Abdomen

Question 1

Organs and abdominal viscera are protected by

Answer 1

Fat and muscles, no bony protection

Question 2

Left upper quadrant structures

Answer 2

The tip of the medial liver lobe, spleen, stomach, left kidney, pancreas, splenic flexure, and parts of the transverse and descending colons

Question 3

Right upper quadrant structures

Answer 3

Liver, duodenum, pyloris, right kidney, hepatic flexure, portions of ascending and part of the transverse colon

Question 4

Left lower quadrant structures

Answer 4

Sigmoid colon, descending colon, bladder, left ovary, uterus, left spermatic cord, and left ureter

Question 5

Right lower quadrant structures

Answer 5

Appendix, cecum, ascending colon, bladder, right ovary, uterus if enlarged, right spermatic cord, and right ureter

Question 6

Under the skin in the abdominal region we have fat to serve as

Answer 6

Thermal insulation and protection from trauma. Also a large band of fascia which runs up and down and connects to the rectus abdominis and will be continuous with the thoracolumbar fascia in the back

Question 7

Rectus abdominis

Answer 7

Origin: ribs 5,6,7
Inserts: pubic tubercle
Action: trunk flexion, compresses and supports the abdominal viscera
Innervated by ventral rami from T8-T12
Global muscle - its superficial and produces large movement

Question 8

External abdominal oblique

Answer 8

Origin: lower 8 ribs
Insertion: ASIS and pubic tubercle via the inguinal ligament; interdigitate (connect) with the serratus anterior
Action: contralateral trunk rotation
External oblique runs down and forward (hands in pockets)
Also a global muscle

Question 9

Internal oblique

Answer 9

Origin: inguinal ligament
Insertion: linea alba, lower 4 or 5 ribs
Action: ipsilateral trunk rotation
Will connect to the back of the thoracolumbar fascia, fibers will run down and backwards
Called a local muscle, meaning its deeper, one of the “core” muscles

Question 10

Transverse abdominis

Answer 10

Comes from the deepest layers of the thoracolumbar fascia and will come forward to pass deep to the rectus abdominis
Action: compresses and supports the abdominal viscera
Will fire first during trunk flexion and extension for stabilization
Also a local muscle

Question 11

Patients with lower back pain (or SI pain or during/post pregnancy) have

Answer 11

Motor control issues of the muscles around the lumbopelvic hip complex. Not a strength issue, its about firing at the appropriate time

Question 12

Abdominal cavity is lined with

Answer 12

Peritoneal lining

Question 13

Organs that are behind the lining are called

Answer 13

Retroperitoneal (i.e. kidneys, and most of your duodenum (first part of small intestine))

Question 14

Omenta

Answer 14

Two: greater and lesser omen, associated with the stomach

Question 15

Mesocolon

Answer 15

Associated with the large intestine

Mesenteries: associated with with the small intestine

Question 16

Ligaments

Answer 16

Peritoneal duplications between the two organs (i.e. pancreato-splenic ligament)

Question 17

Omenta, mesocolon, and ligaments function

Answer 17

Give the abdominal organs support and help connect one abdominal organ to another abdominal organ

Question 18

Food pathway after we swallow

Answer 18

Food travels through our esophagus and through the cardiac sphincter to the stomach. Stomach has two parts: fundus is first, body is second. From the stomach food will pass through the pyloric sphincter to the small intestine, specifically the duodenum. From the duodenum we hit the jejunum and then we go to the ileum. From the ileum we heads to the first part of the large intestine, the cecum. Then it goes to the ascending colon to the transverse colon to the descending colon to the sigmoid colon to the rectum and out.

Question 19

Duodenum

Answer 19

C-shaped organ with 4 parts: superior, descending, transverse, and ascending.
It is a double chamber with 2 functions: receives input from the pancreas and liver.
It will have a connection to the pancreas (LUQ) via the common pancreatic duct

Question 20

Liver

Answer 20

Left lobe in the left upper quadrant but is primarily in the right upper quadrant.
The liver is the breakdown for everything that comes into our system.
The function of the liver is also to produce bile

Question 21

Gallbladder

Answer 21

Functions to store bile.
Sits on top of liver.
Can be removed if it becomes problematic

Question 22

Pancreas

Answer 22

Organ of digestion (exocrine gland that secretes enzymes to go to the duodenum to start digestion), and is also an organ of the endocrine system (secretes hormones).
It has 2 types of cells alpha and beta. Alpha cells release glucagon and beta cells release insulin. Insulin will lower blood glucose sugar by taking glucose from the blood to cells. Glucagon will increase blood sugar by doing the opposite.
First sign of pancreatic cancer can be lower thoracic pain. There is no screening test for pancreatic cancer

Question 23

Large intestine

Answer 23

Function is water reabsorption.

Has 5 parts: ascending colony, transverse colon, descending colon (LLQ), S-shaped or sigmoid colon, rectum

Question 24

Appendix

Answer 24

In the RLQ right off the cecum. People who have right lower quadrant pain and rebound tenderness (when you go to push into the belly it hurts but as soon as the hands let go it hurts even more – rebound guarding) this is a sign of peritoneal inflammation, might have appendicitis and it may need to be removed. Only a 20-minute operation if you get to it before it ruptures, if you get to it after it ruptures there’s bacteria all over the place and you get very sick and you’re in the hospital for 3 or 4 days minimum

Question 25

Spleen

Answer 25

Above the duodenum and pancreas in the LUQ.

Organ of the circulatory system - produces and destroys red blood cells

Question 26

Kidneys

Answer 26

Retroperitoneal. Function to filter blood and pass urine out through the body. Kidneys are a long term regulator of blood pressure.

Question 27

Lymphatic fluid drains through the

Answer 27

Groin (inguinal lymph nodes) and the axilla (axillary lymph nodes)

Question 28

Posterior abdominal wall

Answer 28

We see the posts major, the quadratus lumborum (attaches to the 12th rib and give us hip hiking - works with opp glut med), and the femoral and obturator nerves roots L2-L4