Ch. 17 The Peritoneal Cavity and Abdominal Wall

Question 1

Loops of the digestive tract are anchored to the posterior wall of the abdominal cavity by this large double fold of peritoneal tissue

Answer 1

Mesentery

Question 2

Space anterior to the right kidney and posterior to the inferior border of the liver where ascites of fluid may accumulate or an abscess may develop

Answer 2

Morison’s pouch

Question 3

Pouchlike extension of the visceral peritoneum from the lower edge of the stomach, part of the duodenum, and the transverse colon

Answer 3

Omentum

Question 4

Inferior of the liver

Answer 4

Subhepatic

Question 5

Below the diaphragm

Answer 5

Subphrenic

Question 6

Localized collection of pus

Answer 6

Abscess

Question 7

Accumulation of serous fluid in the peritoneal cavity

Answer 7

Ascites

Question 8

Most dependent areas inthe flanks of the abdomen and pelvis where fluid collection may accumulate

Answer 8

Gutters

Question 9

Collection of blood

Answer 9

Hemorrhage

Question 10

Increase in the number of leukocytes (white blood cells)

Answer 10

Leukocytosis

Question 11

Inflammation of the peritoneum

Answer 11

Peritonitis

Question 12

Pus producing

Answer 12

Pyogenic

Question 13

Sonographic sign that you see when a vessel or organ is surrounded by a tumor on either side

Answer 13

Sandwich sign

Question 14

Spread of an infection from its initial site to the bloodstream

Answer 14

Sepsis

Question 15

Infection in the blood

Answer 15

Septicemia

Question 16

Cyst containing urine

Answer 16

Urinoma

Question 17

Because of the ________ ligament attachments, collections in the right posterior subphrenic space cannot extend between the bare area of the liver and the diaphragm

Answer 17

Coronary

Question 18

The pleural fluid tends to distribute ________ in the chest

Answer 18

Posteromedially

Question 19

Subcapsular liver and splenic collection are seen when they are _________ to the diaphragm unilaterally and conform to the shape of an organ capsule

Answer 19

Inferior

Question 20

A mass is confirmed to be within the retroperitoneal cavity when anterior renal displacement or anterior displacement of the dilated ________ can be documented

Answer 20

Ureters

Question 21

The mass interposed ____________ or superiorly to the kidneys can be located either intraperitoneally or retroperitoneally

Answer 21

Anteriorly

Question 22

Fatty and collagenous connective tissues in the perirenal or anterior pararenal space produce echoes that are best demonstrated on _________ scans

Answer 22

Sagittal

Question 23

Retroperitoneal lesions displace echoes _________ and cranially

Answer 23

Ventrally

Question 24

Hepatic and subhepatic lesions produce _____________ and posterior displacement

Answer 24

Inferior

Question 25

A large, right-sided retroperitoneal mass rotates the intrahepatic portal veins to the _______

Answer 25

Left

Question 26

The peritoneal cavity is made up of multiple peritoneal ligaments and folds that connect the _________ to each other and to the abdominopelvic __________

Answer 26

Viscera, walls

Question 27

Within the cavity are found the lesser and greater _________, the ___________, and multiple fluid spaces (lesser sac, perihepatic and subphrenic spaces)

Answer 27

Omentum, mesenteries

Question 28

The _________ is a smooth membrane that lines the entire abdominal cavity and is reflected over the contained organs

Answer 28

Peritoneum

Question 29

The part that lines the walls of the cavity is the ___________ peritoneum, whereas the part covering the abdominal organs to a greater or lesser extent is the ___________ peritoneum

Answer 29

Parietal, visceral

Question 30

The general peritoneal cavity is known as the _________ sac of the peritoneum

Answer 30

Greater

Question 31

With the development of the stomach and the spleen, a smaller sac, called the __________ sac (omental bursa), is the peritoneal recess posterior to the stomach.

