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Flashcards in Abdomen Deck (312)
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1
Q

What is the abdomen in relation to the trunk?

A

The part between thorax and pelvis

2
Q

True/False: The abdomen is a flexible, dynamic container housing most of the organs of the alimentary system and part of the urogenital system.

A

True

3
Q

Through what type of contraction is the muscular roof, anterolateral wallsm and floor that raises internal pressure to aid air expulsion or substances?

A

Voluntary, reflexive contraction

4
Q

What covers the anterolateral wall and organs against the posterior wall?

A

Periotneum

5
Q

What is formed between the viscera and the abdominpelvic cavity?

A

Peritoneal cavity

6
Q

What structure “separates” the abdominal and pelvic cavities?

A

Pelvic inlet

7
Q

What is the name of the two sagittal planes?

A

Midclavicular to midinguinal

8
Q

What does the transverse plane cross through?

A

The coastal cartilages of 10th row (also called subcostal plane)

9
Q

What is the plane that passes through the iliac tubercles and L5?

A

Transtubercular

10
Q

What plane passes through the ASIS on each side?

A

Interspinous

11
Q

What plane passes halfway between the manibrium and pubic symphysis?

A

Transpyloric

12
Q

What are the nine region used to describe the location of organs, pains, and pathologies?

A

Right Hypochondriac, Right Flank , Right Inguinal, Epigastric, Umbilical, Hypogastric, Left Hypochondriac, Left Flank, Left Inguinal

13
Q

What planes intersect to create the Right Hypogastric region?

A

R MCL x transtubercular

14
Q

What planes intersect to create the epigastric region?

A

Transtubercular and MCLs

15
Q

What planes intersect to create the Left Hypochondriac region?

A

L MCL x transtubercular

16
Q

What planes intersect to create the Left flank region?

A

R MCL x interspinous x subcostal

17
Q

What planes intersect to create the umbilical region?

A

MCLs x subcostal x Interspinous

18
Q

What planes intersect to create the left flank region?

A

L MCL x subcostal x interspinous

19
Q

What planes intersect to create the right inguinal region?

A

L MCL x interspinous

20
Q

What planes intersect to create the hypogastric region?

A

MCLs x interspinous

21
Q

What planes intersect to create the Left Inguinal region?

A

Interspinous x L MCL

22
Q

What are the four quadrants that are created by the median plane and transumbilical plain?

A

RUQ, LUQ, RLQ, LLQ

23
Q

What are the organs of the RUQ?

A

R lobe liver, Gallbladder, Pylorus of stomach, Duodenum, Head of pancreas, R suprarenal gland, R kidney, R colic flexure, ascending colon sup, 1/2 Transverse colon

24
Q

What are the organs of the LUQ?

A

L lobe liver, Spleen, stomach, jejunum, proximal ileum, body and tail of pancreas, L kidney, L suprarenal gland, L colic flexure, Half transverse colon, Descending colon sup

25
Q

What are the organs of the RLQ?

A

Cecum, appendix, ileum, ascending colon inf, R ovary, R uterine tube, R ureter, R spermatic cord

26
Q

What are the organs of the LLQ?

A

Sigmoid colon, Descending colon inf, L ovary, L uterine tube, L spermatic cord

27
Q

To what structures does the anterolateral abdominal wall extend to?

A

Thoracic cage -> pelvis

28
Q

What are the components of the anterolateral abdominal wall?

A

Skin, SubQ tissue: Camper -> scarpa, deep fascia, muscles, extraperitoneal fat, parietal peritoneum

29
Q

What are the muscles of the anterolateral wall?

A

External oblique, internal oblique, Rectus Abdominus, Transverse Abdominus, Pyramidalis

30
Q

What structure forms between the aponeuroses of the anterolateral abdominal muscles?

A

Rectus sheath

31
Q

What structure runs down the midline of the abdomen wall?

A

Linea alba

32
Q

Between what two structure does the linea alba run between?

A

Xiphoid process and pubic symphysis

33
Q

What is the arcuate line?

A

demarcates the transition between the aponeurotic posterior wall of the sheath covering the superior three quarters of the rectus and trasversalis fascia covering the inferior quarter

34
Q

What structures are also found in the rectus sheath?

A

Superior and inferior epigastric arteries and veins, lymphatic vessels, and distal portions of thoraco-abdominal nerves

35
Q

All the layers of the rectus sheath fuse to what structure?

A

Umbilicus

36
Q

What is the OINA of the external oblique?

A

O: ribs 5-12
I: Linea alba, pubic tubercle, anterior 1/2 of iliac crest
N: Thoraco-abdominal nerve (T7-11) and subcostal nerve (T12)
A: Compress and support viscera, Flexion of trunk, Rotation of trunk

37
Q

Where do the fibers of the EO become aponeurotic?

