Week 1/Lab 1 Flashcards
(92 cards)
1
Q
Why is it important to know the quadrants?
A
-so you know where to ausculate, percuss, and palpate them and to record locations of findings during a physical exam
2
Q
important notes about quads
A
- extends up under the rib cage
- belly button separates all quads
- extends down into the pelvis
3
Q
Right Upper quadrant includes:
A
- liver:right lobe
- gallbladder
- pylorous of stomach
- Duodenum(1-3)
- pancreas: head
- right suprarenal gland
- right kidney
- ascending colon
- transverse colon
4
Q
Left Upper quadrant includes:
A
- liver:left lobe
- spleen
- stomach
- pancreas:body and tail
- jejunum and proximal ileum
- left kidney
- left suprarenal gland
- transverse colon:left half
- descending colon
5
Q
Right lower quadrant includes…
A
- cecum
- appendix
- most of ileum
- ascending colon
- right ovary
- right uterine tube
- right ureter:abdominal part
- right spermatic cord:abdominal part
- uterus if enlarged
- bladder if enlarged
6
Q
Left lower quadrant includes…
A
- sigmoid colon
- descending colon
- left ovary
- left uterine tube
- left ureter:abdominal part
- left spermatic cord
- uterus if enlarged
- bladder if enlarged
7
Q
Epigastric region
A
- the upper central region of the abdomen.
- located between the costal margins and the subcostal plane
8
Q
Hypogastric region
A
- region of the abdomen located below the umbilical region
- pubis bone is lower limit
9
Q
Umbilical region
A
area centralized on umbilicus
10
Q
Right and left iliac regions
A
-region of the abdomen, on either side of the hypogastric regions, below the lumbar regions
11
Q
Skin of the abdomen
A
- loosely attached except at the umbilicus where scar tissue makes strong attachment
- collagen runs in natural lines of cleavage that mimic dermatome patterns
12
Q
Cutaneous nerve supply
A
-anterior rami of spinal nerves of lowest 5 intercostal nerves, the subcostal nerve, and the 1st lumbar
13
Q
1st lumbar nerve
A
-iliohypogastric and ilioinguinal nerve
14
Q
Dermatome of T7
A
-in epigastric area near xiphoid process
15
Q
Dermatome T10
A
-near umbilicus
16
Q
Dermatome L1
A
near area of inguinal canal
17
Q
Skin blood supply at midline
A
- superior and inferior epigastric artery
- superior from INTERNAL THORACIC ARTERY
- inferior from EXTERNAL ILIAC ARTERY
18
Q
lateral flanks
A
-branches of intercostal arteries, lumbar, and deep circumflex iliac arteries
19
Q
blood supply at inguinal region
A
- superficial epigastric
- superficial circumflex iliac
- superficial external pedundle arteries
20
Q
Skin venous drainage
A
superiorly: via lateral thoracic vein into the axillary vein
Inferiorly: via superficial epigastric and great saphenous veins into femoral vein
21
Q
skin lymph drainage
A
- drainage of anterior abdominal wall above the level of the umbilicus is upward to the anterior axillary(pectoral) group of nodes
- below the umbilicus, drains downward and laterally to the superficial inguinal node
22
Q
Fascia
A
-thin sheath of fibrous tissue enclosing a muscle or organ
23
Q
Superficial fascia
A
- loose fatty layer named campers fascia found just below the skin
- tough membraneous layer (scarpa’s fascia) that lies beneath the fatty layer and right before the muscle layer
24
Q
Deep fascia
A
thin layer of fascia that envelopes the muscles of the abdominal wall
25
External oblique
most external abdominal muscle found laterally
| -runs anterio-inferiorly
26
Internal oblique
Lies below external oblique
- muscle fibers run anterior-superiorly
- fibers run at 90 degrees from external oblique
27
Transversus
lies below the internal oblique
| -deepest abdominal wall muscle
28
Rectus abdominus
- long strap muscle that extends whole length of anterior abdominal wall
- it is broader above and lies close to the midline
- separated by its fellow by linea alba
29
Rectus sheath
- long fibrous sheath that encloses rectus abdominal muscle and contains ANTERIOR RAMI OF LOWER 6 THORACIC NERVES
- formed by aponeuroses of three lateral abdominal muscles
30
aponeurosis
sheet of white fibrous tissue that takes the place of a tendon in sheet like muscles having a wide area of attachment
31
Thickness of muscles
-no matter where you slice it, you will get different thicknessess
32
fascia transversalis
- thin layer of fascia that lines transversus abdominis and is continuous with a similar layer lining the diaphragm and iliacus muscle
- forms femoral sheath for femoral vessels
33
Inguinal canal
- oblique passage through the lower part of the anterior abdominal wall
- in males, structures can pass from testis to the abdomen(via spermatic cord)
- in females, allows round ligament of the uterus to pass from the uterus to the labium majus
-allows structures to go from deep to superficial
34
Inguinal canal composition
anterior wall- external oblique aponeurosis
posterior wall-conjoint tendon medially, fascia transversalis laterally
Roof/superior wall: arching lowest fibers of the internal oblique and transversus abdominis
floor/inferior wall: upturned lower edge of the inguinal ligament and lacunar ligament
35
Spermatic cord
- collection of structures that pass through the iguinal canal and form the testis
- begins at the deep iguinal ring lateral to the inferior epigastric artery and ends at testis
- round ligament of the uterus
36
Spermatic cord contents
- vas deferens
- testicular artery
- testicular veins
- testicular lymph
- autonomic vessels
- processus vaginalis
- genital branch of genitofemoral nerve (supplies the cremaster muscle of the scrotum)
37
Liver
- located in upper part of abdominal cavity
- inferior to the diaphragm
- divided into two unequal lobes by falciform ligament
38
Liver function
- PRODUCE bile
- detoxifies alcohol,drugs, ammonia
- phagocytizes bacteria and blood cells
- Stores vitamins, iron, and glucose
- synthesize proteins and AA
39
Glucose/glycogen
glucose-in use in the blood
| glycogen-stored form
40
Gallbladder
- 3-4 inches
- tucked into a depression along the anteroinferior margin of the liver's RIGHT lobe
- STORES bile
41
Esophagus
-pierce diaphragm to the left of the midline at the ESOPHAGEAL HIATUS(T10)
-becomes continuous with stomach at the cardiac orifice.