Answer 31

Lesser

Question 32

This sac communicates with the greater sac through a small vertical opening known as the ___________ foramen

Answer 32

Epiploic

Question 33

When the patient is lying supine, the lowest part of the body is the __________

Answer 33

Pelvis

Question 34

A double layer of peritoneum extending from the liver to the lesser curvature of the stomach is known as the __________ omentum

Answer 34

Lesser

Question 35

The _________ omentum is an apron-like fold of peritoneum that hangs from the greater curvature of the stomach

Answer 35

Greater

Question 36

Ligaments on the right side of the liver from the _________ and ___________ spaces

Answer 36

Subphrenic,and subhepatic

Question 37

The ______________ hepatis ascends from the umbilicus to the umbilical notch of the liver within the free margin of the falciform ligament before coursing within the liver

Answer 37

Ligamentum teres

Question 38

The paired _________ abdominis muscles are delineated medially in the midline of the body by the linea alba

Answer 38

Rectus

Question 39

The amount of intraperitoneal fluid depends on the ________, ___________, and patient ___________

Answer 39

Location, volume and position

Question 40

The ascitic fluid first fill the _____________ then the lateral paravesical recesses before is ascends to both paracolic gutters

Answer 40

Pouch of Douglas

Question 41

The small bowel loops __________ or ___________ in the surrounding ascitic fluid, depending of relative gas content and amount of fat in the mesentery

Answer 41

Floats or sinks

Question 42

Inflammatory or malignant ascites appears with ____________ echoes; loculation ; unusual distribution, matting, or clumping of the bowel loops; and thickening of interfaces between the fluid and neighboring structures

Answer 42

Fine or coarse internal

Question 43

A cavity formed by necrosis within a solid tissue or a circumscribed collection of purulent material is a

Answer 43

Abscess

Question 44

Name the five major pathways through which bacteria can enter the liver and cause abscess formation

Answer 44

1. Through the portal system 2. By way of ascending cholangitis of the common bile ducts 3. Via the hepatic artery secondary to bacteremia 4. By direct extension from an infection 5. By implantation of bacteria after trauma to the abdominal wall

Question 45

Extrahepatic loculated collections of bile that may develop because of iatrogenic, traumatic, or spontaneous rupture of the biliary tree are _____________

Answer 45

Lipomas

Question 46

As abscess that forms within the renal parenchyma is a ___________ . Clinical symptoms vary from none to fever, leukocytosis, and flank pain

Answer 46

Renal carbuncle

Question 47

The most common abdominal pathologic process is _____________ which requires immediate surgery

Answer 47

Acute appendicitis

Question 48

A mass or lesion within the mesentery and omentum may have solid or cystic characteristics, whereas a mass within the peritoneum may show a __________ pattern

Answer 48

Infiltrative

Question 49

Mesenteric and omental cysts may be uniloculated or _____________ with smooth walls and thin internal septations

Answer 49

Multiloculated

Question 50

An incomplete regression of the urachus during development is an ________ cyst

Answer 50

Urachal

Question 51

An encapsulated collection of urine, or ____________ may result from a closed renal injury, from surgical intervention, or it may arise spontaneously secondary to an obstructing lesion

Answer 51

Urinoma

Question 52

The most common primary sites of peritoneal metastases are the _________, __________, and ________

Answer 52

Ovaries, stomach and colon

Question 53

The __________ sign of lymphoma represents a mass infiltrating the mesenteric leaves and encasing the superior mesenteric artery

Answer 53

Sandwich

Question 54

A key factor in determining if an abdominal wall mass is present is the _____________ of the rectus sheath muscles

Answer 54

Symmetry

Question 55

A collection of fluid that occurs after surgery in the pelvis, retroperitoneum , or recess cavities is known as a __________

Answer 55

Lymphocele

Question 56

Extraperitoneal rectus sheath ___________ are acute or chronic collections of blood lying either within the rectus muscle or between the muscle and its sheath

Answer 56

Hematomas

Question 57

An abdominal ____________ is the protusion of a peritoneal-lined sac through a defect in the weakened abdominal wall

Answer 57

Hernia

Question 58

A variant of the ventral hernia that is found more laterally in the abdominal wall is a _______ hernia

Answer 58

Spigelian

Question 59

List the four sonographic criteria for a hernia

Answer 59

1. Demonstration of an abdominal wall defect 2. Presence of bowel loops or mesenteric fat within a lesion 3. Exaggeration of the lesion with strain (valsalva) 4. Reducibility of the lesion by gentle pressure