Abdomen 2 Flashcards
Which organs are in the peritoneal cavity?
- None! Within the cavity is peritoneal fluid that lubricates peritoneal surfaces
What organs are almost completely covered by the visceral peritoneum?
Spleen and stomach
T/F: The female peritoneal cavity is completely closed
False! It is completely closed in the male
Why do females have a potential pathway for infection from the exterior?
Because organisms can enter through the vagina, uterine cavity and then through uterine tubes.
T/F: the visceral peritoneum is more sensitive to pressure, pain, heat, and cold than the parietal peritoneum
False! Parietal is more sensitive.
T/F: The Visceral peritoneum is stimulated by stretch and chemical irritation
TRUE
When a patient has appendicitis, why is pain first generalized?
The visceral peritoneum is first irritated, and pain is not localized due to the nerve supply. Pain from the visceral peritoneum is referred to the dermatomes of the spinal ganglia providing sensory fibers. Later the pain shifts from the visceral to parietal peritoneum and the pain is in a specific place.
Match the origin of pain to the region it is experienced in. Choose either (A. pubic region, B. umbilical region, or C. epigastric region):
- Pain from forgut derivatives
- Pain from midgut derivatives
- Pain from hindgut derivatives
1.C , 2. B, 3. A
what is the point of maximum abdominal tenderness?
-McBurney point
What is not true of the greater omentum?
a- prevents visceral peritoneum from adhering to parietal peritoneum
b- has good mobility and moves around peritoneal cavity
c- It’s a fixed apron-like sheet of adipose tissue
d- Can wall off and protect other viscera from an infected organ
c- its not fixed! (all others are true)
What is a disorder of the stomach that can cause a newborn to vomit?
-pyloric stenosis-
Which is not a part of the stomach? a-pyloric b-fundus c-cardia d-none of the above
d- all are parts of the stomach
Match the part of the esophagus with its type of muscle: (choose voluntary or involuntary)
upper 1/3, middle 1/3, lower 1/3
- upper (voluntary), middle (both), lower (invol)
which is correct about the lower esophageal spincter? a-forms the diaphragmatic muscle b-it slows food, c-prevents reflux, d- b & c, only e- all of the above
e- all of the above
What does the esophagus pass through to get to the right diaphragm?
-esophageal hiatus
What does NOT make up the abdominal viscera?
a- end of esophagus, stomach,
b- intestines, spleen, pancreas,
c- liver, gallbladder, kidneys, and adrenal glands
d- Ureter, urethra, bladder
d (a,b and c are in the abdominal viscera)
T/F Visceral pain is vague, while parietal pain is localized.
true
What is the role of the omental bursa?
-to allow free movement of stomach on adjacent structures
How would a surgeon enter the greater sac?
-incision through anterolateral abdominal wall
What does the lesser omentum connect?
Lesser curvature of stomach to proximal part of duodenum to liver
Which of the following ligaments do NOT make up the greater omentum? -a- gastrophrenic b- gastrosplenic c- gastrohepatic d- gastrocolic
(c; I just made up the word gastrohepatic, all the rest are ligaments of the greater omentum)
What connects the liver to the anterior abdominal wall?
Falciform ligament
Which of the following is not true of the mesentery?
a-it provides a means of neurovascular communication btw organ and body wall
b- its a thick, single layer of peritoneum
c-it has a core of connective tissue with blood/ lymph vessels, nerves, fat, and lymph nodes
d- the degree of mobility depends on the length of mesentery
e- all are true
b- its a DOUBLE layer (all the rest are true)
Why do small bowels have a large mesentery?
Allows for more mobility
Which of the following is not true about the relations of the stomach?
a-by right lobe of liver b-anteriorly related to diaphragm c-anteriorly related to omentum and pancreas d- a & c e- all are true
d- (a is false because the stomach by the left lobe of liver and c is not true because its posteriorly related to omentum and pancreas.
b is true about the stomach)
T/F: when the contracted mucosa has longitudinal gastric folds (rugae) they are marked away from the pyloric part and toward the lesser curvature of the stomach
False- they are marked TOWARD the pyloric part and toward the GREATER curvature of stomach
which of the following is not true of the duodenum?
a- shortest part of small intestine
b-the C-shape is necessary for the head of the pancreas to sit
c- it has 3 parts (horizontal, descending, ascending)
d-begins at pyloris on right and ends at duodenojejunal junction on left
c- it has 4 parts (all those and a superior part)
a, b, d are true
Which is NOT true of the jejunum and ileum?
a- Jejunum begins at duodenojejunal junction and ileum ends at ileocecal junction
b- blood is supplied from superior mesenteric artery in arterial arcades
c- blood is drained by the superior mesenteric vein that unites with splenic vein to form portal vein
d- there is a clear demarcation between the jejunum and ileum
d – no clear distinction; all the rest are true
T/F- the appendix is on the medial side of cecum
true
All of the following distinguish the large intestine from the small intestine except:
a- large has teniae coli
b- large intestine is larger in diameter and length
c- large contains omental appendices
d- the large contains pouchings between tenai
e- all the above can distinguish large from small intestine
b- although the large intestine is larger in diameter (caliber) it is shorter in length (all the rest are true)
What occurs in high frequency in patients post appendectomies?
