Abdomen 2 Flashcards by Robert Kucera

Which organs are in the peritoneal cavity?

None! Within the cavity is peritoneal fluid that lubricates peritoneal surfaces

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What organs are almost completely covered by the visceral peritoneum?

Spleen and stomach

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T/F: The female peritoneal cavity is completely closed

False! It is completely closed in the male

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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.

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T/F: the visceral peritoneum is more sensitive to pressure, pain, heat, and cold than the parietal peritoneum

False! Parietal is more sensitive.

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T/F: The Visceral peritoneum is stimulated by stretch and chemical irritation

TRUE

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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.

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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

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what is the point of maximum abdominal tenderness?

-McBurney point

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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)

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What is a disorder of the stomach that can cause a newborn to vomit?

-pyloric stenosis-

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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

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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)

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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

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What does the esophagus pass through to get to the right diaphragm?

-esophageal hiatus

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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)

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T/F Visceral pain is vague, while parietal pain is localized.

true

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What is the role of the omental bursa?

-to allow free movement of stomach on adjacent structures

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How would a surgeon enter the greater sac?

-incision through anterolateral abdominal wall

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What does the lesser omentum connect?

Lesser curvature of stomach to proximal part of duodenum to liver

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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)

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What connects the liver to the anterior abdominal wall?

Falciform ligament

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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)

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Why do small bowels have a large mesentery?

Allows for more mobility

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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