major clinical: abdomen

Question 1

what are the 5 F’s for abdominal protrusions

Answer 1

fat, feces, fetus, flatus and fluid (+tumors)

Question 2

where is the gallbladder found via surface anatomy

Answer 2

at the intersection of the semilunar line and the 9th costal cartilage

Question 3

where is the spleen located (surface anatomy)

Answer 3

under the 9th-11th ribs on the left side of the midaxillary line

Question 4

where are the kidneys located (surface anatomy)

Answer 4

along the scapular line

Question 5

what is the dermatome for the xiphoid process

Answer 5

T6

Question 6

what is the dermatome for the umbilicus

Answer 6

T10

Question 7

what is the dermatome for the inguinal ligament

Answer 7

L1

Question 8

how is the cremaster reflex elicited

Answer 8

by stroking the medial aspect of the upper thigh

Question 9

what spinal cord level does the cremaster reflex test

Answer 9

L1-2

Question 10

who are direct inguinal hernias most common in

Answer 10

older men with weak abdominal muscles

Question 11

where do direct inguinal hernias exit the abdomin

Answer 11

medial to the inferior epigastric vessels through Hesselbach’s trinagle

Question 12

what is hesselbachs triangle bound by

Answer 12

rectus abdominis, inguinal ligament and inferior epigastric vessels

Question 13

what are the most common type of abdominal hernias

Answer 13

indirect inguinal hernias

Question 14

where do indirect inguinal hernias leave the abdomen

Answer 14

lateral to the inferior epigastric vessels via the deep inguinal ring

Question 15

where do epigastric hernias occur

Answer 15

in the midline between the xiphoid and umbilicus

Question 16

where do Grynfeltt’s hernias occur

Answer 16

at superior lumbar triangle

Question 17

where doe Petit’s hernias occur

Answer 17

inferior lumbar trinagle

Question 18

what are common signs/symptoms of torsion of the testes

Answer 18

sudden testicular enlargement and pain, nausea/vomiting, abnormal cremaster reflex and abnormal positioning of epididymis

Question 19

what is a collection of blood in the cavity of the tunica vaginalis; trauma to testicular veins

Answer 19

hematocele of testis

Question 20

where do the testes drain their lymph

Answer 20

to lumbar (para-aortic) nodes

Question 21

where does the scrotum drain its lymph

Answer 21

superficial inguinal nodes

Question 22

what is another name for inflammation of the testes

Answer 22

orchitis

Question 23

what is the accumulation of serous fluid within the peritoneum

Answer 23

ascites

Question 24

what is culdocentesis

Answer 24

removal of fluid from the recto-uterine pouch

Question 25

when it peritoneal dialysis done

Answer 25

with renal failure

Question 26

what is compression of the 3rd part of the duodenum between the SMA and aorta creating an obstruction; due to insufficient intra-abdominal fat; more common in young, anorexic women

Answer 26

wilkie's (SMA) syndrome

Question 27

what is a chronic inflammatory disease of the intestine that typically leads to fibrosis and obstructive symptoms (abdominal pain and diarrhea)

Answer 27

crohn;s disease

Question 28

what is indicated at the middle third of a line connecting the ASIS and the umbilicus; used to surgically remove the appendix

Answer 28

McBurney's point

Question 29

what is a telescoping of a proximal gut segment into the lumen of an adjacent segment; most common in ileocolic region (can result in necrosis)

Answer 29

intussusception

Question 30

what occurs with weakness in puborectalis and pubovaginalis muscles that can result in bulging of the rectal wall into the posterior vaginal wall

Answer 30

rectocele

Question 31

what color are stools in upper GI bleed and what are common causes

Answer 31

stool is black; common causes are stomach cancer, ulcers, gastritis, esophageal varices

Question 32

what color are the stools with lower GI bleed

Answer 32

red or maroon

Question 33

what is the most common site of bowel ischemia

Answer 33

splenic flexure

Question 34

where does most of the lymph from the liver drain

Answer 34

hepatic nodes which in turn drain into celiac nodes

Question 35

where does lymph from the bare area of the liver drain

Answer 35

phrenic nodes and then to posterior mediastinal nodes

Question 36

where does lymph from falciform ligament drain

Answer 36

parasternal nodes

Question 37

where does typhoid from round ligament drain

Answer 37

around the umbilicus and anterior abdominal wall

Question 38

what are the boundaries of Calot's triangle

Answer 38

cystic duct, common hepatic duct, and base of liver

Question 39

what is pringle's maneuver

Answer 39

clamping vessels of the portal triad to control bleeding during hepatic procedures