A

MCL and spino-umbilical line

38
Q

What is the OINA of the internal oblique?

A

O: thoracolumbar fascia, ant 2/3s of iliac crest, connective tissue of lateral 1.3 of inguinal ligament
I: Inf borders of 10-12 ribs, linea alba, pecten pubis
N: T6-12 and L1 ant rami
A: compress and rotate viscera, Flexion of trunk, Rotation of trunk

39
Q

What is the OINA of the tranverse abdominus?

A

O: Internal surfaces of 7-12 costal cartilages, thoracolumbar fascia, iliac crest, connective tissue deep to lateral 1/3 of inguinal ligament
I: linea alba, pubic crest, pecten pubis
N: T6-12 and L1 anterior rami
A: compress and support the viscera

40
Q

What is the OINA of the rectus abdominus?

A

O: pubis symphysis, pubic crest
I: Xiphoid process and 5-7 costal cartilages
N: T6-12 anterior rami
A: flexes trunk, Compresses viscera, Stabilizes and controls tilt of pelvis (antilordosis)

41
Q

What are the paired rectus muscles separates by?

A

Linea abla

42
Q

What structure exists within the rectus abdominus?

A

Tendinous intersections

43
Q

What is the pyramidalis muscle?

A

abest in 20% of people, small, insignificant triangular muscle. Lies anterior to the inferior part of RA and attaches to anterior surface of pubis and anterior pubic ligament

44
Q

What supplies the majority of the abdominal wall?

A

Anterior rami of T7-T12

45
Q

What are they and what structures do the thoraco-abdominal nerves supply?

A

anterior rami of T7-11, supply the abdominal skin @ and IO, TA muscles

46
Q

What are they and what structures do the lateral cutaneous branches of nerves supply?

A

T7-9 or t10, supply skin supply the skin of the L and R hypochondriac regions

47
Q

What are they and what structures do the anterior cutaneous branches of nerves supply?

A

T7-9, supply the skin abobe umbilicus, T10, supplies the skin around umbilicus, T11+T12+ iliohypogastric + Ilioinguinal, supply the skin below umbilicus

48
Q

What is the subcostal nerve and what does it supply?

A

Anterior ramus of T12, supplies muscles of the anterolateral abdominal wall and overlying skin superior to iliac crest but inf to umbilicus

49
Q

What is the Iliohypogastric nerve and what does it supply?

A

Anterior ramus of L1, supplies skin over iliac crest, upper inguinal, hypogastric regions, IO and TA muscles

50
Q

What is the ilioinguinal nerver and what does it supply?

A

Anterior ramus of L1, supplies skin of lower inguinal region, mons pubis, anterior scrotum/labium, medial thigh, inferiormost IO and TA

51
Q

What is the origin, course, and distribution of the musculophrenic artery?

A

O: Internal thoracic artery
C: descends along costal margin
D: hypochondriac region, anterolateral diaphragm

52
Q

What is the origin, course, and distribution of the superior epigastric artery?

A

O: Internal Thoracic artery
C: Descends in rectus sheath deep to RA
D: RA, epigastric and upper umbilical regions

53
Q

What is the origin, course, and distribution of the intercostal arteries?

A

O: Aorta
C: beyond ribs to descend abd. wall between IO and TA
D: Lumbar/Flank region

54
Q

What is the origin, course, and distribution of the subcostal artery?

A

O: Aorta
C: beyond ribs to descend abd. wall between IO and TA
D: Lumbar/Flank region

55
Q

What is the origin, course, and distribution of the inferior epigastric artery?

A

O: External Iliac artery
I: runs superiorly and enters rectus sheath, runs deep to RA
D: RA, pubic and umbilical regions

56
Q

What is the origin, course, and distribution of the deep circumflex iliac artery?

A

O: Exteral Iliac artery
C: runs Deep aspect of abd. wall, parallel to inguinal ligament
D: Iliacus, inguinal region, iliac fossa

57
Q

What is the origin, course, and distribution of the Superficial circumflex artery?

A

O: Femoral Artery
C: Runs in subQ tissue along inguinal ligament
D: Superifcial wall of inguinal regions and adj. anterior thigh

58
Q

What is the origin, course, and distribution of the superificial epigastric artery?

A

O: femoral artery
C: Runs in subQ tissue toward umbilicus
D: Superficial wall of pubic and inferior umbilic region

59
Q

What is a surgical method for removing unwanted subcutaneous fat using a suction tube and high vacuum pressure?

A

Liposuction

60
Q

Which fascia provides a plane that can be opened, enabling a surgeon to approach structures without entering the peritoneal sac?

A

Endoabdominal fascia

61
Q

Describe an abdominal protrusion.

A

Anything that causes the abdomen to protrude, can be food, feces, fetus, flatus, fat, fluid, ascites (serous fluid), Large mass (tumor, enlarged organ)

62
Q

What is an umbilical hernia?

