Chapter 17 Peritoneal Cavity/ABD Wall

Question 1

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

Answer 1

mesentary

Question 2

Space anterior to the right kidney and posterior to the inferior border of the liver where ascites or 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 to the liver

Answer 4

subhepatic

Question 5

Below the diaphragn

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 in the flanks of the abdomen and pelvis where fluid collections may accumulate

Answer 8

gutters

Question 9

Collection of blood

Answer 9

hemorrhage

Question 10

Increase in the number of WBC’s (leukocytes)

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 infection 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

Subscapular liver and splenic collections 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 in confirmed to be in the retroperitoneal cavity when anterior renal displacement or anterior displacement of the dilated __ can be documented.

Answer 20

ureters

Question 21

The mass intersposed ___ or superiorly to kidneys can be located either intraperitoneally or retroperitoneally.

Answer 21

anteriorly

Question 22

Fatty and collagenous connective tissues in the perirenal or anterior perirenal 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 peritoneal 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,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 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 form the ___ and ___ spaces.

Answer 36

subphrenic, subhepatic

Question 37

The subphrenic space is divided into right and left components by the ___ ligaments.

Answer 37

falciform

Question 38

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 38

ligamentum teres

Question 39

The paired ___ abdominus muscles are delineated medially in the midline of the body by the linea alba.

Answer 39

rectus

Question 40

The amunt of intraperitoneal fluid depends on the ___,___, and patient ___.

Answer 40

location, volume, position

Question 41

The ascitic fluid first fills the ___, then the paravesical recesses before it ascends to both paracolic gutters.

Answer 41

pouch of Douglas

Question 42

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

Answer 42

floats ;sinks

Question 43

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

Answer 43

fine or coarse internal

Question 44

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

Answer 44

abscess

Question 45

Name the 5 major pathways in which bacteria can enter the liver and cause abscess formation.

Answer 45

through portal system; by way of ascending cholangitis of the CBD; via hepatic artery secondary to bacteremia; direct extension from an infection; implantation of bacteria after trauma to ABD wall

Question 46

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

Answer 46

bilomas

Question 47

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

Answer 47

renal carbuncle

Question 48

The most common abdominal pathologic process is ___, which requires immediate surgery.

Answer 48

acute appendicitis

Question 49

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

Answer 49

infiltrative

Question 50

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

Answer 50

multiloculated

Question 51

An incomplete regression of the urachus during development is a/an ___cyst.

Answer 51

urachal

Question 52

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 52

urinoma

Question 53

The most common primary sites of peritoneal metasteses are the ___, ___, and ___.

Answer 53

ovaries, stomach, colon

Question 54

The ___ sign of lymphoma represents a mass infiltrating the mesenteric leaves and encasing the SMA.

Answer 54

sandwich

Question 55

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

Answer 55

symmetry

Question 56

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

Answer 56

lumphocele

Question 57

Extraperitoneal rectus sheath ___ are acute or chronic collectionsof blood lying either within the rectus muscle or between the muscle and its sheath.

Answer 57

hematomas

Question 58

An abdominal ___ is the protrusion of a peritoneal-lined sac through a defect in the weakened abdominal wall.

Answer 58

hernia

Question 59

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

Answer 59

spigelian

Question 60

List the 4 sono criteria for a hernia.

Answer 60

seen on sono as an abd wall defect; presence of bowel loops or mesenteric fat within a lesion; exaggeration of a lesion with strain (Valsalva); reducibility of lesion by application of gentle pressure