Lymphoma
T/F: the hepatic flexure is on the right while the splenic flexure is on the left
True
T/F: the cecum has no mesentery
True
T/F: the ileum enters the cecum horizontally and partly invaginates into it forming ileocecal valve
False- it enters it OLBIQUELY
What is the purpose of the ileocecal valve?
- To prevent backflow between the large and small bowels
Which is true of the appendix?
a- Has a short round mesentery
b- is not retrocecal
c- The base is usually at the MacConkey’s point
d- Has a fixed end and a free end
D is true (note, it has a TRIANGULAR mesentery, it is retrocecal, and the base is at the McBURNEY’s point)
T/F : The transverse part of the colon is the most fixed and largest part
False ,it’s the most MOBILE and largest part
Which is true of the spleen?
a- Under the 9th-11th rib,
b- Size is constant
c- Hilum in contact with tail of pancreas
d- Blood supply from the splenorenal artery
C (all rest are false)
Which is true of the pancreas?
a- Its an exocrine gland because it secretes insulin
b- It’s an endocrine gland because it secretes gastric enzymes
c- It contains alpha cells that secrete insulin
d- A and b only
e- None of the above
None of the above (note, the exocrine secretes gastric enzymes and endocrine secretes insulin. Insulin is secreted by beta cells)
T/F : The sphincter of Oddi controls the flow of pancreatic juices and bile into the duodenum.
true
Describe the Peritoneum
glistening, transparent serous membrane with 2 continuous layers
which layer lines the internal surface of abdominopelvic wall?
Parietal Peritoneum
which layer surrounds the organs of the abdomen; organs are intraperitoneal or extraperitoneal?
Visceral Peritoneum
Where are the kidneys located? are they covered with visceral?
retroperitoneal and covered on surface of the kidney
describe Intraperitoneal Organs
almost completely covered with visceral peritoneum (eg. spleen & stomach)
describe Extraperitoneal Organs
outside the peritoneal cavity (external or posterior); partially covered by peritoneum (usually 1 surface); kidneys between parietal peritoneum & posterior abdominal wall
what is the potential space between visceral & parietal peritoneum?
peritoneal cavity
what is located in the peritoneal cavity?
a thin layer of peritoneal fluid (lubrication)
where is the peritoneal cavity located?
within the abdominal cavity and continuous with pelvic cavity
what does peritoneal fluid contain?
leukocytes & antibodies
which layer of the peritoneum is sensitive to pressure, pain, heat, and cold?
Parietal Peritoneum
which layer of the peritoneum is served by same blood & lymphatic vasculature & same somatic nerve supply as region of abdominoplevic wall it lines?
Parietal Peritoneum
which layer is served by same nerves & vessels as the organs it covers
Visceral Peritoneum
what stimulates/doesn’t stimulate the Visceral Peritoneum?
insensitive to touch, heat, cold
stimulated by stretch & chemical irritation
pain poorly localized
pt complains of a sharp ab pain that is generally well localized. What layer of the peritoneum would you suspect?
parietal
what causes the referred pain associated with the visceral layer?
dermatomes providing the sensory fibers
what double layer invaginates the peritoneum?
Mesentery
What provide a means for neurovascular communication between the organ & body wall?
Mesentery
What does the mesentery consist of?
connective tissue with blood/lymphatic vessels, nerves, fat, lymph nodes;
viscera with mesentery are mobile
Name the 3 parts of the greater omentum?
gastrophrenic ligament, gastrosplenic ligament, gastrocolic ligament
what connects lesser curvature of stomach & prox. part of duodenum to liver?
Lesser Omentum:
what are the two parts of the lesser omentum?
hepatogastric & hepatoduodenal ligaments
What is the peritoneal ligament?
double layer of peritoneum connects an organ with another organ or to abdominal wall
What connected the liver to anterior abdominal wall?
falciform ligament
What are the peritoneal folds?
reflection of peritoneum raised from the body wall
Whats underneath the peritoneal folds?
blood vessels, ducts, & obliterated fetal vessels
Name the two umbilical folds?
medial & lateral umbilical folds
Whats clinically important about the greater sac?
surgical incision thru anterolateral abdominal wall enters greater sac
Where is the omental bursa located? And what does its positioning allow?
lies posterior to stomach & lesser omentum
permits free movement of stomach on adjacent structures
Name the compartments of the perotineal cavity
Supracolic Compartment Infracolic Compartment
What are the two subdivisons of the peritoneal cavity?
Greater sac Omental bursa (lesser sac)
Name Abdominal Viscera
esophagus (terminal part), stomach, intestines, spleen, pancreas, liver, gallbladder, kidneys & suprarenal glands
what does the esophagus pass through and where?
passes thru esophageal hiatus in right diaphragm
what causes GERD?
failure of inferior spincter - backs up into esophagus heart burn (sits behind the heart)
Name the parts of the small intestine and where it starts/ends
duodenum, jejunum, ileum;
extends from pylorus to ileocecal junction
