US of Abdominal Wall- Dey

Question 1

what structures are at the level of the transpyloric plane

Answer 1

pylorus
gall bladder
pancreas

Question 2

what structures must be put back together in a certain order when closing a paramedian incision above the arcuate line

Answer 2

a

Question 3

what structures must be put back together in a certain order when closing a paramedian incision below the arcuate line

Answer 3

a

Question 4

what lymph nodes are affected by melanoma on the left lateral region of the abdominal wall

Answer 4

a

Question 5

what lymph nodes are affected by testicular carcinoma

Answer 5

a

Question 6

what is the advantage of a paramedic and midline incision compared to a pararectus incision?

Answer 6

a

Question 7

what complications come from severing or compressing a nerve on the anterior abdominal wall

Answer 7

a

Question 8

what position should the patient be in for an abdominal exam and why

Answer 8

supine with relaxed abdomen and knees bent to relax the fascia between the legs and the abdomen

Question 9

what is the elicited reflex

Answer 9

stroking the abdomen lateral to medial, should see a contraction

Question 10

what is a guarding reflex

Answer 10

involuntary reflex with pain in the abdomen, commonly seen with appendicitis

Question 11

what are the 6 Fs causing abdominal distension and the other cauess

Answer 11

food
fat
fluid
feces
flatus
fetus
tumors
enlarged organs
reduced muscle tone (age, lack of exercise, paralysis)

Question 12

what structures are in the RUQ

Answer 12

R liver
gallbladder
stomach
duodenum
pancrease
R kidney
R colic flexture
transverse and ascending colon

Question 13

what structures are in the LUQ

Answer 13

L liver
spleen
pancreas
stomach
L kidney
L colic flexture
transverse and descending colon

Question 14

what structures are in the RLQ

Answer 14

cecum
appendix
ileum
ascending colon
R ovary and uterine tube
uterus
R ductus deferns and spermatic cord
full bladder

Question 15

what structures are in the LLQ

Answer 15

sigmoid colon
descending colon
L ovary and uterine tube
full bladder
uterus
L ductus deferns and spermatic cord

Question 16

what are the planes that divide the abdomen into 9 quadrants

Answer 16

midclavicular/midinguinal lines
subcostal plane L2-3
transtubercular plane at L5

Question 17

where is the transpyloric plane

Answer 17

crosses at pylorus of stomach at the midpoint between sternal notch and pubic symphysis around L1

Question 18

what are the 9 regions of the abdomen

Answer 18

R/L hypochondriac
epigastric
R/L lateral
umbilicus
R/L inguinal
pubic (hypogastric)

Question 19

where are the parts of the pancreas

Answer 19

head- right L2/3
body- L1
tail- left T12

Question 20

where is the duodenum-jejunal junction

Answer 20

L2/3

Question 21

where is the bifurcation of the aorta

Answer 21

L4 (sternal angle)

Question 22

what are the 3 arteries supplying the abdomen and where do they come off of the abdominal aorta

Answer 22

celiac- T12
superior mesenteric- L1
inferior mesenteric- L3

Question 23

what level are the iliac crests

Answer 23

L4

Question 24

what are the iliac crests used as a landmark for

Answer 24

lumbar puncture

Question 25

where is the liver

Answer 25

under ribs and diaphragm- pushed down when diaphragm contracts

Question 26

where is the gallbladder

Answer 26

at the midclavicular line

Question 27

what ligaments are on the anterior liver surface

Answer 27

falciform ligament | round ligament

Question 28

how is the falciform ligament formed and what does it do

Answer 28

fused periotoneal reflections from the left and right sides of the liver that extend anteriorly divides liver into left and right lobes

Question 29

how is the round ligament formed and what does it do

Answer 29

obliterated umbilical vein that extends from the free margin of the liver, inferior to the falciform ligament

Question 30

what part of the gallbladder is visible from an anterior view of the liver

Answer 30

fundus

Question 31

what structures are in the porta hepatis

Answer 31

hepatic portal vein proper hepatic artery common hepatic duct

Question 32

what surrounds the structures in the portal hepatis

Answer 32

hepatoduodenal ligament

Question 33

what are the 4 lobes of the liver

Answer 33

right left quadrate cuadate

Question 34

where is the quadrate lobe of the liver

Answer 34

between the falciform ligament and the gallbladder

Question 35

where is the caudate lobe of the liver

Answer 35

between the inferior vena cava and the ligamentum venosum

Question 36

where is the ligamentum venosum

Answer 36

directly behind the falciform ligament in the main lobar fissure

Question 37

where do all hepatic veins drain into

Answer 37

inferior vena cava

Question 38

where is the bare area of the liver

Answer 38

on the visceral aspect, area that is directly against the diaphragm that is not covered by peritoneum

Question 39

where is the coronary ligament and how is it formed

Answer 39

reflection of the peritoneum at the bare area

Question 40

what forms the left and right triangular ligament

Answer 40

where the peritoneum reflections from the coronary ligament layers meet

Question 41

what is the difference between the hepatic vein and portal vein

Answer 41

portal vein- delivers blood to the liver to be filtered hepatic vein- drains blood into the IVC that supplies nutrients to the liver and what is brought to it by the portal vein

Question 42

where does the blood from the GI tract go

Answer 42

portal venous system

Question 43

what arteries go to the liver from the celiac artery

Answer 43

common hepatic artery which branches into the proper hepatic arteries (left and right)

Question 44

path of bile

Answer 44

hepatic duct- exits liver cystic duct- enters/exits gallbladder common bile duct- forms from intersection of hepatic and cystic ducts and empties into the duodenum

Question 45

what is bile for

Answer 45

digest fats

Question 46

what is in the portal triad

Answer 46

portal vein bile duct hepatic artery

Question 47

what is the shape of the gallbladder on US

Answer 47

exclamation point- gall bladder is the long part, the portal triad is the dot

Question 48

what is the shape of the portal triad on US

Answer 48

mickey mouse portal vein is the head hepatic artery and common bile duct are ears

Question 49

where is the spleen

Answer 49

posteiror to th emidaxillary line on the left

Question 50

what is Traub's space

Answer 50

left hypochondriac region between lung nd spleen

Question 51

what is splenomegaly

Answer 51

enlarged spleen that fills Traub's space

Question 52

what are the 3 spaces in the peritoneal cavity

Answer 52

subphrenic (subdiaphragmatic) perisplenic hepatorenal

Question 53

where is the subphrenic space

Answer 53

between the liver and diaphragm connected to the hepatorenal recess infections here cause referred shoulder pain because the phrenic nerve is supplied by C3,4,5 which also go to the shoulder

Question 54

where is the perisplenic space

Answer 54

between the spleen and diaphragm | connected to the pelvic cavity via the left colic gutter

Question 55

where is the hepatorenal space

Answer 55

between the liver and right kidney in contact with subphrenic space drains into pelvic vacuity via right colic gutter

Question 56

what are the lower points peritoneal spaces in the supine position

Answer 56

hepatorenal space and pelvic cavity--where all the fluid pools