ABDOMEN III

Question 1

When the perineal body is broken it causes?

Answer 1

Incontinence of the pelvic floor, leading to prolapse of the uterus into the vagina

Question 2

What is the peritoneum? Where is the innervation of the parietal peritoneum and visceral peritoneum.

Answer 2

It is a serous membrane, which has 2 layers: a parietal and visceral. In between them there is fluid which assists friction. Parietal innervation is from the lower thoracic nerves.
Visceral innervation is the same according to which organ it innervates

Question 3

The small intestine is ? Which organs are retroperitoneal? Which are subperitoneal?

Answer 3

Intraperitoneal, the pancreas and kidneys are retroperitoneal. The bladder/uterus are subperitoneal

Question 4

Where is the greater sac? Where is the lesser sac?

Answer 4

The greater sac is anterior and the lesser sac is posterior to the stomach

Question 5

Explain hemodialysis

Answer 5

You must connect the arterial and venous supply to a channel, from here blood will travel through a dialysis machine where all the metabolic wastes are absorbed by a membrane. This must occur in a hospital for 2/3 hours twice a week

Question 6

Explain peritoneal dialysis

Answer 6

It is preferred for young people, since the peritoneum is well vacularized we can connect a bag of fluid to a hanger, and insert it onto the peritoneum, the peritoneum will get saturated and then we apply a catheter to remove the fluid and the fluid will have taken the metabolic wastes with it

Question 7

What is peritonitis

Answer 7

Is is when there is an infection or disease on an organ in the peritoneum, this can be fatal

Question 8

What is the omenta

Answer 8

It is the peritoneal membrane that connects the stomach and the proximal duodenum. It can be divided into the greater momentum: from greater curvature of stomach and head of duodenum and goes downwards, turns and goes upwards and attached to transverse colon. The lesser omentum: connects the lesser curvature of the stomach to the liver

Question 9

What are the ligaments of the peritoneum

Answer 9

Go to slide 69

Question 10

Where is the epiploic foramen

Answer 10

It is between the lesser sac and greater sac, it is surrounded by the IVC, hepatoduodenal ligament, liver, pancreas

Question 11

What are mesentaries and what is their purpose. There are 3 mesenteries name them

Answer 11

They are 2 layers of the peritoneum, they connect the intestine with the abdominal wall. They carry arteries and veins for the small intestine.
Of the sigmoid colon, transverse mesocolon, small intestine

Question 12

What are the peritoneal divisions?

Answer 12

Above and below the transverse colon mesentary, right/left of the infracolic space (due to small intestine mesentery). Note that there are w pericolic gutters that allow the right and left infracolic space to communicate.

Question 13

what kind of organ is the small intestine?

Answer 13

intraperitoneal.

Question 14

what is the Z line and what does it separate?

Answer 14

it is the line of the distal esophagus that separates the mucosa of the esophagus from that of the stomach

Question 15

Discuss a herniation of the stomach. What is the symptom?

Answer 15

the cholidic acid of the stomach contacts the mucosa of the esophagus due to the cardia and fundus of the stomach being above the diaphragm. heart burn

Question 16

what kind of organ is the stomach? What are its divisions?

Answer 16

intraperitoneal. The fundus, cardia, pyloric antrum (pyloric canal/sphincter/constriction)

Question 17

which part of the stomach contacts the diaphragm?

Answer 17

the fundus

Question 18

what arteries supply the lesser curvature? Greater curvature? Posterior area? of the stomach

Answer 18

Lesser: branch of the abdominal aorta- esophageal branch-hepatic artery proper-right gastric artery.
Greater: short gastric arteries- left/right gastro-omental artery
Posterior: splenic artery

Question 19

how is the arterial supply of the stomach? the venous?

Answer 19

go to graph book

Question 20

the stomach is in communication with which organs?

Answer 20

the transverse colon, liver (top), anterior abdominal wall, lesser sac, pancreas (the posterior [art of stomach)

Question 21

what are the 2 kinds of hernia of the stomach? Explain them?

Answer 21

Paraesophageal hernia: where only the fundus moves upwards of the esophageal hiatus of the diaphragm–> asymptomatic. Hiatal hernia: fundus and cardia through the right crus of diaphragm–> heart burn

Question 22

why is the paraesophageal hernia asymptomatic?

Answer 22

No regurgitation occurs cuz the cardiac orifice is in the right position .the stomach twists within itself and this can cause ischemia, necrosis, and then can be fatal. Now there is pain in the epigastric region

Question 23

where can an ulcer of the stomach occur? How does an ulcer occur? Where is it more dangerous?

Answer 23

in the anterior of posterior wall of the body. It happens due to a lack of the bicarbonate ions in the mucosa. It is more dangerous on the posterior body wall as it can eat through the wall and reach and infect the splenic artery.

Question 24

what is the duodenum made of? What is the orientation and location of these units?

Answer 24

of 4 parts. (between L1-L3)
1- Horizontal: pyloric orifice till bile duct: intraperitoneal.
2- vertical: along L2: is in front of the right kidney/renal artery. On its medial surface is the entrance is bile duct/pancreatic duct.
3- Horizontal: L3: is in front of the IVC and the abdominal aorta, it is superiorly crossed by the superior mesenteric artery/vein
4- is hooked upwards to enter the jejunum: kept up by the ligament of treitz: which is connected to the diaphragm

Question 25

what is distinctive of the jejunum and the ileum?

Answer 25

have mesenteries, mucosa has villi, loops of arterial supply. Nutrients are absorbed through the venous system.

Question 26

where does the large intestine start? End?

Answer 26

in the false pelvis (right wing of the ilium), ends at the sigmoid colon at the pelvic inlet. Rectum is in the true pelvis

Question 27

what is a true diverticulum? Example?

Answer 27

the appendix off of the cecum is one. It has the same layers of mucosa as the cecum.

Question 28

where is the root of the appendix? Where is the superficial part?

Answer 28

it is on the posterior-medial wall of the cecum. The position of the head varies in the pop.

Question 29

what can we palpate in reference to the appendix area?

Answer 29

a line joining Mcburney’s point (on the root of appendix), till the umbilicus and the superior iliac spine anterior

Question 30

what kind of organ is the appendix?

Answer 30

intraperitoneal