A

A hernia in umbilical ring due to failure to normally close, common in neonates

63
Q

What is an epigastric hernia?

A

A hernia through the linea alba. typicall just lobules of fat

64
Q

What is a Spligelian hernia?

A

Occur along semilunar line.

65
Q

Describe a longtiduinal incision.

A

Midline/ paramedian incisions, good for exploratory operations due to best exposure to viscera, can extend as necessary with minimal complications

66
Q

Describe a median incision.

A

Any part of the linea alba, won’t cut any major muscles, BVs, or nerves.

67
Q

Describe an oblique incision.

A

(McBurney) 2.5 cm superomedial to the ASIS on the spino-umbilical line

68
Q

Describe a suprapubic incision.

A

Horizontal with a slight convexity along pubic hairline (c-section)

69
Q

Describe a subcostal incision.

A

parallel but at least 2.5 cm inf to costal margins to avoid the 7th and 8th spinal nerves, access to gallbladder and biliary ducts on R side and spleen on the :

70
Q

What is a pararectus incision?

A

Along the lateral border of the rectus sheath

71
Q

Why is the pararectus incision so high risk?

A

Risk to cutting nerve supply to RA

72
Q

Describe an endoscopic procedure.

A

Minimally invasive, tony perforations, allow entry of instruments (laparoscope)

73
Q

What makes up the internal surface of the anterolateral abdominal wall?

A

Transversalis fascia, extraperitoneal fat, parietal peritoneum

74
Q

What “structure(s)” are exhibited in the infra-umbilical part of the internal surface?

A

Umbilical folds

75
Q

How many umbilical fold are there?

A
  1. Two median, two lateral, one medial
76
Q

What are the depressions lateral to the umbilical folds?

A

Peritoneal fosse

77
Q

What supra-umbilical structure extends between the superior anterior abdominal wall and liver?

A

Falciform ligament

78
Q

What is another term for the inguinal region?

A

Groin

79
Q

The inguinal region is a passage from what cavity?

A

Abdominal

80
Q

What is the dense band constituting the inferiormost part of the EO aponeurosis?

A

Inquinal ligament

81
Q

What structure forms the medial boundary of the subinguinal space, between the superior pubic ramus to tubercle?

A

Lacunar ligament

82
Q

What structure runs along the pectin pubis?

A

Pectineal ligament

83
Q

What structure is formed by the bypassing of the pubic tubercle and crossing the linea alba to blend with the lower fibers of the EO aponeurosis?

A

Reflected inguinal ligament

84
Q

What structure is the thickened inferior margin of the transversalis fascia, appearing as a fibrous band running parallel to posterior to inguinal ligament?

A

Iliopubic tract

85
Q

What is the weak area in the inguinal region that is the site of direct and indirect hernias?

A

Myopectineal orifice

86
Q

Describe the difference between direct and indirect hernias.

A

Direct hernias form in the abdominal canal, indirect ones do not

87
Q

What is formed in relation to the relication of the testis during fetal development?

A

Inguinal canal

88
Q

What is the main occupant of the inguinal canal?

A

Spermatic cord/round ligament of uterus

89
Q

What muscle aponeourosis forms the inguinal canal?

A

EO

90
Q

What are the superficial inguinal rings?

A

exit by the spermatic cord/round ligament

91
Q

What are the deep inguinal rings?

A

Entrance to inguinal canal

92
Q

What other structures does the inguinal canal contain?

A

Inguinal nerve, blood and lymphatic vessels

93
Q

What is a hydrocele in the inguinal region?

A

Excess fluid in a persistent processus vaginialis, testis, spermatic cord - detection by transillumination

94
Q

What is a hermatocele of the testis?

A

Collection of blood in the tunica vaginalis that results from trauma

95
Q

What is a spermatocele?

A

Retention cyst in the epidymis

96
Q

What is an epidymal cyst?

A

Collection of fluid anywhere in the epidymis

97
Q

What is a variocele?

A

varicose vein plexus

98
Q

What is a thoraco-epigastric vein?

A

Formed between superior epigastric vein and lateral thoracic vein

99
Q

What are the two layers of the peritoneum?

A

Parietal and visceral

100
Q

What does the parietal peritoneal line?

A

Abdominal wall

101
Q

What does the visceral peritoneal line?

A

Visceral organs

102
Q

True/False: The peritoneum has separate neurovasculature than the wall lining it.

A

False, same

103
Q

What is created in the potential space between the peritoneal layers?

A

Peritoneal cavity

104
Q

What surrounds the peritoneal cavity?

A

peritoneal fluid

105
Q

What is the double layer of peritoneum that encloses the abdominal organs?

A

Mesentery

106
Q

What does the mesentery function to connect?

