abd final review canvas Flashcards
Coverings of organs- Liver; ______________capsule.
Glissons
Coverings of organs kidney______capsule then _______then __________
renal capsule
perinephric fascia
gerota’s fascia
Layers of vessels from inner to outer
intima
media
adventia
Fluid collections: Bile
biloma
Fluid collections: ,pus
abcess
Fluid collections: urine
urinoma
Fluid collections: Blood
hematoma
Landmark for locating the gallbladder is the_________ _________ ___________.
Main Lobar Fissure
Separates the left lobe and caudate lobe ______________ ________________.
Ligamentum Venosum
Separates the left lobe and right lobe of the liver
Main Lobar Fissure, GB fossa, middle hepatic vein
Separates the left lobe into lateral and medial segments
Ligamentum Teres, falciform ligament, left hepatic vein, left intersegmental fissure
Separates the right lobe into anterior and posterior segments
right intersegmental ligament, right hepatic vein
Normal length of spleen
8-13 cm
normal length of AP Liver
15 cm
normal diameter of aorta
<3 cm
Approx 2.5 cm prox,
- 0 cm mid,
- 8 cm distal just before the bifurcation
normal diameter of iliac arteries
2 cm
normal diameter of popliteal arteries
<10 mm males
<7.5 mm females
normal length of kidney
9-12 cm
normal length of lymph node
1 cm
normal length of pancreas
Head 1.9 - 2.5 cm
Body 1.5 – 2.1 cm
Tail 1.0- 2.0
normal length of GB wall
3 mm
normal CBD measurment
less than 6mm
normal CBD measurment post GB removal (cholecystectomy
<10 mm
normal GB length and width
5 cm wide
7-10 cm length
Define portal hypertension
increase in the blood pressure within a system of veins called the portal venous system
Congenital abnormalities of the kidneys
column of bertin
dromedary hump,
junctional parenchymal defect,
fetal lobulation,
lobar dysmorphism,
duplex collecting system,
bifid renal pelvis (incomplete duplex),
extrarenal pelvis,
horseshoe kidney
Labs for checking renal function
Urinalysis,
Urine pH,
Specific Gravity,
Blood,
Hematocrit,
Hemoglobin,
Protein,
Creatinine Clearance,
Blood Urea Nitrogen (BUN),
Serum Creatinine
Labs for checking liver function
aspartate aminotransferase
alanine aminotransferase
lactic acid dehydrogenase
alkaline phosphatase
bilirubin
prothrombin
albumin
globulins
Congenital anomalies of the pancreas
Agenisis
pancreas divisum
ectopic
annular
Sonographic appearance of gallstone
echogenic, mobile, shadowing structures within the lumen of the GB, stones that lodge in the neck may not move, WES sign present when GB filled with stones
Sonographic appearance of polyp
echogenic, nonshadowing and nonmobile masses that project from the wall
Sonographic appearance of carcinoma
nonmobile mass with in lumen greater than 2 cm, gallstones, diffuse or focal wall thickening, irregular mass that may completely fill the GB fossa, invasion of mass into surrounding liver tissue
Most common Islet Cell Tumor
insulinoma
Most common benign liver tumor
cavernous hemangioma
Location of organs intraperitoneal
GB
Liver
Ovaries
Spleen
Stomach
Location of organs retroperitoneal
S: suprarenal (adrenal) gland
A: aorta/IVC
D: duodenum (second and third part)
P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: (o)esophagus
R: rectum
Splenic rupture
Subcapsular hematoma: Splenic capsule remains intact.
Perisplenic or Intraperitoneal Hematoma: Capsule ruptures.
