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OSPE 2020 > Abdo > Flashcards

Abdo Flashcards

1
Q

What does the Right Upper quadrant contain?

A

right lobe of liver, pancreatic head, right kidney, 1st part transverse colon, gallbladder, right adrenal gland, duodenum

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2
Q

What does the Left Upper Quadrant contain?

A

left liver lobe, stomach, left kidney, left adrenal, upper descending colon, final transverse colon, pancreatic body and tail, spleen

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3
Q

What does the right lower quadrant contain?

A

appendix, caceum, right ovary/follopian tube, right vas deferens, nerves/vessels right testis, lower ascending colon, bladder (if full)

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4
Q

What does the left lower quadrant contain?

A

Sigmoid colon, lower secesnding colon, left follopian tube/ovary, left vas deferens, nerves/vessels to left testis

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5
Q

Which planes separate the 9 regions?

A

subcostal, transtubecular, 2 MCL

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6
Q

What is the level of the transtubecular plane?

A

L5

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7
Q

What is the level of the subcostal plane?

A

L3

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8
Q

What are the 9 regions?

A

Right hypochondriac, epigastric, left hypochondria, left flank, umbilical, right flank, right inguinal, suprapubic, left inguinal

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9
Q

What structures are present at the transpyloric plane?

A

Peter Pan Doesnt Like Golden Orange Hair

  • Pancreatic head
  • pylorus of stomach
  • 1st part duodenum
  • L1
  • Gallbladder
  • Origin of SMA
  • Hila of spleen and kidneys
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10
Q

WHat is the surface anatomy for the liver?

A

1) right 5th rib at MCL
2) lower end of sternum
3) left 5th ICS at MCL
4) Right costal Margin at MAL

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11
Q

What is the surface anatomy of the gallbladder?

A

Where transplyoric plane meets the MCL, tip of right 9th CC at MCL

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12
Q

What would you hear during gut ascultation?

A

Normal bowel sounds

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13
Q

What is the surface markings for the spleen?

A

Posteriorly, left ribs 9-11 from lateral border of erector spinae muscles to the MAL

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14
Q

Where is gallbladder referred pain?

A

Right shoulder

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15
Q

What are the surface markings for the kidneys?

A

Hilum of left kidney at L1 4-5cm lateral to posterior midline. Superior pole is at Rib 12/Inferior pole is at supracristal plane L4.

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16
Q

How do the ureters move down?

A

Descend vertically from kidney location to the iliac fossae

17
Q

Where is an adult lumbar puncture?

A

L3/4

18
Q

Childs Lumbar puncture location?

A

L4/5

19
Q

How would you palpate the abdominal aort?

A

Just superior and left of the umbilicus

20
Q

Describe dermatome distribution of T7 to L1?

A

T7-T9 runs from xiphoid process to just above the umbilicus
T10 is level of umbilicus
T11 - L1 runs below umbilicus to just inferior to the pubic symphysis

21
Q

Where is liver, gallbladder and duodenal referred pain?

A

Right shoulder as irritation to diaphragm as well is innervated here

22
Q

What is the cause of epigastric pain?

A

Pain in foregut structures, stomach, proximal duodenum, ancreas, liver and gallbladder

23
Q

What is the cause of umbilical region pain?

A

Pain in midgut structures, also known as the periumbilical region. This the from the duodenal flexure down to the splenic flexure of colon

24
Q

Usual cause of umbilical region pain?

A

Colicky

25
Q

Cause of suprapibic region pain?

A

Pain in the hindgut structures e.g. descending colon down to the anal canal

26
Q

Features of the male pelvis?

A 
Pelvic Inlet: Narrow/heart shaped
Sub-pubic angle: narrow 50-60 degrees
Ischial spines: pointing medially
greater (false) pelvis: deep
Lesser (true) pelvis: narrow, deep and tapering
X:Y ratio (acetabelum):< 1
27
Q

Features of the female pelvis?

A 
Pelvic Inlet: Oval/roud
Sub-pubic angle: wide >80 degrees
Ischial spines: dont project medially
greater (false) pelvis: shallow
Lesser (true) pelvis: wide, shallow and cylindrical
X:Y ratio (acetabelum): 1 or >1`
28
Q

Where does the inguinal ligament attach?

A

Anterior superior Iliac Spine to pubic tubercle

29
Q

What are the borders of the inguinal canal?

A
  • Roof: arching fibres of internal oblique and transversus abdominis muscle fibres
  • Posterior Wall: Transversalis fascia and conjoint tendon medially
  • Anterior Wall: External oblique aponeurosis reinforced with internal oblique muscle
  • Floor: Inguinal ligarment under infeior edge of external obique aponeurosis
30
Q

What are the contents of the inguinal canal?

A

MALE: ilioinguinal nerve and spermatid cord
Female: iliinguinal nerve, round ligament and gential branch of genitofemoral nerve

31
Q

Where is the deep inguinal ring location?

A

Midway along the inguinal ligament and just superior. Between the ASIS and pubic symphysis

32
Q

Where is the superficial inguinal ring located/

A

Medially to deep ring, medial 1/3rd of ASIS to pubic symphysis

OSPE 2020 (6 decks)

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