A

Organs and body wall

107
Q

What is the double layer extension/fold of peritoneum that passes from stomach and proximal duodenum to organs in the abdominal cavity?

A

Omentum

108
Q

What is the greater omentum?

A

Prominent, four layered peritoneal fold that connects the stomach to transverse colon

109
Q

What is the lesser omentum?

A

Much smaller, double layered peritoneal fold that connect the lesser curvature of the stomach and proximal part of duodenum to the liver

110
Q

What is the double layer of peritoneum that connect an organs with another to the abdominal wall?

A

Peritoneal ligament

111
Q

What connects the liver to the anterior abdominal wall?

A

Falciform ligament

112
Q

What connects the liver to the stomach?

A

Hepatogastric ligament

113
Q

What connects the liver to the duodenum?

A

Hepatoduodental ligament

114
Q

What connects the stomach to the inferior surface of the diaphragm?

A

Gastrophrenic ligament

115
Q

What connects the stomach to the spleen?

A

Gastrosplenic ligament

116
Q

What connects the stomach to the transverse colon?

A

Gastrocolic ligament

117
Q

What is the inflammation of peritoneum?

A

Peritonitis

118
Q

Describe peritoneal adhesions.

A

damage or infection fill with fibrin which changes to fibrous tissue

119
Q

What is the surgical separation of peritoneal separations?

A

Adhesiolysis

120
Q

What is the surgical puncture of the peritoneal cavity for the aspiration or drainage of fluid?

A

Paracentesis

121
Q

What is the removal of soluble substances and excess water by the transfer across the peritoneum?

A

peritoneal dialysis

122
Q

What is a circumscribed collection of pus in the subphrenic recess?

A

Abscess

123
Q

How does an abscess form?

A

From a perforation of a duodenal ulcer, rupture of gallbladder, or perforation of appendix

124
Q

What results from an inflamed/injured pancreas in the passage of pancreatic fluid into the bursa?

A

Pancreatic pseudocyst

125
Q

What is the removal of the gallbladder?

A

Cholecystectomy

126
Q

What is the sac-like cavity that lies posterior to the stomach, lesser omentum, and adj. structures?

A

Omental bursa

127
Q

What is the communication point for the omental bursa with the greater sac?

A

Omental foramen

128
Q

What is the muscular tube that extends from the pharynx to stomach?

A

Esophagus

129
Q

Approximately, how long and how wide is the esophagus?

A

25 cm, 2 cm

130
Q

What is the function of the esophagus?

A

Transport of food through peristaltic action from the oral cavity to stomach

131
Q

Where are the three constrictions to aid in food propellant?

A

Cervical (upper esophageal sphincter), thoracic (broncho-aortic), diaphragmatic constriction

132
Q

What does the esophagus follow the curvature of?

A

Vertebral column

133
Q

What structure does the esophagus pass through in the right crus of the diaphragm?

A

Esophageal hiatus

134
Q

What structure does the esophagus terminate at by entering the stomach at?

A

Cardial orifice

135
Q

What two layers of muscles makes up the esophagus?

A

Circular and external longitudinal

136
Q

Describe the makeup of muscle in the esophagus.

A

Exterior: striated voluntary. Inferior 1/3: smooth muscle. Middle 1/3: combo

137
Q

What is the expandable part of the digestive tract between the esophagus and small intestine?

A

Stomach

138
Q

What is the function of the stomach?

A

Accumulate ingeted food, enzymatic digestion, and transport into duodenum

139
Q

Gastric juice converts food to what for easier passage through the intestine?

A

Chyme

140
Q

how many liters is the stomach capable of holding?

A

2-3 L

141
Q

What are the four parts of the stomach?

A

Cardia, fundus, body, pylorus

142
Q

What is the part of the stomach that surrounds the opening of the esophagus?

A

Cardia

143
Q

What is the part of the stomach that dilates related to the dome of the diaphragm?

A

Fundus

144
Q

What structure separates the cardiac and fundus?

A

Cardial notch

145
Q

What is the body of the stomach?

A

The center, between the fundus and pylorus

146
Q

What is the funnel-shaped outflow region of the stomach?

A

Pylorus

147
Q

Describe the pathway through the pylorus.

A

Pyloric antrium -> pyloric canal -> pylorus -> pyloric orifice

148
Q

What is the specific piece of the pyloric part of the stomach that is the sphinctric region controlling the discharge of stomach contents?

A

Pylorus

149
Q

Through which structure does chyme flow through in the stomach to enter the duodenum?

A

Orifice

150
Q

What is the primary site for absorption of nutrients from ingested materials?

A

Small intestine

151
Q

What are the three parts of the small intestine?

A

Duodenum, jejunum, ileum

152
Q

Rank the size order of the three parts of the small intestine.

A

ileum > jejunum > duodenum

153
Q

What is the first portion of the small intestine?

