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OSPE > Abdomen > Flashcards

Abdomen Flashcards

1
Q

what organs can be found in the R upper quadrant?

A
  • right lobe of liver
  • pancreatic head
  • R kidney
  • upper part of asc colon
  • first part of transverse colon
  • gall bladder
  • right adrenal gland
  • duodenum
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2
Q

what organs can be found in the L upper quadrant?

A
  • left lobe of liver
  • left kidney
  • stomach
  • pancreatic body and tail
  • left adrenal gland
  • spleen
  • final part of transverse colon
  • upper part of descending colon
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3
Q

what organs can be found in the R lower quadrant?

A
  • appendix
  • caecum
  • right ovary and fallopian tube
  • right vas deferens
  • nerves and vessels of R testis
  • lower part of ascending colon
  • bladder (if very full)
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4
Q

what organs can be found in the L lower quadrant?

A
  • sigmoid colon
  • lower part of descending colon
  • left ovary and fallopian tube
  • nerves and vessels of left testis
  • left vas deferens
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5
Q

how do you divide the abdomen into 9 regions with horizontal lines?

A
  • subcostal plane (L3)

- Transtubercular plane (L5)

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6
Q

how do you find the transtubercular plane?

A
  • line passing through iliac tubercles

- illiac tubercles: can be palpated posteriorly to ASIS

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7
Q

what divides the abdomen into 9 regions vertically?

A

2 MCL on either side

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8
Q

what are the 3 regions on the top row?

A
  • R hypochondriac
  • epigastric
  • left hypochondriac
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9
Q

what are the 3 regions on the middle row?

A
  • R lumbar
  • umbilical
  • L lumbar
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10
Q

What are the 3 regions on the bottom row?

A
  • R inguinal
  • Suprapubic (hypogastic)
  • L inguinal
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11
Q

what is in the R hypochondriac?

A
  • SI
  • R kidney
  • gall bladder
  • hepatic flexure of colon
  • liver
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12
Q

what is in epigastric?

A
  • adrenal glands
  • spleen
  • pancreas
  • duodenum
  • stomach
  • liver
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13
Q

What is in the L hypochondriac?

A
  • pancreas
  • L kidney
  • splenic flexure of colon
  • spleen
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14
Q

What is in the R lumbar?

A
  • ascending colon
  • liver
  • gall bladder
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15
Q

What is in the umbilical region?

A
  • duodenum
  • ileum
  • jejunum
  • umbilicus
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16
Q

what is in the L Lumbar region?

A
  • descending colon

- left kidney

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17
Q

what can be found in the R inguinal region?

A
  • cecum

- appendix

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18
Q

what can be found in the suprapubic region?

A
  • female reproductive organs
  • sigmoid colon
  • urinary bladder
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19
Q

what can be found be in the L inguinal region?

A
  • descending colon

- sigmoid colon

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20
Q

what structures are present at the transpyloric plane?

A
  • pylorus of stomach
  • 1st part of duodenum
  • L1
  • origin of SMA
  • hilum of spleen
  • liver
  • fundus of gallbladder
  • neck of pancreas
  • hila of kidneys
21
Q

what acronym can be used to remember the things at the transpyloric plane?

A

Grandparents Like Paediatric Doctors Preventing Kids Sickness
G = gall bladder, L= liver, P = pylorus, D = duodenum, P = pancreas, k = kidneys, S = spleen

22
Q

where are the corners of the liver?

A

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

23
Q

where is the gall bladder located?

A

inferior border of liver

where rectus abdominis meets costal margin on 9th CC

24
Q

where is the spleen located?

A

L hypochondriac region
ribs 9-11
lateral margin = level of MAL
medial margin = lateral border of erector spinae

25
Q

what is important to remember before doing an abdo exam?

A

ask if in pain

26
Q

how do you palpate liver?

A

start at iliac crest, move up to costal margin
breathe in and out (liver is pushed down with each inhalation)
light palpation first, then deep

27
Q

how do you palpate the gall bladder?