Potential spaces for fluid to collect
gutters
most dependent areas in the flanks of the abdomen and pelvis where fluid collections may accumulate
Basic functions of the spleen
Part of the reticuloendothelial system
Synthysis of blood proteins
Largest mass of lymphoid tissue in the body
Active in flood formation during the initial part of fetal life
Storage of iron
Blood reservoir
Basic functions of the liver
carb metabolism, lipid meta, protein metab, removal of waste, synthesis and secretion of bile, drug inactivation, vitamin and mineral storage
Basic functions of the kidneys
excreting waste
regulating blood composition
Basic functions of the pancreas
edochrine
exocrine
Basic functions of the adrenal glands
Outer portion; secretes steroids that help to regulate electrolyte metabolism, carbohydrate metabolism, and sex hormones
produces epinephrine and noreinephrine
Define infarct
an area of necrosis in a tissue or organ resulting from obstruction of the local circulation by a thrombus or embolus
Define Candida albicans
Candida Albicans is an opportunistic fungus (or form of yeast) that is the cause of many undesirable symptoms ranging from fatigue and weight gain, to joint pain and gas
AIDS related
Define urachal cyst
It is a cyst which occurs in the remnants between the umbilicus and bladder
reverse
missing body and tail with a large (hypertropic) head
Agenesis
reverse
lack of fusion of the dorsal and ventral pancreatic buds
pancreas divisum
reverse
most common anomalie
pancreatic nodules are found throughout the GI tract
.5-2.0cm in size
acute pancreatitis and tumor may be found in these nodules
ectopic
reverse
head of the pancreas surrounds the second portion of the duodenum
male prevalence
annular
reverse
Exocrine
Endochrine
pancreas functions
reverse
digestive function
Exocrine
reverse
produces up to 2 liters of pancreatic juice per day
arranged in sac-like structures
juice converges into the two ducts which drain the juice into the duodenum for digestion
pancreatic juice enzymes capable of completing almost all of the digestion of our food
Acini cells
reverse
produces pancreatic juice to aid in digestion
enzymes
lipase
trypsin
amylase
nucleases
sodium bicarbonate
Excocrine function
reverse
breaks down fats
lipase
reverse
digest proteins
trypsin
reverse
digest carbohydrates
amylase
reverse
digest nucleic acids
nucleases
reverse
neutralizes gastric acids
ph of juice needs to be almost neutral for best action
sodium bicarbonate
reverse
chyme (partially digested food) in the duodenum triggers release of hormones that start pancreatic juice formation
gastrin
cholecystokinin
aceytlcholine
secretin (sodium bicarbonate)
these now enter duodenum after allowing the sphincter of Oddi to relax
Exocrine enzyme triggers
reverse
produces glucagons and insulin
Endocrine function
reverse
alpha, beta and delta cells within the islets of Langerhans
insulin production
reverse
regulates the metabolism of sugars
insufficient leads to diabetis mellitus
hormone that causes glycogen formation from teh glucose stored within the liver
Insulin
reverse
changes the forms of sugar
hormone that causes our cells to release glucose to meet the bodies energy needs
stimulates the liver to convert glycogen to glucose and increase sugar levels
glucagon
reverse
autoregulator
inhibits the production of both insulin and glucagon
gastrin
reverse
most prevalent cells
produces insulin
enables cells within insulin receptors to take up clucose which lowers blood sugar
Beta cells
reverse
produce glucagon
alpha cells
reverse
smallest number of cells
produce gastrin
delta cells
reverse
digestive enzyme produced by the pancreas as well as the parotid glands, bowel and gynecological system
certain types of pancreatic disease escapes into the surrounding tissue causing death of tissue, resulting in severe pain and inflammation
Amylase
reverse
blood test twice normal usually indicates acute pancretitis, or obstruction of panc duct, acute cholecystitis, perforated peptic ulcer, alcohol poisoning
differentials include mumps, ischemic bowel disease, pelvic inflammatory disease
ANypase lab tests
reverse
may be elevated in pancreatitis
diseases not affectin the pancreas may cause an elevation of blood serum amylase with elevation
urine amylase
reverse
enzyme excreted only by the pancreas
small amounts pass into the blood
used to assess damage to the pancreas
rises at teh same rate as amylase, but persists for a longer period of time
Lipase
reverse
obstruction of panc duct
pancreatic CA
acute cholecystitis
lipase differentials
reverse
controls the blood sugar lever in the body
GTT performed to asses a disorder of glucose metablolism
glucose
Mineralocoricoids Glucocorticoids Sex Hormones
Physiology of cortex Steroids fall into 3 main categories
regulate electrolyte metabolism. Aldosterone is the primary steroid Regulates mineral ions in the body fluids which affect the water content of tissue Decreased steroid level leads to an increased secretion of sodium and chloride ions, and water into the urine. This leads to lowered pH in the blood causing acidosis.
Mineralocoricoids
play an important role in the metabolism of carbohydrates Cortisone and hydrocortisone are the primary ones. These help diminish the allergic response to inflammatory diseases of the body eg. Rheumatoid arthritis and rheumatic fever
Glucocorticoids
Androgen-male sex hormone Estrogen-female sex hormone Secretes both in minute amounts regardless of gender. Controlled by the adrenocorticotropic hormone (ACTH) from the pituitary gland Hypofunction is termed Addison’s disease
Sex Hormones
pancreas exocrine labs
amylase
lipase
pancreas endochrine labs
glucose