A

Duodenum

154
Q

What is the middle portion of the small intestine?

A

Jejunum

155
Q

What is the bottom portion of the small intestine?

A

Ileum

156
Q

Which portion of the small intestine is c shaped and has biliary and pancreatic ducts that enter into it?

A

Duodenum

157
Q

Which portion of the small intestine begins at duodenal flexure, where the GI resumes?

A

Jejunum

158
Q

Which portion of the small intestine ends and meets the cecum?

A

Ileum

159
Q

What is the approximate length of the jejunum and ileum together?

A

6-7 m

160
Q

What attaches the small intestine to the body wall?

A

Mesentery

161
Q

Between jejunum and ileum: which has a deeper red vs paler pink?

A

Jejunum

162
Q

What is the approximate length of jejunum vs ileum?

A

2-4cm, 2-3 cm

163
Q

Between jejunum and ileum: which has greater vascularity?

A

jejunum

164
Q

Between jejunum and ileum: which has a longer vasa recta?

A

Jejunum

165
Q

Between jejunum and ileum: which has large, tall folds vs low sparse, absent folds?

A

Jejunum

166
Q

Between jejunum and ileum: which has many lymph nodes over the other?

A

Ileum

167
Q

Between jejunum and ileum: which has few, large arcade loops vs many short arcade loops?

A

Jejunum

168
Q

What is the first 2 cm of duodenum?

A

Ampulla

169
Q

What structure is the entrance between the duodenum and the ducts leading to it?

A

Papilla

170
Q

What is the water absorption site from the ingestible residues of liquid chyme, coverting them to solid waste?

A

Large intestine

171
Q

What are the parts of the large intestine?

A

cecum, appendix, colon, rectum and anal canal

172
Q

What are the distinguishable parts of the large intestine?

A

omental appendices (small, fatty projections), teniae coli (3 bands: mesocolic tenia, omental tenia, free tenia), haustra (sacculations of the wall of the colon between the teniae)

173
Q

What structure connects the ileum and cecum?

A

Ileocecal valve

174
Q

What is the blind intestinal pouch that lies in the iliac fossa of RLQ?

A

cecum

175
Q

What is the blind intestinal diverticulum containing masses of lymphoid tissue?

A

Appendix

176
Q

What part of the large intestine encircles the small intestine and functions to move fluid from fecal matter?

A

Colon

177
Q

What are the four parts of the colon?

A

Ascending colon (passes from R side of abd @ cecum ro R lobe of liver, turning at the R colic flexure ~ 9-10 ribs) -> Transverse colon (R colic flexure to L colic flexure) -> descending colon (L colic flexure and L iliac fossa) -> Sigmoid colon (S-shaped loop linking descending colon to rectum)

178
Q

What is the fixed terminal part of the small intestine, continuous with the sigmoid colon ~ S3?

A

Rectum

179
Q

What continues after the rectum to the outside?

A

Anal canal

180
Q

What condition results from increased BP causing esphogeal varices?

A

Portal hypertension

181
Q

What condition can increase the likelihood of portal hypertension?

A

Cirrhosis

182
Q

What is pyrosis?

A

Heartburn - burning sensation usually resulting from regurgitation of food/gastric fluid (GERD)

183
Q

Is pyrosis common?

A

Yes

184
Q

What can pancreatic pseudocysts and abscesses in the omental bursa do to the stomach?

A

Push it anteriorly

185
Q

What is a hiatal hernia?

A

A protrusion pf part of the stomach into the mediastinum through the esophageal hiatus

186
Q

Describe the difference between a para-esophageal hiatal hernia and sliding hiatal hernia?

A

Para-esophageal: cardia remains in position but fundus extends, sliding: esophagus, cardia, and fundus extend through eso. hiatus

187
Q

What is the results of the failure of smooth muscle fibers encircling the pyloric canal to relax nomrally?

A

Pylorspasm

188
Q

What is the marked thickening of smooth muscle of the pylorus?

A

Congenital hypertrophic pyloric stenosis

189
Q

What is the surgical treatment of congential hypertrophic pyloric stenosis?

A

Pyloromyotomy

190
Q

What is the removal of the stomach?

A

Gastrectomy

191
Q

What results from an infection of H. pylori?

A

Gastric ulcers

192
Q

True/False: An anterior gastric ulcer may erode the stomach wall into the pancreas, resulting in back pain.

A

False, posterior gastric ulcer may do this

193
Q

How can you distinguish between organic pain and visceral pain?

A

organic - poorly localized, visceral - epigastric region

194
Q

What type of ulcers can cause peritonitis?

A

Dudoneal ulcers

195
Q

How does ischemia of intestine occur?

A

By emboli, thrombus, or plague (atherosclerotic occulsion) - can result in necrosis

196
Q

What is the acute inflammation of the appendix?

A

Appendicitis

197
Q

What is the surgical removal of the appendix?