-located posterior to LEFT liver lobe
Function: transport food, liquid, saliva to stomach
42
Peristalsis
-wave like constriction of muscles to move food down esophagus into stomach
43
What are the 4 tunics composing the gastrointestinal tract
- mucosa
- submucosa
- muscularis externa
- serosa
44
Mucosa
- innermost tunic of GI tract
- mucosal membrane lining from mouth to anus
- 3 parts(epithelium, lamina propria, muscularis mucosae)
45
Epithelium layer of mucosa
- -stratified squamosal epithelial cells
- proctection(mostly in orifices)
- secretion and absorption(stomach and small intestine)
46
Lamina propria layer of Mucosa
- provides the epithelium with blood and lymph supply
| - contains MALT
47
MALT
- mucosa-associated lymphoid tissue
- NODULES of lymphatic tissue containing lymphocytes and macrophages
- protect GI tract wall from bacteria and other pathogens that are mixed with food
- all along GI tract, ESPECIALLY in tonsils, small intesting, appendix, and large intestine
48
Muscularis mucosae layer of mucosa
-thin layer of smooth muscle responsible for local expansion
49
Local expansion
SMOOTH muscle that allows wrinkles which extend surface area and increase absorption
50
Submucosa
- highly vascular
- contains part of the submucosal nerve plexus
- Meissner's complex: part of the autonomic nerve supply that innervates mucosa and submucosa
- vasoconstriction of vessels and innervates secretory cells for buffers and enzymes
51
Muscularis externa
- other than mouth and pharynx(SKELETAL MUSCLE) it is smooth muscle for peristalsis
- main nerve supply to GI
- myenteric/auerbachs plexus-controls GI tract motility (frequency/ strength of contractions)
52
Serosa
- covers external surfaces of most digestive organs and is continuous with serous membrane lining the abdominopelvic cavity
- watery substance with enzymes, used for lubrication
53
Stomach
- J shaped, sac-like dilation of the GI tract between he esophagus and small intesting
- 2 orifices (pyloric and cardial)
- function: stores, mixes, and breaks down food
54
Rando stomach number facts
-stomach can hold 1-2 liters of fluid
55
Chyme
- semi-fluid mix of gastric juice, water, food, semi-digested
- being broken down physically and chemically
56
Small intestine
1-2 inches in diameters and 20 inches long
- extends from pyloric sphincter to ileocecal junction of large intesting
- divided into 3 sections
57
Duodenum
- in RUQ
- 10 inches ish (smallest section in length)
- c-shaped and surrounds head of pancreas
- begins at pyloric sphincter and ends at duodenojejunal junction
- 4 parts: superior, descending, transverse, ascending
58
Jejunum and ileum
- j begins at duodenojejunal junction
- I ends at the ileocecal junction
- J is proximal 2/5 and 8 inches long
- I is distal 3/5 and 12 inches long
59
Small intestine function
Mechanical digestion: bile separates fat into smaller fat globules
Chemical digestion: complete digestion of carbs, proteins, fats, and nucleic acids
Absorption: 90% of NUTRIENTS absorbed
60
Large intestine functions
Mechanical digestion: Rhythmic contractions(hostral and mass)
Chemical digestion: fermentation due to the bacteria in large intesting
Absorption: Vitamins K and B, some electrolytes, WATER(can hold 500-1000mL and absorbs all but 200)
Defecation: whatever is not absorbed
61
Large intestine overview
- frames jejunum and ileum on 3 sides and extends from ileocecral valve to anus
- 5 inches
- divided into cecum, appendix, colon, rectum, anal canal, anus
62
Cecum
- part of the large intestine
- blind pouch at the beginning of the large intesting just below ileocecral junction
- RLQ
63
Appendix
- long skinny attachment to the cecum
- lined with lymphatic nodules serving immunity functions
- MALT
- RLQ
64
Rectum
- begins at level of S3
| - when you no longer see bulges, you're in the rectum
65
Anal canal
-opens to the exterior of the body at the anus
66
Colon
Ascending: extends superiorly from ileocecral juntion to hepatic flexure
Transverse: extends from hepatic flexure to splenic flexure
Descending: extends from splenic flexure to left iliac fossa
Sigmoid: begins in left iliac fossa, terminate at S3
67
Pancreas
-stretches across the posterior abdominal wall from duodenum to spleen
