Case 6 - Acute Abdomen Flashcards
(37 cards)
functions of the abdomen
Housing major viscera
Assist breathing
Regulation of intra-abdominal pressure:
micturition, defecation,
childbirth
The abdominal cavity is lined by a serous epithelial-like layer called the ______
peritoneum
we have the:
Parietal peritoneum
Visceral peritoneum
what does the lesser omentum contain?
hepatogastric ligament
portal triad in hepatoduodenal ligament, which contains:
hepatic artery
bile duct
hepatic portal vein
Retroperitoneal Structures are:
- S=Suprarenal (adrenal) Glands
- A=Aorta/IVC
- D=Duodenum (except the proximal 2cm, the duodenal cap/1st part of duodenum)
- P=Pancreas
- U=Ureters
- C=Colon (except the tail) (just ascending and
descending parts are retroperitoneal) - K=Kidneys
- E=(O)esophagus
- R=Rectum
The oesophagusconnects with the
stomach after crossing the diaphragm,
widens and becomes J-shaped. It is
divided in the following segments:
- Cardia
- Fundus
- Body
- Pylorus
First part of small intestine, 20
25 cm long, C-shaped and
adjacent to head of the
pancreas.
1) what is this called?
2) It is divided in four
portions:
1) duodenum
2) * Superior
* Descending
* Inferior
* Ascending
the jejunum is the Proximal __1___ of the small intestine. Its inner mucosa lining has
numerous prominent folds that circle the lumen called ____2____. Another unique
characteristic is that the arterial
arcades are __3___, leaving place for
___4___ vasa recta
1) 2/5
2) plicae circulares
3) short
4) longer
the ileum is the Distal __1__ of small intestine. Has ___2___ plicae circulares, ___3___vasa recta, more mesenteric fact and more arterial arcades than the jejunum
1 - 3/5
2 - fewer
3 - shorter
Ileum opens into the ___1___, where the ___2___(most proximal part of colon) and ___3____come together. The
ascending colon reaches up to the __4__ flexure
1 - large intestine
2 - caecum
3 - ascending colon
4 - hepatic
what is the hepatic flexure
where the ascending colon bends and so transitions into the transverse colon is the hepatic flexure
what is the splenic flexure
it’s the bend where the transverse colon transitions into the descending colon
Extending from the sigmoid colon is the __1__. The rectosigmoid junction is typically described at the level of __2__. In turn the anal canal is a continuation of the ___3___.
1 - rectum
2 - S3
3 - rectum
what does the pectinate line mark?
It demarcates two
separate sections that come
from different embryonic
origins, and have therefore
different vascular supply,
venous drainage, lymphatics
and innervation.
the pectinate line is in where?
An important structure in the
anal canal is the pectinate
line
___1___ is the Largest visceral organ in the body. Has a superior ___2___surface and an inferior ___3___surface. ___4___lies immediately inferiorly
1 - liver
2 - diaphragmatic
3 - visceral
4 - Gallbladder
what is the pancreas
The pancreas is a dual endocrine and exocrine organ lying mostly posterior to the stomach. It is divided into head, uncinate process, neck, body,
and tail.
uncinate process of the pancreas extends from what?
extends from posterior to superior mesenteric vessels
spleen develops as part of the vascular system, lying directly underneath left rib __1__to rib __2__in an adult person.
1 - IX
2 - X
The “acute abdomen” is defined as what?
The “acute abdomen” is defined as sudden onset
severe abdominal pain.
what can be seen from abdominal x-ray?
Abdominal x-ray can provide evidence of
bowel obstruction by showing dilated bowel
loops.
what can be seen from erect x-ray?
Erect chest x-ray can demonstrate air under
the diaphragm when there is an intra
abdominal perforation. This is caused by air
within the peritoneal cavity
(pneumoperitoneum).
what can be seen from abdominal ultrasound?
Abdominal ultrasound can be useful in
checking for gallstones, biliary duct
dilatation and gynaecological pathology
what can be seen from CT scans ?
CT scans are often required to identify the
cause of an acute abdomen and determine
correct management.
Sarah is a previously healthy 26-year-old woman who presents with a 3
week history of progressively worsening diarrhea occurring 6–8 times daily,
often with visible blood and mucus. She describes lower abdominal
cramping, particularly in the left lowerquadrant, which is relieved by
defecation. She also reports fatigue, unintentional weight loss of 3 kg.
She denies recent travel, antibiotic use, or sick contacts. No known food
intolerances. No recent NSAID use.
What are your differential diagnosis so far?
- Inflammatory bowel disease (IBD)- Irritable bowel syndrome (IBS)- Gastroenteritis- Food poisoning- Ischemic colitis- Drug induced colitis
