71

sits in hilum of the spleen

Question 72

can you see all parts of the pancreas in one level and one plane in imaging

Answer 72

no head, neck and body and some tail in one horizontal plane but to see the uncinate process, need to drop one level

Question 73

what do you notice about the head of the pancreas in comparison to other divisions

Answer 73

head has more vertical dimension than other components (eg sits on 2 levels while others site more on one) coronal and sagittal therefore would show it entirety

Question 74

which important vein is formed behind the neck of the pancreas

Answer 74

portal vein

Question 75

what are the transpyloric plane structures

Answer 75

renal hila pylorus of stomach gall bladder fundus SMA origin of aorta