A

Appendectomy, through McBurney’s incision

198
Q

What is the condition resulting in chronic inflammation/ulceration of the colon/rectum?

A

Colitis (Chrohn’s)

199
Q

What is the removal of the colon?

A

Colectomy

200
Q

What is the surgical operation in which part of the ileum is diverted to an artificial opening to allow egress of contents?

A

Ileostomy

201
Q

What surgical procedure creates an artificial cutaneous opening in the colon for egress of contents?

A

Colostomy

202
Q

What procedure utilizes a long, flexible, fiberoptic endocscope to enter the colon through the anus and rectum for view of colon?

A

Colonoscopy

203
Q

Where do most intestinal tumors occur?

A

Sigmoid colon, rectum, or ascending colon

204
Q

What is the disorder in the which multiple external invaginations develop alone the intestine?

A

Diverticulosis

205
Q

What is the condition in which diverticulum rupture?

A

Diverticulitis

206
Q

Volvulus of the sigmoid colon can lead to what?

A

Ischemia and obstipation -> necrosis

207
Q

What is the ovoid, purplish, pulpy lymphatic organ?

A

Spleen

208
Q

What is the approximate size of the spleen?

A

Shape of fist

209
Q

What are the functions of the spleen?

A

Defense system as a site of lymphocyte proliferation/elimination of old, damaged RBCs and immune surveillance

210
Q

True/False: You cannot live without your spleen.

A

False, you can, it is not vital to sustain life

211
Q

Where does the spleen rest?

A

L colic flexure ~ 9-11th ribs

212
Q

What is the elongated, accessory digestive gland?

A

Pancreas

213
Q

What is the approximate location of the pancreas?

A

~ L1, L2, posterior to stomach between spleen and duodenum

214
Q

What are the functions of the pancreas?

A

Produce exocrine secretion (pancreatic juice), supply body with insulin and glucagons from the Islets of Langerhans

215
Q

How does pancreatic juice flow to the duodenum?

A

Main and accessory pancreatic ducts

216
Q

What are the components of the pancreas?

A

Head, neck, body, and tail

217
Q

What is the largest gland, and, second to skin, organ?

A

Liver

218
Q

True/False: All nutrients absorbed are initially conveyed to the liver by the portal venous system.

A

True

219
Q

What are the functions of the liver?

A

Metabolic activities, stores glycogen, secrete bile, processes the products of digestion and exo/endogenous substances (drugs, toxins) that enter circulation

220
Q

Describe the passage of bile from the liver.

A

via bile duct to join w/ cystic ducts to form the common hepatic duct -> hepatic artery

221
Q

What is the storage site of bile?

A

Gallbladder

222
Q

What is the approximate size of the gallbladder?

A

7-10 cm

223
Q

What causes release of bile from the gallbladder?

A

fat enters the duodenum via cystic duct to bile duct

224
Q

True/False: The spleen, pancreas, liver can be ruptured.

A

True

225
Q

What is the removal of the spleen?

A

Splenectomy

226
Q

What is the removal of the pancreas?

A

Pancreatectomy

227
Q

What is a lobectomy?

A

Removal of part of the liver

228
Q

what is the removal of the gallbladder?

A

Cholecystectomy

229
Q

What is cholelithiasis?

A

Gallstones - crystallized concretion in GB, cystic duct, or bile duct

230
Q

What is inflammaton of the pancreas?

A

pancreatitis

231
Q

What does a whipple procedure do?

A

Removal of pancreatic cancer

232
Q

What is a subphrenic abscess and how is it “treated”?

A

Collection of pus, drained by incision

233
Q

What is the enlargement of the liver due to increased blood?

A

Hepatomegaly

234
Q

What is the destruction of hepatocytes becoming replaced with fat and fibrous tissue?

A

Cirrhosis

235
Q

What is the surgical procedure in which portal hypertension is reduced by connecting the hepatic portal vein and IVC?

A

Portosystemic shunt

236
Q

What is the function of the kidneys?

A

remove excess water, salts, and wastes of protein metabolism converting it to urine

237
Q

Where is the location of the kidneys?

A

Approx. T12-L3 along posterior wall

238
Q

What are the muscular ducts that carry urine from the kidney to the bladder?

A

Ureters

239
Q

What do the ureters “run” over?

A

Common iliac arteries

240
Q

What are the yellowush hormone and steroid producing glands?

A

Supradrenal

241
Q

Where are the supradrenal glands located?

A

Above the kidney, below the diaphragm

242
Q

What is the hollow pouch with strong, distensible muscular walls that serves as a temporary reservoir for urine?

A

Bladder

243
Q

What is the muscular tube that converys urine from the bladder?

A

Urethra

244
Q

True/False: the urethra is longer in females.

