Abdomen Flashcards
What are the 2 main muscles of the abdomen?
Diaphragm and psoas muscles
Describe the diaphragm
Important for breathing, separates thoracic and abdominal cavities
Where do the psoas muscles start?
T12 to L5
Describe the psoas muscles
help flex trunk, flexes and rotates thighs medially
How long is the small intestine?
15 to 18 feet
Name the 3 parts of the small intestine
Duodenum, Jejunum, Ileum
What is the duodenum?
The first portion of the small intestine, shortest and widest
What is the jejunum?
The first 2/5ths following the duodenum
What is the ileum?
The distal 3/5ths of the small intestine
What is the ileocecal valve?
The orifice between the ileum and cecum
What is the cecum?
Part of large intestine, saclike area below ileocecal valve, appendix is attached to cecum
What is the ascending colon?
Vertical portion of large intestine. Ascends on right side of abdomen, reaches the inferior surface of the liver and turns abruptly to form the right colic (hepatic) flexure
Transverse colon?
Large intestine contines across to the left side of the abdomen. It curves beneth the inferior end of the spleen on the left side as the left colic (splenic) flexure
Descending colon?
Large intestine passes inferiorly to the level of the iliac crest
Sigmoid colon?
Begins near left iliac crest, projects medially to midline and terminates as rectum at about S-3
Rectum?
Last 6 inches of GI tract, lies anterior to sacrum and coccyx
Anus?
Rectum ends at the anus, the sphincter muscle at the terminal opening of the large intestine
Spleen?
Part of lymphatic system. Located posterior and to the lft of stomach in LUQ
What are the 3 accessory organs of the digestive system?
Pancreas, liver, and gallbladder
Where is the pancreas located?
Posterior to stomach, between stomach and spleen
What type of gland is the pancreas?
Endocrine- produces hormones
Exocrine- produces digestive juices
Liver?
URQ, inferior to right hemidiaphragm, produces bile
Gallbladder?
Pear shaped sac in the inferior aspect of the liver, stores and concentrates bile
What percentage of gallstones can be seen on a radiograph?
10-15%
Which kidney is slightly lower?
right
What do the kidneys do?
Remove liquid waste products from blood
Where are the kidneys located?
from T12 to L3
Ureters do what?
connect kidneys to the bladder
How long are the ureters?
10 to 12 inches
What is the urethra?
Tube leading from the floor of the urinary bladder to the outside
Adrenal (suprarenal) glands
Part of the endocrine system, superior and medial to each kidney
What are the 2 major cavities of the body?
Dorsal and ventral
Viscera means?
organs
The dorsal cavity contains which 2 cavities?
Cranial and spinal
The ventral cavity contains which 2 cavities?
Thoracic and abdominopelvic
What is the parietal peritoneum?
The covering of the walls of the cavity
What is the visceral peritoneum?
the covering on an organ
Peritoneum
double walled seromembranous sac that encloses the abdominopelvic cavity
Peritoneal cavity
space between the parietal peritoneum and the visceral peritoneum. contains serous fluid
Ascites
Abnormal accumulation of fluid
Mesentary
Fold of the peritoneum, holds the small intestine in place and attaches it to the abdominal wall. Also hold various nerves and arteries of the abdomen.
Mesocolon
Fold of peritoneum that attaches the large intestine to the posterior abdominal wall. Carries blood and lymphatic vessels to the intestines
Which 2 folds of the peritoneum allow for peristalsis
Mesentary and mesocolon
Lesser omentum
Double fold of peritoneum. Extends from the lesser curvature of the stomach to portions of the liver
Greater omentum
Largest peritoneal fold. “Fatty apron” that hangs over the transverse colon and small intestine
Pneumoperitoneum
Free air or gas in the pertoneal cavity. Can be caused by perforation of a gas containing viscus. ex perforating ulcer
Where is a pneumoperitoneum likely to be found and why?
Right side because the diaphragm is higher due to liver placement
Peritonitis
An acute inflammation of the peritoneum
What causes peritonitis?
Contamination of the peritioneum by infectious microbes. ex ruptured appendix
List 10 retroperitoneal (organs behind the peritoneum) organs
kidneys ureters adrenal glands pancreas duodenum ascending colon descending colon upper rectum abdominal aorta inferior vena cava
List 3 infraperitoneal (organs under the peritoneum) organs
lower rectum
urinary bladder
reproductive organs
List 9 intraperitoneal (organs located within the abdominal cavity) organs
liver gallbladder spleen stomach jejunum ileum cecum transverse colon sigmoid colon
What is the difference in peritoneal enclosures with regards to gender?
The lower aspect of the peritoneal sac is closed in males but open in females. The males reproductive organs are not in the peritoneum while the females reproductive organs are.
List the 7 bony landmarks of the body
xiphoid process inferior costal margin iliac crest anterior superior iliac spine (ASIS) greater trochanter pubic symphysis ischial tuberosity
Where is the xiphoid process located?
T-9, T-10
Where is the inferior costal margin located?
L-2, L-3
Where is the iliac crest located?
L-4, L-5
Where is the anterior superior iliac spine located?
inferior to iliac crest
How do you find the greater trochanter?
Have patient rotate leg internally and externally
What is the purpose of the ischial tuberosity?
bear most of the weight when seated
What is seen on a properly exposed abdomen radiograph? (5 things)
psoas muscles lower liver margin kidney outlines lumbar vertebrae transverse processes
Name 4 reasons to do an AP supine of the abdomen? Same reasons for PA
bowel obstruction
neoplasm (new growth)
calcifications
ascites
What is the anatomy demonstrated in an AP abdomen? Same for PA
outline of liver kidneys spleen air filled stomach bowel segments arch of pubis
Which body parts (3) should appear symmetrical to ensure no rotation?
iliac wings
obturator foramina
ischial spines
Why is AP projection preferred over PA?
If you take the image PA there is more magnification of the kidneys
Name 3 reasons to do a lateral decubitus position
check for abdominal masses
air-fluid levels
intraperitonal air
Where do you position for a lateral decubitus?
2 inches above iliac crest. It’s okay if you clip the pubic symphysis
What is the anatomy demonstrated on a lateral decubitus?
Air filled stomach
loops of bowel
air- fluid levels
bilateral diaphragm
What are 3 reasons to do an upright AP?
abdominal masses
air-fluid levels
intraperitoneal air under diaphragm
Where should you center for an upright AP?
2 inches above iliac crest. Top of IR should be at the axilla
What is the anatomy demonstrated on an upright AP?
air filled stomach
loops of bowel
air-fluid levels
bilateral diaphragms included
Name 5 reasons to do a dorsal decubitus position?
Abnormal masses accumulation of gas/air-fluid levels Aneurysms (widening of the wall of an artery, vein, or heart calcifications of aorta umbilical hernias
Where should you center for a dorsal decubitus?
2 inches above the iliac crest
What is the anatomy demonstrated on a dorsal decubitus?
diaphragm and as much lower ab as possible
air filled loops of bowel
soft tissue in anterior
prevertebral regions
Name 4 reasons to do a lateral position
Abnormal soft tissue masses
umbilical hernia
prevertebral region for aneurysms of aorta or calcificaton
localization of foreign bodies
Where should you center for lateral position?
You can center either 2 inches above the crest or at the crest
Which positions are included in an acute abdomen series (3 way abdomen)?
AP supine
erect
PA chest
Why would you do a 3 way abdomen series?
Ileus (small bowel obstruction) ascites perforated hollow viscus (ulcer) intra-abdominal mass postoperative (abdominal surgery)
