Accumulation of serous fluid in the peritoneal cavity Appears echo-free, indented, and shaped by surrounding organs

Abdomen wall Flashcards by Amberley Rivadeneira

What does Gross Anatomy study?

Studies the body by dissection

Gross Anatomy focuses on the structure of the body as a whole, often through hands-on examination.

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What is the focus of Histology?

Studies tissues under the microscope

Histology involves examining the cellular structure and organization of tissues.

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What does Embryology study?

Studies development before birth

Embryology explores the formation and development of embryos from fertilization to birth.

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What is the primary focus of Pathology?

Studies disease processes

Pathology investigates the causes, development, and effects of diseases on the body.

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Define Pathophysiology.

How normal body processes are altered by disease

Pathophysiology links the basic anatomy and physiology of the body to the study of disease.

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What is a Urinoma?

Encapsulated collection of urine from renal trauma or surgery, may arise spontaneously from obstruction

Commonly associated with renal transplantation and posterior urethral valve obstruction in males.

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What conditions are Urinomas commonly associated with?

Renal transplantation
Posterior urethral valve obstruction (males)

These conditions increase the risk of developing Urinomas.

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How do Urinomas appear sonographically?

Sonographically similar to lymphoceles (anechoic)

This similarity can complicate diagnosis.

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Which type of fluid collection increases in size the quickest?

Urinomas

They can enlarge rapidly compared to other fluid collections.

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What is the term for physical and chemical changes within the body?

Metabolism

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What must be stable to maintain the life of the organism?

Water, food, oxygen, heat, and pressure

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Define homeostasis.

Ability to maintain a steady and stable internal environment

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What disrupts homeostasis?

Stressors

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What are vital signs?

Medical measurements to determine how the body is functioning

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List the vital signs.

Temperature
Blood pressure
Pulse
Respirations

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What are vital signs a result of?

Metabolic activity

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What indicates the absence of metabolic activity?

Death is the absence of vital signs

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What types of lesions can be found within the superficial abdominal wall?

Inflammatory lesions
Hematomas
Neoplasms
Hernias
Postsurgical lesions

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What is a key factor in determining whether an abdominal wall mass is present?

Symmetry of the rectus sheath muscles

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What is a lymphocele?

A cyst that contains lymph, usually due to leakage from surgical disruption of lymphatic channels

Common complication of renal transplantation, gynecological, vascular, or urological surgery

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What are the characteristics of a lipoma?

Echogenic, propagation speed artifact, commonly superficial, palpable, soft, mobile

Can be small or large anywhere on the body

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What is a seroma?

Collection of serum in tissue resulting from a surgical incision or liquefaction of a hematoma

Common after mastectomy

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Define hernia.

Protrusion of peritoneal-lined sac through a defect in the weakened abdominal wall

Types include inguinal, umbilical, hiatal, femoral, and epigastric

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What are the most common areas of weakness for hernias?

Umbilical area and the femoral and inguinal rings

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What is the peritoneal cavity?

The potential space between the parietal and visceral peritoneum ## Footnote May become distended with fluid, leading to ascites

What is ascites?

Accumulation of serous fluid in the peritoneal cavity ## Footnote Appears echo-free, indented, and shaped by surrounding organs

Where is fluid typically first seen in the abdomen during ultrasound?

Morrison’s pouch

In the pelvis, where is fluid typically first seen during ultrasound?

Pouch of Douglas, then right paracolic gutter

What can mask small amounts of fluid in the abdomen?

Overdistended bladder

What features suggest inflammatory or malignant ascites on ultrasound?

Echoes, loculations, matting, clumping of bowel loops, thickening of interfaces ## Footnote These features may not be immediately visible

What happens to the bowel in strangulation?

Blood supply is interrupted; bowel can become necrotic

Fill in the blank: The space between the parietal and visceral peritoneum may become distended into an actual space containing several liters of _______.

fluid

What is the appearance of ascites on ultrasound affected by?

Pressure, patient position, rapidity of accumulation, adhesions, density of fluid, degree of bladder fullness

What is Pseudomyxoma peritonei (PMP)?

A rare condition of filling of peritoneal cavity with mucinous material and gelatinous ascites

What causes Pseudomyxoma peritonei?

Occurs due to a cystic ovarian mass

What are the characteristics of ascites in Pseudomyxoma peritonei?