A

False, it is longer in males

245
Q

What is the female reproductive organ that produces ova/oocytes and estrogen?

A

Ovaries

246
Q

What is the female reproductive organ that transports ovum from ovary to uterus?

A

Fallopian (uterine) tube (one pair)

247
Q

What is the female reproductive hollow organ that is thick walled prividing the environment for embryonic/fetal development?

A

Uterus

248
Q

What is the female reproductive organ that serves as the passageway from uterus?

A

vagina

249
Q

What is the extension of the vagina that dilates to allow for fetal passage?

A

Cervix

250
Q

What is the male reproductive organ that is one of two reproductive glands too produce spermatozoa and testosterone?

A

Testis

251
Q

What is the male reproductive organ that lies between the bladder and rectum that secretes a thick, alkaline fluid that mixes with sperm?

A

Seminal vesicle

252
Q

What is the male reproductive organ that begins in the epididmysis and eventually joins with duct of seminal vesicle?

A

Vas deferens

253
Q

What is the male reproductive organ that is a slender tube that arises by the union of the Seminal vesicle and the vas deferens?

A

Ejaculatory duct

254
Q

What is the male reproductive organ that is an accessory gland that secretes seminal fluid?

A

Prostate

255
Q

What is a collection of pus around the kidney?

A

perinephric abscess

256
Q

What is the term given to a dropped kidnye?

A

Nephroptosis

257
Q

What is a congenitally misplaced kindey?

A

Ectopic kidney

258
Q

What is the preferred treatment of renal failure,, removing the defective kidney and replacing it with another without damaging surrounding/supporting structures?

A

Renal transplant

259
Q

What is a renal cyst?

A

A cyst in the kidney - can be polycystic disease

260
Q

What is renal vein entrapment syndrome?

A

Compression of Left renal vein

261
Q

What are the signs/symptoms of renal vein entrapment syndrome?

A

Hematuria, proteinuria, flank pain, nausea, vomiting, L testicular pain (in males)

262
Q

What is the term given to an additional kidney developed by the separation of blastomas?

A

Supernumerary kidney

263
Q

What is a retrocaval ureter?

A

a rare congenital anomaly with the ureter passing posterior through the IVC

264
Q

What is the term given to a fused, U-shaped kidney?

A

horseshoe kidney

265
Q

How does a horseshoe kidney form?

A

Mesentaric artery fails to normally relocate the kidneys

266
Q

True/False: A horseshoe kidney can cause an array of symptoms.

A

False, generally produce no symptoms or problems

267
Q

What is the official term of a kidney, ureter stone?

A

Renal, ureteric calculus

268
Q

What is the double-domed, musculotendinous partition that separates the thorax and abdomen?

A

Diaphragm

269
Q

True/False: The diaphragm is the major muscle for respiration.

A

True

270
Q

What are the compositions of the diaphragm?

A

Central tendon, sternal portion, costal portion, lumbar portion

271
Q

What is the central tendon?

A

Boomerang shape insertion point for peripheral muscular portions of the diaphragm.

272
Q

What is the sternal portion of the diaphragm?

A

Two muscular slips that arise from the xiphoid process and insert to central tendon

273
Q

What is the costal portion of the diaphragm?

A

Wide muscular slips arise from the interior surfaces of lower 6 ribs and costal cartilage to CT

274
Q

What is the lumbar portion of the diaphragm?

A

Arises from the medial and lateral ligaments ~ LV1-3 to CT

275
Q

What does the lumbar portion form?

A

R and L muscular crura that ascend to CT

276
Q

What is a crura?

A

musculotendinous band that arises from the anterior surfaces of the bodies of L1-3, ALL, and IV discs.

277
Q

Is the right or left crus larger?

A

R

278
Q

What LV does the R crus arise from?

A

L1-3 maybe 4

279
Q

What LV does the L crus arise from?

A

L1-2 or 3

280
Q

What are the four openings in the diaphragm that permit passage of structures between the thorax and abdomen?

A

IVC foramen (caval opening), Esophagea hiatus, Aortic hiatus, Stenocostal hiatus (triangle, foramen)

281
Q

What is the caval opening?

A

The passage between the IVS and R phrenic nerve

282
Q

Where is the caval opening located?

A

to R of median plane @ central tendon junction ~ IV disc between T8&9

283
Q

What is the esophageal hiatus?

A

The passage between the esophagus and vagal trunks

284
Q

Where is the esophageal hiatus located?

A

located superior to and left of the aortic hiatus ~ T10

285
Q

What is the aortic hiatus?

A

Passage of aorta and thoracic ducts

286
Q

Where is the aortic hiatus located?

A

passes between crura to MAL

287
Q

What is the sternocostal hiatus?

A

between sternal and costal attachments of the diaphragm, transmit lymphatic, epigastric vessels

288
Q

What are the five components of the posterior abdominal wall?