A

palpate in diagonal direction with same technique

28
Q

how do you auscultate the abdomen?

A 
pick 2 places
would listen for 3 mins ideally but listen for 30
normal = presence of bowel sounds
abnormal = no bowel sounds heard
always tap on diaphragm before use
29
Q

how do you percuss the liver?

A

start at superior border = start at 2nd right ICS, work way down until you hear the sound change from resonant to dull
inferior border = same thing but start from R inguinal region up

30
Q

in what direction do you percuss the liver?

A

start from R inguina, region and advance towards L hypochondriac

31
Q

what could cause an enlarged spleen?

A
  • liver disease
  • infection e.g. bacterial endocarditis
  • inflammation e.g. Rheumatoid arthritis
  • sickle cell, HA
32
Q

what could R upper quadrant pain indicate?

A
  • gallbladder disease

- think gallbladder and liver

33
Q

why can gallbladder pain refer to R shoulder?

A

gallbladder inflamed –> enlarged, might push on diaphragm = irritation
sends a signal through R phrenic nerve, which arises from same place in spinal cord as supraclavicular nerve
supraclavicular nerve innervated shoulder
brain gets confused

34
Q

what are the surface landmarks of the kidneys?

A
  • 9-12cm long
  • Left slightly higher (R side has liver)
  • hilum = at transpyloric plane (L1) 4-5cm lateral to posterior midline
  • superior pole of L is at rib 10, R is half a vertebrae below
  • inferior pole of L is 4cm above supracristal plane (L4)
35
Q

how do you palpate the kidneys?

A
  • balloting
  • place one hand underneath patients flank with palm facing up, fingers in renal angle
  • other hand to palpate ant abdo wall by pressing just below costal margin
  • ask pt to take a deep breath, try and capture kidney
36
Q

where is a lumbar puncture carried out in adults/children?

A

adults - between L3/4
children - L4/5
find supracristal plane and move up 1 vertebrae

37
Q

label bony landmarks of pelvis

A

GO TO GREY’S ANATOMY FLASHCARDS

38
Q

what are the differences between male and female pelvic bones?

A
  • ilium: males more narrow, women broad
  • pelvic inlet shape: males narrower/heart shaped, females wider/oval shaped
  • pubic arch (b/ 2 inferior pubic rami): males = 70 degrees, female = 90-100
  • sacrum: males longer/narrow, females shorter/wider
39
Q

what are hernias?

A

protrusions of abdominal contents through a weak spot in muscle layer of abdo wall

40
Q

what is the difference b/ direct and indirect inguinal hernias?

A

direct: arises directly through inguinal nerve
indirect: arises through inguinal ring and through canal

41
Q

what are the 2 inguinal rings and what do they maark?

A
  • deep and superficial

- beginning and end of inguinal canal

42
Q

what is the location of the deep ring?

A

located just superiorly to inguinal ligament (midway between ASIS and pubic symphysis)

43
Q

what is the location of the superficial ring?

A

medial to deep
in medial 1/3 of distance between ASIS and pubic symphysis
superficial to inguinal ligament

44
Q

what does the inguinal canal contain?

A

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

45
Q

what is the route of semen in ejaculation?

A 
SEVEnUP
S: seminiferous tubules of testes
E: epididymis
V: vas deferens
E: ejaculatory duct
46
Q

describe the route of urine in micturition in males

A

overlaps with seminal route
urine from ureters collects in bladder
travels through urethra to penis

47
Q

describe the route of a fertilised oocyte

A

egg created in ovaries
released into fallopian tubes
fertilised by sperm if present
travels to uterus where it implants itself and remains until birth

48
Q

what is the route of micturition in females

A

doesnt overlap with any reproductive procedures
ureters transport urine into bladder
urine exits through urethra

49
Q

why are females more susceptible to UTIs?

A
  1. male urethra longer than female
    length between external bacteria and bladder short –> harder for body to fight infections
  2. opening of urethra in females is closer to anus –> easier for pathogens to travel up

OSPE (8 decks)

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