-head, neck, body, tail
Function: Exocrine-produce digestive enzymes
Endocrine-produces hormones to maintain blood glucose level
68
Accessory spleen
-spleen cells embedded in tail of pancreas
69
Spleen
- Largest single mass of lymphatic tissue
- between stomach and diaphragm on left side of body
- total protection by rib cage
70
Spleen function in adults
- production of antibodies(WBC)
- phagocytosis of bacteria and bad RBC and platelets
- reservoir for blood platelets (hold them until you need)
71
Spleen function in fetus
- hemopoesis-formation of formed elements of blood
| - RBC and WBC
72
Kidneys
-in all 4 quads
-4-5 inches in length, 2-3 in width, 1 thick
-between T12 and L3 vertebrae on either side of body(belly button at L3/L4)
-PARTIALLY protected by 11 and 12 ribs
-positioned between peritoneum and posterior wall of the abdomen (retroperitoneal)
-each gives rise to a ureter
Function: produce hormones, absorb materials, filter blood, produce urine)
73
Adrenal glands
-suprarenal glands
-one on superior pole of each kidney
-capsule of DENSE IRREGULAR connectve tissue
-adrenal cortex
-innermost adrenal medulla
Function
Cortex: secretes steroid hormones(DHEA) in really small amounts
Medulla: secrete epi and norepi as part of the sympathetic system
74
Cardial and pyloric sphincters
- smooth muscle tissue
- around orifices
- cardial is looser so you can throw up if you swallow something bad
- pyloric is tighter cause you don't want that shit coming back up
75
Peritoneum
serous membrane lining abdominal and pelvic cavity walls(parietal)
-covers surface of abdominal and pelvic organs--stomach, intestines(Visceral)
76
Peritoneal Cavity
potential space between parietal and visceral peritoneal layers
-has serous fluid
77
Intraperitoneal organs
- organs within the abdominal cavity and wrapped in peritoneum
- every organ that is not considered retroperitoneal
78
Retroperitoneal organs
-located behind peritonium
-SAD PUCKER
Suprarenal glands
Abdominal aorta(and IVC)
Duodenum(2-4 part)
Pancreas(all but tail)
Ureters
Colon(ascending and descending)
Kidneys
Esophagus(lower 2/3)
Rectum
79
Ligaments
-pass between 2 organs or between organs and the abdominal wall
-made of serous membrane
-NOT DENSE REGULAR CONNECTIVE TISSUE
Function: to hold organ in place, transmit neurovascular structures to and from organs
80
Falciform Ligament
- peritoneal fold connecting liver to diaphragm and anterior abdominal wall
- Contains: round ligament of the liver
81
Gastrosplenic ligament
-peritoneal fold connecting spleen to stomach
| Contains: short gastric vessels(going to the stomach) AND left gastroepiploic vessels(travel curvature of the stomach)
82
Lesser omentum
- fold of peritoneum
- connecting stomach and 1st part of duodenum to liver
- has 2 parts!!
83
Hepatogastric ligament
- part of the lesser omentum
- real thin and not sturdy
- connects liver to lesser curvature of stomach
84
Hepatoduodenal ligament
- part of lesser omentum
- structurally sound
- veins ducts and arteries run through it
85
Greater Omentum
- hangs superficially from stomach in front of loops of jejunum and ileum
- consists of 4 peritoneal layers
- policeman: if surgery or tumor, greater omentum will surround area and attempt to cut it off
86
Mesentery
- fold of peritoneum
- in small intestine
- suspending jejunum and ileum from posterior abdominal wall(holds loops)
- transmits neurovascular structures(superior mesenteric vessels and intestinal vessels)
- innervates and supplies blood
87
Median umbilical fold
- attaches to urachus(urine will come out umbilicus)
| - only active in fetus
88
Medial umbilical fold
- carry deoxygenated blood
| - obliterated umbilical artery
89
Lateral umbilical fold
-raised by inferior epigastric vessels
90
Nerve supply for parietal peritoneum
-pain originates from parietal peritoneum is SEVERE AND LOCALIZED
-localized because of dermatomes
Nerves:
Phrenic-C3,4,5-sends signals to shoulder, but it is for diaphragm
Lower 5 intercostals
subcostals
iliohypogastric
ilioinguinal
91
Umbilicus innervation
T10
| -intercostals
92
Nerve supply for visceral peritoneum
-DULL AND POORLY LOCALIZED
Nerves
-visceral afferent sensory fibers traveling with autonomic nerves that supply organs or travel in the mesenteries