Appears simple or multiloculated

When is Pseudomyxoma peritonei considered borderline malignant?

If rupture of benign process occurs from ovarian or appendiceal adenoma

What is a common source of Pseudomyxoma peritonei?

Rupture of a mucinous cystadenocarcinoma of the ovary, appendix, or other sources

What are adhesions in the context of Pseudomyxoma peritonei?

Present, causing matting of mesentery and bowel posteriorly

What are the most common causes of Pseudomyxoma peritonei?

Ovarian and appendiceal origin

What is the greater sac in the peritoneum?

Contains many organs

What is the lesser sac in the peritoneum?

Contains no organs

What are the most common primaries for peritoneal metastases?

* Ovaries * Stomach * Colon

What is the sandwich sign in peritoneal metastases?

Refers to a specific imaging finding associated with tumors

What is the most common cause of cholangitis in the United States?

Ascending cholangitis of the common bile duct

What are the five pathways through which bacteria can enter the liver and cause abscess formation?

* Through the portal system * By way of ascending cholangitis of the common bile duct * Via the hepatic artery secondary to bacteremia * By direct extension from an infection * By implantation of bacteria after trauma to the abdominal wall

What is an abscess?

Cavity formed by necrosis in solid tissue or circumscribed collection of purulent material

What are common clinical signs of an abscess?

* Fever * Chills * Weakness * Malaise * Pain * Heat * Redness * Swelling at site

What laboratory findings are associated with an abscess?

* Normal LFT’s * ↑ WBC * Sepsis * (+) bacterial cultures (superficial)

What is the ultrasound appearance of an abscess?

Variable depending on time; predominantly fluid-filled with irregular borders; complex with debris; solid-appearing

What is a urachal cyst?

Cystic mass between umbilicus and bladder due to incomplete regression of urachus

What types of cysts can occur in the peritoneum?

* Embryological * Traumatic or acquired * Neoplastic * Infective and degenerative * Peritoneal inclusion cyst

What can be a result of asbestos exposure?

Mesothelioma

What is a gas-containing abscess characterized by?

Varying echo pattern with dirty shadowing and some through transmission ## Footnote May be difficult to determine

What is peritonitis?

Inflammation of the lining of the abdominal wall ## Footnote May be generalized or localized

How can a subphrenic abscess be distinguished from ascites?

Look at margins and other fluid collections in the abdomen or pelvis

What is a renal carbuncle?

An abscess within the renal parenchyma

What is a perinephric abscess?

Usually from a perforated renal abscess that leaks into adjacent tissues

What is the most common abdominal pathologic process that requires immediate surgery?

Acute appendicitis

What are the typical symptoms of acute appendicitis?

Fever, severe pain at McBurney’s point, ↑ WBC’s

What are some differential diagnoses for acute appendicitis?

PID, ovarian cyst, gastroenteritis

What percentage of general abdominal abscesses appear after surgery or trauma?

85%

Where are the most common locations for general abdominal abscesses?

Hepatic recesses and perihepatic spaces, also pelvis

What is a hematoma?

Collection of blood due to surgical injury or trauma

What changes in blood parameters might indicate a hematoma?

↓ hct and RBC’s; shock (NL hct= 40-50%)

What does the sonographic appearance of a hematoma depend on?

Age of the collection

What is a biloma?

Collection of bile within the peritoneal cavity outside of the biliary tract

What are some common causes of a biloma?

* Liver transplant due to biliary leak * Trauma * Biopsy * Cholecystectomy

What is a urinoma?

Encapsulated collection of urine from renal trauma or surgery

What conditions are commonly associated with urinomas?

* Renal transplantation * Posterior urethral valve obstruction (males)

How does the sonographic appearance of a urinoma compare to lymphoceles?

Sonographically similar (anechoic)

Which type of fluid collection increases in size the quickest?

Urinomas

What are the three retroperitoneal spaces?

* Anterior pararenal * Posterior pararenal * Perirenal (enclosed by renal fascia)

How is a mass confirmed to be in the retroperitoneal cavity?

By documenting anterior renal displacement or anterior displacement of the dilated ureters

What can indicate that a mass is located either intraperitoneally or retroperitoneally?

Mass interposed anteriorly or superiorly to the kidneys