Block 2: TBL 3 Review

Question 1

How do the normal positions of abdominal viscera arise?

Answer 1

due to a series of rotations and growth of the abdominal cavity

Question 2

What is the consequence of anomalies during abdominal rotation and growth?

Answer 2

congenital disorders

Question 3

Malrotation

Answer 3

rotation is not complete and the midgut is fixed

Question 4

f(x) of the suspensory muscles of duodenum

Answer 4

determines the position of the duodenal junction

Question 5

Where does the small bowel end?

Answer 5

ileocecal junction of the RLQ

Question 6

Volvulus

Answer 6

twisting of the bowel

Question 7

How does a volvulus happen?

Answer 7

the duodenal flexure of the cecum doesn’t end up in the right place

Question 8

What does a volvulus lead to?

Answer 8

decreased blood flow and infarction

Question 9

Mechanical Bowel Obstruction

Answer 9

caused by an intra-luminal, mutual or extrinsic mass

Question 10

Functional bowel obstruction

Answer 10

inability of the bowel to peristalse

Question 11

How does a functional bowel obstruction usually happen?

Answer 11

excessive bowel handling during surgery

Question 12

What are the signs and symptoms of a bowel obstruction?

Answer 12

central abdominal, intermittent, colicky pain

Question 13

Why is the pain associated w/ a bowel obstruction usually intermittent?

Answer 13

this is a characteristic of the peristaltic waves trying to overcome the obstruction

Question 14

When will bowel distension happen?

Answer 14

in a low bowel obstruction

Question 15

Bowel obstruction treatment

Answer 15

IV fluid replacement, relief of the obstruction

Question 16

Diverticula Disease

Answer 16

development of multiple colonic diverticula (pouches)

Question 17

Where is diverticula disease most common? Why?

Answer 17

most common in the sigmoid colon b/c it has the smallest diameter

Question 18

When does diverticula disease produce symptoms?

Answer 18

when the neck of the diverticulum is obstructed by feces and becomes infected

Question 19

Ostomy

Answer 19

surgical externalization of the bowel to the abdominal wall

Question 20

Gastrostomy

Answer 20

stomach attached to the anterior abdominal wall & tube is placed through the skin to the stomach

Question 21

F(x) of gastrostomy

Answer 21

used to feed the patient

Question 22

Jejunostomy

Answer 22

jejunum brought to the anterior surface of the abdominal wall and fixed

Question 23

F(x) of jejunostomy

Answer 23

used as the site for a feeding tube

Question 24

Ileostomy

Answer 24

small intestine (ileum portion) is connected to the abdominal wall and small bowel contents diverted from the distal bowel

Question 25

Colostomy

Answer 25

large intestine (colon) is connected to the abdominal wall

Question 26

Ileal Conduit

Answer 26

allows urine to pass from the kidneys, to the ureters, through a short segment of small bowel to the anterior abdominal wall

Question 27

For which conditions will a patient have a collecting bag fixed to the anterior abdominal wall?

Answer 27

colostomy ileostomy ileal conduit

Question 28

What are the locations of the domes of the diaphragm?

Answer 28

left dome at the 5th intercostal space, right dome at rib 5

Question 29

What is the diaphragm appearance caused by?

Answer 29

underlying abdominal contents pushing the area upward

Question 30

Psoas Muscle Abscess

Answer 30

the psoas muscles attach the lumbar vertebrae and each individual IVD if the IVD's get infected, the infection can pass into the psoas muscle and sheath, spreading within the muscle and sheath

Question 31

Where would a psoas muscle abscess be located?

Answer 31

below the inguinal ligament as a mass

Question 32

Why do diaphragmatic hernia's happen?

Answer 32

fusion of the sections of the diaphragm may fail and hernia's may occur

Question 33

2 main types of Diaphragmatic Hernias

Answer 33

Morgangi's Hernia | Bochadalek's Hernia

Question 34

Morgangi's Hernia location

Answer 34

hernia b/w the xiphoid process and the costal margin on the R side

Question 35

Bochdalek's Hernia: how does it occur?

Answer 35

pleuroperitoneal membrane doesn't close the pericardioperitoneal canal

Question 36

Which types of diaphragmatic hernias occur at birth?

Answer 36

morgangi's hernia, bochdalek's hernia

Question 37

In addition to Morgangi's & Bochdalek's, where else can diaphragmatic hernias occur?

Answer 37

they can occur through the central tendon if the esophageal hiatus is larger than normal

Question 38

Hiatus Hernia location; what's happening?

Answer 38

location: at the level of the esophageal hiatus | diaphragm may be lax, allowing the fundus of the stomach to herniate to the posterior mediastinum

Question 39

Result of Morgangi's and Bochdalek's hernias?

Answer 39

the abdominal bowel can enter the thoracic cavity

Question 40

What are the main ureter constriction points? (3)

Answer 40

1. uretopelvic junction 2. where the ureter crosses the common iliac vessels 3. where the ureters enter the wall of the bladder

Question 41

In what sex do urinary tract stones more frequently occur?

Answer 41

in men

Question 42

Urinary tract stone pain characteristics

Answer 42

pain radiates from the loin to the groin

Question 43

What is an additional symptom of urinary tract stones?

Answer 43

hematuria

Question 44

What is the most common type of kidney tumor?

Answer 44

renal cell carcinoma

Question 45

Nephrostomy

Answer 45

tube is placed through the lateral or posterior abdominal wall to reach the renal cortex

Question 46

Function of a nephrostomy

Answer 46

drainage of urine from the renal pelvis to the tube

Question 47

Kidney Transplant harvesting technique

Answer 47

donor kidney is harvested with a small cut of aortic, venous tissue & a ureter

Question 48

Ideal placement of a kidney transplant? Why?

Answer 48

ideal placement: L or R iliac fossa why: ideal b/c new space can be created w/o compromising other structures

Question 49

IVU meaning

Answer 49

intravenous urogram

Question 50

How does an IVU work

Answer 50

patient is injected with iodine contrast medium and the media is excreted by glomerular filtration, some excreted by renal tubes

Question 51

What is an ultrasound good to visualize? (in the kidneys)

Answer 51

kidney size, size of calices, urinary bladder when full

Question 52

Ultrasound is not good to visualize (in the kidneys)

Answer 52

ureters

Question 53

What is a CT good for in kidney visualization?

Answer 53

good to stage primary urinary tract tumors

Question 54

Nuclear medicine is good to visualize

Answer 54

urinary tract

Question 55

Most common sites for abscess to develop

Answer 55

pelvis | heptorenal recess

Question 56

When a patient is in the supine position, what is the lowest point in the abdominal and pelvic cavities?

Answer 56

hepatorenal recess | retro uterine pouch (pouch of Douglas; in women)