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Miranda's Flash Cards > Abdominal Anatomy Powerpoint > Flashcards

Abdominal Anatomy Powerpoint Flashcards

1
Q

Aorta

A

-Largest artery in the body
-Originates at the Left Ventricle of the heart
-Positioned left of midline and anterior to the spine
-wall consists of three layers:
Tunica intima (inner most)
Tunica media (middle)
Tunica adventitia (outer most)
-function is to supply blood to the abdominal organs, pelvis, and lower extremities

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2
Q

Inferior Vena Cava (IVC)

A

-Largest vein in the body
-created by the union of the iliac veins
-enters the right atrium of the heart
-three layers:
tunica intima (inner most)
tunica media (middle, less smooth muscle than aorta)
tunica adventitia (outer most)
-marks posterior border of the caudate lobe of liver
-lies right of the abdominal aorta
-size varies with respiration
-3 hepatic veins drain into the IVC

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3
Q

Portal Venous System

A
  • main portal vein created by the union of the superior mesenteric vein and the splenic vein
  • referred to as the portal/splenic confluence
  • confluence lies in the mid abdomen and collects blood from the intestines and spleen
  • not connected directly to the IVC
  • MPV enters the liver at the porta hepatis branches into right and left portal veins
  • normal flow is toward the liver (supplies 80%) known as hepatopetal
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4
Q

Patient Prep Before Scanning

A 
OUT PATIENTS
-fat free, cream free evening meal, NOP after midnight
INPATIENTS
-NPO for 8 hours
ER
-Post Big Mac :0)
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5
Q

Liver

A
  • Largest organ in the body next to the skin
  • occupies almost all the R hypochondrium, the greater part of the epogastrium, and the L hypochondrium
  • aorta lies posterior to the L lobe of the liver
  • lies inferior to the diaphram
  • the posterior border is in contact with the R kidney and inferior vena cava
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6
Q

Sub Phrenic Space

A

-between the liver and the diaphram is a common site for abscess formation

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7
Q

Right Subhepatic space

A

-includes Morison’s Pouch, a common space for periotoneal fluid or blood to collect

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8
Q

Main Lobar Fissure

A
  • boundry between the right and left lobes of the liver
  • on a longitudinal scan, it may seem as a hyperechoic line extending from portal vein to the neck of the gallbladder
  • sonographoc landmark
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9
Q

Lobes of the Liver

A
  • Right Lobe
  • Left Lobe
  • Caudate Lobe
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10
Q

Right Lobe of Liver

A

-Largest of the three
-Contains Three Fossae:
Porta Hepatis
Gallbladder
IVC
-A congenital varient, Riedels Lobe, can sometimes be seen as an anterior porjection of the liver. Sometimes extends down to the iliac crest

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11
Q

Left Lobe of the Liver

A
  • Size varies from patient to patient
  • men seem to have small left lobes
  • can be found just under xiyphoid process
  • if larger, makes a great acoustic window for pancreas and aorta
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12
Q

Caudate Lobe

A
  • Small Lobe

- Situated inferior to the ligamentum venosum and superior to the IVC

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13
Q

Ligamentumteres

A
  • appears as a bright echogenic triangle on the transverse scan
  • separates the medial and lateral segments of the left lobe of the liver
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14
Q

Ligamentum Venosum

A

-appears as a hyperechoic line separating the left lobe from the caudate lobe of the liver

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15
Q

Vascular Supply

A
  • Portal Venous System, supplies 80% of the blood flow to the liver from digestive system
  • flow should be toward the liver (hepatopetal)
  • main portal vein (MPV) enters the liver at the portahepatis, it divides into the right (RPV) and left (LPV) portal veins
  • RPV is the largest and further divides into the anterior and posterior branches
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16
Q

Hepatic Veins

A

-Drain the blood from the liver back into the IVC
-Divided into three components
Right (RHV)
Middle (MHV)
Left (LHV)
-Can be distinguished from the portal veins by the lack of bright walls

17
Q

Hepatic Arteries

A
  • Supplies blood to the liver (About 20%)

- a branch of the celiac artery from the aorta

18
Q

Primary Functions of the Liver

A
  • Metabolism-carbohydrate and protein
  • Digestion
  • Storage
  • Detoxification
19
Q

Liver Funtions Tests (LFT’S)

A
  • AST
  • ALT
  • LDH
  • ALK phos
  • Bilirubin
  • PT
  • Albumin and globulins
20
Q

Liver Scanning

A
  • TGC should be adjusted to balance the far gain and near gain echo signals
  • over all gain should be adjusted to adequatley penetrate the entire right lobe of the liver as a smooth, homogenous echo pattern
  • Depth- posterior right libe is positioned at the lower border of the screen
  • focus- near the posterior border of the liver
  • Transducer frequency- depends on the patient body habitus
21
Q

Evaluate Liver for….

A
  • the size of the liver in longitudinal plane
  • the attenuation of the liver parenchyma
  • texture
  • presence of hepatic vascular structures, ligaments, and fissures
22
Q

Gallbladder

A
  • should be anechoic with a wall thickness less than 3mm
  • should not have any fluid between wall and liver
  • lies on the visceral surface of the liver
23
Q

Should not be there

A
  • polyps
  • gallstones
  • tumors
  • thick walls with fluid around
  • sludge
24
Q

Pancreas

A
  • Consists of the head, body, tail, uncinate process
  • most easily seen in transverse scan
  • GDA and CBD delineate the lateral border of the head
  • the spenic vein delineates the posterior border
  • sometimes can see the pancreatic duct
  • body lies inferior to left lobe of liver
25
Q

Cortex

A

-outer parenchyma of the kidney

26
Q

Hilum

A

-the midportion of the kidney where renal vessels and ureter enter and exit

27
Q

Pyramids and Calyx of the kidney

A
  • Pyramids-convey urine to the minor calyces
  • calyx-part of the collecting system that collects urine
  • may become obstructed
28
Q

Kidney Function

A
  • Excretes wastes
  • regulates the composition of the blood by removing harmful wastes and conserving water and metabolites in the body
  • Nephron- the functional unit of the kidney
29
Q

Normal texture and patterns of the kidneys

A
  • Smooth outer contours surrounded by perirenal fat
  • echogenicity is equal (isoechoic) to or hypoechoic to the liver/spleen
  • Imortant to include these organs to compare echogenicity
  • there should not be any fluid
30
Q

Kidney Lab Tests

A
  • BUN- Urea Nitrogen
  • Creatinine
  • Measures the amount of nitrogenous wastes, waste products accumulate in the blood when kidneys are not properly funtioning
31
Q

Screening the Kidneys

A
  • always bi lateral exam
  • if patient has had a nephrectomy-long and trvs image of the renal fossa looking for fluid collection
  • ideally, patients should be hydrated
  • liver and spleen should be used as an acoustic window
  • deep inspiration will allow approx a 2cm downward shift of the kidneys for better visual
  • start with right kidney longitudinal lateral- medial then transverse sup- inferior making sure to scan beyond the outer contours
32
Q

spleen

A
  • part of the reticulorendothelial system
  • synthysis of blood proteins
  • largest mass of lymphoid tissue in body
  • active in blood formation during the initial part of fetal life
  • this function decreases gradually by the 5th or 6th month when the spleen assumes it’s adult characteristics and discontinues this function
  • plays important role in the defense of the body
  • although it is affected by systemic disease process it’s rarely the cause of them
33
Q

Characteristics of Spleen

A
  • Variable in size and shape

- generally smooth borders with a convex superior and concave inferior surface

Miranda's Flash Cards (14 decks)

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