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오스피 > abdomen > Flashcards

abdomen Flashcards

1
Q

what are the lines for division into 4 quadrants?

A

midline & horizontal line through umbilicus

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2
Q

what are the planes for division into 9 regions?

A

subcostal plane L3
transtubercular plane L5

midclavicular line

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3
Q

what are the 9 regions?

A

R/L hypochondriac, epigastric
R/L lumbar, umbilical
R/L inguinal, suprapubic

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4
Q

what structures are at transpyloric plane? (9)

A 
L1
pylorus stomach
1st part of duodenum
neck of pancreas
liver
hilum of spleen
hilum of kidneys
fundus of gallbladder
origin of superior mesenteric artery
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5
Q

describe surface anatomy of liver

A

right corner: 5th rib on MCL
left corner: 5th ICS on MCL
right lower corner: costal margin at MAL

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6
Q

how do you palpate liver?

A 
use right hand medial border
start from right inguinal region
ask patient to breathe in and press against abdominal wall
move up 2cm and repeat
until right costal margin
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7
Q

how do you percuss liver?

A

upper border: start from 2nd ICS & move downwards - sound from resonant to dull

lower border: start from right inguinal region & move up

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8
Q

describe surface anatomy of gallbladder

A

costal margin on 9th CC

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9
Q

describe surface anatomy of spleen

A

span from rib 9 to 11
medial border: lateral border of erector spinal
lateral border: MAL

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10
Q

how do you palpate and percuss spleen?

A

medial border of right hand
start from right inguinal region
move obliquely/diagonally
to left hypochondriac region

percussion - only assess lower border

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11
Q

what might you hear in auscultation of spleen?

A

friction rub

- on left hypochondriac region

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12
Q

where do you get initial pain from gallbladder?

A

costal margin on 9th CC

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13
Q

where do you get referred pain from gallbladder - explain why?

A

right shoulder

gallbladder inflamed -> enlarged -> press against diaphragm -> right phrenic nerve root from the same place as supraclavicular nerve (C3,4) which innervates shoulder -> stimulated supraclavidular nerve -> brain confuses the location of pain

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14
Q

describe the surface anatomy of kidneys

A

9-12cm
right kidney half a vertebra lower

left kidney: hilum at transpyloric plane (L1), 4/5cm lateral to midline
upper border - 12th rib
lower border - 3/4cm above supracristal plane (L4)
ureter vertically down from hilum to iliac fossa

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15
Q

how do you palpate kidneys?

A

“balloting”
right hand behind - fingers in renal angle
left hand to anterior surface, upper quadrant
press down just below costal margin with bouncing motion + deep breath in

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16
Q

where do you do a lumbar puncture?

A

L3/4 in adults - locate supracristal plane (L4) and move 1 intervertebral disc up
patient sitting at the edge leaning forward with chin flexed towards the chest

L4/5 in children

17
Q

how do male and female pelvic bone differ? (4)

A

ilium - male narrower
pelvic inlet - male heart-shaped and wider
- female oval-shaped and narrower
pubic angle - male acute 70’
- female obtuse 90-100’
sacrum - male longer and narrower

18
Q

where does direct and indirect hernias arise?

A

direct - through inguinal wall

indirect - through inguinal ring and canal

19
Q

where are the two inguinal rings located?

A

deep ring: just superiorly to inguinal ligament
midway between ASIS and pubic symphysis
superficial ring: superficial to inguinal ligament
medial third between ASIS and pubic symphysis

20
Q

what structures are within inguinal canal?

A

ilio-inguinal nerve
genital branch of genitofemoral nerve
spermatic cord in male
round ligament of uterus in female

21
Q

describe route of semen in ejaculation

A 
seminiferous tubule of testes
epididymis
vas deferens
spermatic cord
ejaculatory duct-prostate
                                  seminal vesicle
urethra
penis
22
Q

what are the differences in route of urine between male and female?

A

female urine route does not overlap with reproductive procedures

23
Q

how does urethra differ between male and female?

A

male urethra longer

means that females are more prone to acquiring urinary tract infections

  - shorter distance from external environment to fight bacteria
  - urethra opening closer to anus

오스피 (6 decks)

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