Anatomy??

Question 0

What are the nine regions of the abdomen called?

Answer 0

Right and left hypochondriac regions
Right and left lumbar regions
Right and left iliac regions
Epigastric region
Umbilical region
Hypogastric region

Question 1

What divides the abdomen into 9 regions? (Surface anatomy)

Answer 1

Mid clavicular lines

Subcostal and transtubecular lines

Question 2

What divides the abdominal cavity into supracolic and infracolic compartments?

Answer 2

The transverse mesocolon

Question 3

What is contained in the supracolic compartment?

Answer 3

Stomach
Liver
Spleen

Question 4

What is in the infracolic compartment?

Answer 4

Small intestine

Ascending and descending colon

Question 5

What allows communication between the supracolic compartments and infracolic compartments?

Answer 5

Paracolic gutters

-grooves between lateral aspect of ascending and descending colon and the posterolateral abdominal wall

Question 6

What is the greater sac/omental bursa made up of?

Answer 6

Supracolic and infracolic compartments

Question 7

Where does the lesser sac lie?

Answer 7

Posterior to the stomach and lesser omentum

Question 8

How do the lesser and greater sacs communicate?

Answer 8

Through the omental/epiploic foramen

Question 9

What causes the right sub phrenic space to be bigger than usual?

Answer 9

Absence of the spleen

Question 10

Where is the right sub phrenic space?

Answer 10

Between the diaphragm, left lobe of liver, stomach and spleen

Question 11

Clinical significance of right sub phrenic space?

Answer 11

Common site for fluid collection, especially after a splenectomy.

Question 12

What separates the sub phrenic spaces into left and right?

Answer 12

The falciform ligament of the liver

Question 13

What is the retrovesical pouch?

Answer 13

A double folding of peritoneum between the rectum and the bladder seen in males.

Question 14

What are the two peritoneal ‘pouches’ in women? Where are they seen?

Answer 14

Retrouterine pouch - double folded extension of peritoneum between the rectum and posterior wall of the uterus

Vesicouterine pouch - double fold of peritoneum between the anterior surface of the uterus and the bladder

Question 15

Why are females more susceptible to peritonitis?

Answer 15

Abdominal ostia of uterine tubes open into the peritoneal cavity - potential pathway between the female genial tract and the peritoneum

Infections of vagina, uterus and uterine tubes may result in infection and inflammation of the peritoneum

Question 16

What prevents spread of infection through the abdominal ostia into the peritoneum?

Answer 16

Mucous plug in the external os (opening) of the uterus - prevents passage of pathogens, sperm can still enter the uterus

Question 17

What is paracentesis?

Answer 17

Procedure used to drain fluid from the peritoneal cavity

-needle inserted through the abdominal wall into the peritoneal cavity

Question 18

What structures do you need to be careful of in a paracentesis?

Answer 18

Needs to be done above the urinary bladder

Avoid the inferior epigastric artery

Question 19

Why would you do a paracentesis?

Answer 19

Drain ascitic fluid, diagnose cause of ascites, check for certain cancers which may metastasise via the peritoneum eg liver cancer

Question 20

What is ascites?

Answer 20

Accumulation of excess fluid in the peritoneal cavity

Question 21

Common causes of ascites?

Answer 21

Portal hypertension secondary to cirrhosis
Infection and peritonitis
Malignancy of the GI tract
Malnutrition
Mechanical injuries causing internal bleeding

Question 22

What is peritonitis?

Answer 22

Infection and inflammation of the peritoneum

Question 23

What can cause peritonitis?

Answer 23

Bacterial contamination as a result of a laparotomy
Secondary to infection elsewhere in the GI tract eg burst appendix, acute pancreatitis, gastric ulcer eroding through wall of stomach

Question 24

Symptoms of peritonitis?

Answer 24

Pain and tenderness of the overlying skin
Anterolateral muscles contract to protect the viscera (guarding)
Fever
Nausea
Vomiting
Constipation

Question 25

What is between the two layers of peritoneum of the mesentery of the small intestine?

Answer 25

Blood vessels
Lymph vessels
Nerves

Question 26

Which wall is the small intestine connected to?

Answer 26

Posterior wall of the abdominal cavity