Abdominal and Renal Lab

Question 1

What are pathological causes of striae?

Answer 1

Cushings disease or syndrome secondary to high dose of steroids

Question 2

What is an incarcerated v strangulated hernia?

Answer 2

Incarcerate - can’t reduce w/o surgery

Strangulated - compromised vascular supply warranting emergency surgery

Question 3

What is diastasis recti?

Answer 3

Seperation of rectus abdominis muscle causing a midline ridge formed by abdominal contents - only seen w head above shoulder when pt is supine

Common in obesity, chronic lung disease, and repeat pregnancies (benign in these cases)

Question 4

What is the sensitivity/specificity of fluid wave, shifting dullness, and bulging flanks when evaluating ascites?

Answer 4

Fluid wave - 50%/80-90%
Shifting dullness - 83%/55%
Bulging flanks - 72%/low

Question 5

Why is the sensitivity low for fluid wave?

Answer 5

bc is volume dependent, so negative result doesn’t mean no ascites

Question 6

What is “liver flap”?

Answer 6

Asterix. flapping tremor when arms are outstretched and hand is dorsiflexed

Question 7

What is seen on an abd x-ray of small bowel obstruction?

Answer 7

air-fluid loops of bowel on upright view

Question 8

What are the sympathetics for upper GI, SI/ascending colon, Ascending/Transverse colon, and descending/sigmoid colon/rectum?

Answer 8

Upper GI: T5-T10
SI/Ascending: T9-T11
Ascending/Trans: T10-L2
Descending/sigmoid/rectum: T12-L2

Question 9

What organs does the vagus nerve (OA/AA) provide innervation for?

Answer 9

esophagus. upper GI, small intestine, ascending and transverse colon

Question 10

What organs does S2-S4 provide innervation for?

Answer 10

colon and rectum

Question 11

Where is sympathetics innervation for the GU tract and ureters located?

Answer 11

GU: T10-L2

Upper ureters: T10-L2, lower T12-L2

Question 12

PNS for kidneys, ureters, and bladder

Answer 12

kidney and upper ureter - vagus nerve

Bladder and lower ureter - S2-S4 (pelvic splanchnic)

Question 13

Chapman’s points for kidney

Answer 13

1 inch lateral, 1 inch superior to umbilicus

Question 14

Chapman’s points for bladder

Answer 14

around umbilicus

Question 15

Chapman’s points for esophagus and pylorus

Answer 15

Esophagus- 2nd ICS (intercostal space) bilaterally

Pylorus- sternal

Question 16

Chapman’s for liver, gallbladder, pancreas

Answer 16

Liver- 5th ICS on right
Gallbladder- 6th ICS on right
Pancreas- 7th ICS on right

Question 17

Chapman’s for stomach acidity, stomach, and spleen

Answer 17

Stomach acidity- 5th ICS on left
Stomach- 6th ICS on left
Spleen- 7th ICS on left

Question 18

Chapman’s for SI and appendix

Answer 18

Small intestine- 8-10 ICS bilaterally

Appendix- tip of 12th rib

Question 19

Anterior right thigh chapman’s

Answer 19

Proximal to distal- cecum,

ascending, and 1st half of transverse colon

Question 20

What chapman’s point is located on the posterolateral thigh?

Answer 20

prostate

Question 21

Anterior left thigh chapman’s points

Answer 21

Proximal to distal- rectum,
sigmoid colon, descending colon, 2nd half of
transverse colon

Question 22

Posterior chapman’s for stomach acidity, gallbladder, and spleen

Answer 22

Stomach acidity- b/w T5 & T6 on left
Gallbladder- b/w T5 & T6 bilaterally
Spleen- b/w T7 & T8 on left

Question 23

Posterior chapman’s for SI and esophagus

Answer 23

Small intestine- upper- b/w T8 & T9, middle- b/w
T9 & T10, lower- b/w T11 & T12
Esophagus- T2 bilaterally

Question 24

Posterior chapman’s for liver, pancreas, and pylorus

Answer 24

Liver- between T5 and T6 on right
Pancreas- between T7 and T8 on right
Pylorus- right T10 at costotransverse joint