Question 40

what does blockage of hepatopancreatic ampulla result in

Answer 40

blockage of hepatic and pancreatic secretions

Question 41

what occurs when there is a tear in the intimal/inner layer of the aorta and hemorrhage between the layers of the vessel

Answer 41

aortic dissection

Question 42

what are the alternative routes for venous return if IVC obstructed

Answer 42

inferior to superior epigastric, superficial epigastric to lateral thoracic, vertebral/lumbar veins to azygos system

Question 43

what is a test used to diagnose dysfunction/contracture of the posts major muscle

Answer 43

thomas test

Question 44

what nerve is most commonly injured in inguinal hernia surgery, hysterectomy, appendectomy, abdominal muscle tears and pregnancy

Answer 44

iliohypogastric nerve

Question 45

what nerve is most commonly injured during inguinal hernia or other abdominal surgery, pregnancy or placement of femoral catheter

Answer 45

ilioinguinal

Question 46

what nerve is most commonly injured during hernia repair, appendectomy, retroperitoneal hematoma

Answer 46

genitofemoral nerve

Question 47

where are renal transplants typically placed

Answer 47

along the iliac fossa

Question 48

what are the transplanted renal arteries in a transplant anastomosed with

Answer 48

internal iliac artery

Question 49

what occurs when there is inferior displacement of the kidney due to insufficient peri-renal adipose tissue; may be associated with flank or groin pain and hematouria

Answer 49

nephroptosis

Question 50

where are the ureters constricted (where kidney stone can get lodged)

Answer 50

junction of renal pelvis and ureter, crossing the pelvic inlet, passage through wall of bladder

Question 51

what side does the material supply to the abdominal ureter come from

Answer 51

medial side

Question 52

where does arterial supply of the pelvic ureter come from

Answer 52

lateral side

Question 53

what is the sympathetic innervation of upper and lowe esophagus

Answer 53

lower is T5-8; upper is T1-4

Question 54

what is the sympathetic for the stomach/duodenum

Answer 54

T5-9

Question 55

what is the sympathetic innveration for the liver and gallbladder

Answer 55

T6-9 (right side)

Question 56

what is the sympathetic innervation for the spleen

Answer 56

T7-9

Question 57

what is the sympathetic innervation for the pancreas

Answer 57

T7-9

Question 58

what is the sympathetic innervation for adrenal medullaT

Answer 58

T11-12

Question 59

what is the sympathetic innervation for the midgut

Answer 59

T9-11

Question 60

what is the sympathetic innervation for the kidney and upper ureter

Answer 60

T10-11

Question 61

what is the sympathetic innervation for the testes

Answer 61

T10-11

Question 62

what is the sympathetic for the pelvic organs

Answer 62

L1-2

Question 63

what is the dermatome for the suprapubic area

Answer 63

T12

Question 64

what is the vertebral level associated with origin of SMA

Answer 64

L1

Question 65

what is the vertebral level associated with origin of renal and gonadal arteries

Answer 65

L2

Question 66

what structure forms the deep inguinal ring

Answer 66

transversals fascia

Question 67

what is the communication between the greater and lesser sacs of the abdomen

Answer 67

epiploic foramen

Question 68

what does the hepatoduodenal ligament contain

Answer 68

portal vein, hepatic artery, bile duct

Question 69

what ducts join to form common bile duct

Answer 69

cystic and common hepatic

Question 70

what is the origin of the cystic artery

Answer 70

right hepatic artery

Question 71

what veins unite to form portal vein

Answer 71

splenic and SMV

Question 72

what structures lie posterior to SMA near its origin

Answer 72

left renal vein, duodenum

Question 73

what is the termination of the left gonadal vein

Answer 73

left renal vein

Question 74

what is the termination of the right gonadal vein

Answer 74

IVC

Question 75

what is the location of initial pain of the appendicitis

Answer 75

umbilical region