Abdo for PACES

Question 1

Significance of Transpyloric plance of Addison

Answer 1

L1 - fundus of gallbladder (Murphys signs)

Level of kidney

Question 2

Significance of Supracoristal plane

Answer 2

L4/5 - bifurcation of Aorta. Above this plan to palpate aorta.

Question 3

What is blodd supply to the foregut

Answer 3

Coeliac trunk

Question 4

Blood supply to the midgut

Answer 4

SMA

Question 5

Blood supply to the hindgut

Answer 5

IMA

Question 6

Where is the lesser sac?

Answer 6

Behind the stomach in front of the pancreas

Question 7

Significance of lesser sac -

Answer 7

Pseudocyst formation

Question 8

Why do you get back pain in pancreatitis?

Answer 8

Pancreas is located in the retroperitoneum

Question 9

After completing Abdo exam what should you ask for

Answer 9

Examination of hernial orifices, groin and perineum

Complete with pr, observations and urine dip

Question 10

Clubbing causes in GI

Answer 10

Familial
Chronic Liver disease
UC/CD

Question 11

What is cockers incision

Answer 11

Open cholecystectomy

Question 12

What is lanz incision

Answer 12

Open appendicectomy

Question 13

Oblique incision

Answer 13

inguinal hernia

Question 14

Vertical inguinal incision

Answer 14

For femoral vessels

Question 15

Laporostomy

Answer 15

don’t close the abdo due to lack of abdo fascia or abdo compartment syndrome

Question 16

Where is the pathology in relation to laproscopic scars

Answer 16

Opposite side

Question 17

What are the four f’s of distended abdo

Answer 17

Faeces, Fat, foetus and flatus

Question 18

Shapes of abdomen

Answer 18

Extended
Gravid
Scaphoid - boat shape

Question 19

causes of splenomegaly

Answer 19

Infection
Cirrhosis
Haemolytic
Cancer

Question 20

Renal masses what else to expect?

Answer 20

Dialysis
AV fistula
Systemic signs

Question 21

Polycystic Kidneys expect to see

Answer 21

HTN, loin pain, mass symptoms and FHx

Question 22

Where are kidneys transplanted into?

Answer 22

Iliac vein

Question 23

What should you do if you can’t get below a pelvic organ on palpation?

Answer 23

Consider rectal, uterine or bladder pathology. PV or PR

Question 24

if a colostomy what else should you ask to inspect

Answer 24

perineum

Question 25

how to inspect a hernia

Answer 25

KY jelly and gloves

ask them to cough
inspect outside skin
inspect inside with LITTLE finger
See if lumen is open and how many lumens there are

Question 26

When is a colostomy used

Answer 26

After APR/Hartmanns

Question 27

When is a loop ileostomy used

Answer 27

defunctioning of bowel

Question 28

Permanent ileostomy

Answer 28

after panproctocolectomy

Question 29

Complications of stoma

Answer 29

allergic
intusseception
retraction 
stenosis
parastomal hernia

Question 30

What position should you examine the inguinal hernias?

Answer 30

Stood up
Find the symphysis and tubercles.
Find the deep ring - half way along the ligament, occlude and ask to cough.