A

Five lumbar vertebrae and IV discs, wall muscles, diaphragm, fascia, lumbar plexus, and fat, nerves, and lymph nodes.

289
Q

What fascia exists between the parietal peritoneum and muscles?

A

Endoabdominal fascia

290
Q

What is the extensive fascial complex that attaches the muscles to the VC?

A

Thoracolumbar fascia

291
Q

What are the muscles of the posterior abdominal wall?

A

Psoas, iliacus, quadaratus lumborum

292
Q

What is the OINA of the psoas major?

A

O: Transverse processes of LV bodies and discs of T12-L5
I: Tendon to lesser trochanter of femur
N: anterior rami of L1-3
A: Thigh flexion, Trunk flexion, Trunk Lateral flexion

293
Q

What is the OINA of the psoas minor?

A

O: Bodies and IV discs of T12-L1
I: pubic bone
N: anterior ramus of L1
A: Pelvic and trunk flexion

294
Q

What is the OINA of the iliacus?

A

O: iliac fossa, ala of sacrum, anterior sacroiliac ligaments
I: Lesser trochanter of psoas major
N: Femoral Nerve
A: Thigh flexion, Hip stabilization

295
Q

What is the OINA of the quadratus lumborum?

A

O: Iliac crest, Iliolumbar ligament
I: Rib 12, transverse processes of upper lumbar vertebrae
N: Subcostal and upper lumbar (L1-4) anterior rami
A: Trunk lateral flexion, Trunk Extension, Hip elevation, stabilization of 12th rib during inspiration

296
Q

Where do the subcostal nerves arise, course, and distribute?

A

In the thorax, pass posterior to LCLs into abdomen and run inferiolaterally on the anterior surface of QL passing through TA and IO to supply EO and skin

297
Q

Where do the lumbar spinal nerves arise and course?

A

Pass from SC through IV foramina inferior to the corresponding vertebrae, where they split into posterior and anterior rami

298
Q

What does the posterior rami of lumbar spinal nerves supply?

A

Muscles of back and overlying skin

299
Q

What does the anterior rami of lumbar spinal nerves supply?

A

SKin and muscles of the inferiormost trunk and lower limb

300
Q

Where is the lumbar plexus of nerves formed?

A

Anterior to the lumbar tranverse processes, within the proximal attachment of psoas major

301
Q

What is the lumbar plexus of nerves composed of?

A

Anterior rami of L1-4, Femoral nerve branch, obturator nerve branch

302
Q

What and where is the femoral nerve?

A

L2-L4, emerges @ inf psoas major and innervates the iliacus and passes deep to inguinal ligament/IT to anterior thigh, supplying the hip flexors and knee extensors

303
Q

What and where is the obturator nerve?

A

L2-L4, emerges @ med psoas major and passes into lesser pelvis, passing through obturator foramen to pubic ramus to medial knww, supplying the adductor muscles

304
Q

What and where is the Ilioinguinal nerve?

A

ant rami of L1, emerges from lateral psoas major and passes across QL and IL, supplying the scrotum, labia, mons pubis, medial thigh, Io and TA

305
Q

What and where is the Iliohypogastric nerve?

A

ant rami of L1,received fibers from T12, innervates the skin over the lateral gluteal region and IO and TA

306
Q

What and where is the Genitrofemoral nerve?

A

L1-2, pierces psoas major and runs inferior on anterior surfacem deep to psoas fascia, divides laterally to the common and external iliac arteries into femoral and genital branches

307
Q

What and where is the lateral cutaneous femoral nerve of thigh?

A

L2-3, runs inferiolaterally oniliacus and enters the thing deep to inguinal ligaemt/IT just medial ASIS, supplies the skin on anterolateral surface of thigh

308
Q

Describe the passage of blood through the posterior abdominal wall.

A

Descending thoracic aorta enters abdomen and becomes abdomional aorta @ abdominal hiatus ~T12-L4. -> divides into R and L common iliac arteries that diverge and run inferiolaterally to medial psoas major to pelvic brim -> divides into Internal and External Arteries, internal supplies viscera, external follow iliopsoas) External iliac divides into inferior epigastric and deep circumflex arteries that supply the anterolateral abdominal wall

309
Q

Describe the venous pattern of the posterior abdominal wall.

A

Common iliac veins unionize to form IVC ~L5, which returns deoxygenated blood from lower extremities, anterolateral abdominal wall and abdominal pelvic viscera, ascends through caval opening in the diaphragm and continues to the heart. Major veins from the IVC to body = Renal veins, common iliac veins, suprarenal veins, lumbar veins

310
Q

What structures fuse to form the pelvic girdle?

A

ilium, ischium, pubis

311
Q

At what structure does the pelvic girdle fuse together?

A

Acetabulum

312
Q

What is the name given to the fused hip bones?

A

Ox coxae