Blue boxes

Question 1

When the gut is traumatically penetrated or ruptured as the result of an infection, the gas, fecal matter, and bacteria enter the peritoneal cavity in which the abdomen is filled with pus, fluid, and other inflammatory immune cells and results in an infection. This is called __________ ___________

Answer 1

generalized peritonitis

Question 2

What are some of the sx that a patient with generalized peritonitis may present with?

Answer 2

Abdominal pain
Abdominal rigidity
N/V/D
fever

Question 3

________ ________ ________ is when the abdomen is drawn in when the chest expands and is typically secondary to abdominal rigidity

Answer 3

Paradoxical Abdominothoracic rhythm

Question 4

A _________ is a surgical puncture of the peritoneal cavity for the aspiration of fluid from the abdominal cavity

Answer 4

paracentesis

Question 5

________ _______ is performed in the event of renal failure. Soluble substances and excess water are removed from the system via transfer across the peritoneum with a dilute sterile solution that is introduced on one side and drained from the other, allows for the transfer of several molecules via concentration gradients

Answer 5

Peritoneal dialysis

Question 6

What are some of the functions of the greater omentum?

Answer 6

It is often called the “policeman of the abdomen”

goes to the organ that is inflamed and forms adhesions, protecting the other viscera from it

Acts as a cushion for the organs and defends against injury

Forms insulation against the loss of body heat

Question 7

In the abdomen, how are pathological fluids able to spread from one organ to another?

Answer 7

Via peritoneal recesses and the paracolic gutters

Question 8

The ______ Artery must be ligated or clamped and then severed during a cholecystectomy

Answer 8

cystic artery

Question 9

What causes esophageal varices?

Answer 9

Portal hypertension the blood is unable to pass through the liver via the hepatic portal vein which leads to a reversal of the flow in the esophageal tributary

The submucosal veins start to change secondary to the increase in blood flow causing the varices

These can rupture and cause you to choke on your blood yikes

Question 10

Esophageal varicose are common in people with _______ ________

Answer 10

alcoholic cirrhosis

Question 11

_______ or heartburn is secondary to regurgitation of food and acid into the esophagus

Answer 11

Pyrosis

Question 12

What are some reasons in which the stomach may be displaced?

Answer 12

A pancreatic pseudocyst or an abscess in the omental bursa may push the stomach anteriorly

After pancreatitis, the posterior wall of the stomach will adhere to the posterior wall of the omental bursa that covers the pancreas

Question 13

A ______ _______ is a protrusion of the part of the stomach into the mediastinum though the esophageal hiatus of the diaphragm

Answer 13

hiatal hernia

Question 14

In this type of hiatal hernia, the cardia remains in its normal position but the pouch of the peritoneum (usually with part of the fundus of the stomach) extends through the esophageal hiatus anterior to the esophagus

no regurgitation of the gastric contents

Answer 14

para-esophageal hiatal hernia

Question 15

In this type of hiatal hernia, there abdominal part of the esophagus, the cardia, and parts of the fundus of the stomach slide superiorly through the esophageal hiatus into the thorax, some regurgitation is possible

Answer 15

common sliding hiatal hernia

Question 16

When the fingers are suddenly removed, extreme localized pain is usually felt, known as ______ ________

Answer 16

rebound tenderness

Question 17

______ _______ are inflammatory erosions of the duodenal mucosa. Most occur in the posterior wall of the superior part of the duodenum within 3 cm of the ______

Answer 17

duodenal ulcers

pylorus

Question 18

In the event of a duodenal ulcer, which organs are at risk of becoming inflamed?

Answer 18

liver, gallbladder, pancreas

Question 19

What are the embryonic foregut derivatives?

Answer 19

esophagus 
stomach 
pancreas 
duodenum 
liver 
biliary ducts in the epigastric region

Question 20

What are the embryonic midgut derivatives?

Answer 20

small intestine
bile duct
cecum
appendix
ascending colon
transverse colon

Question 21

What are the hindgut derivatives

Answer 21

distal part of transverse colon
descending colon
sigmoid colon
rectum

Question 22

In the event of a normal rotation of the midgut, the duodenum passes ______ to the SMA

Answer 22

posterior

Question 23

In the event of a normal rotation of the midgut the transverse colon and mesocolon are transversely oriented, pass ______ to the SMA and divide the peritoneal cavity into supra and infracolic compartments

Answer 23

anterior

Question 24

Occlusion of the _____ ______ by emboli, thrombus, or atherosclerotic occlusion results in ischemia of part of the intestine

Answer 24

vasa recta

Question 25

_______ _______ is a remnant of the proximal part of the embryonic omphalo enteric duct, the diverticulum appears as a finger like pouch

Answer 25

Meckels (ileal) diverticulum

Question 26

List and briefly describe the treatments that are used for colitis (Crohns disease)

Answer 26

Colectomy: removal of the terminal ileum, colon, and rectum are removed Ileostomy: establishes a stroma, an artificial opening of the ileum through the anterolateral abdominal wall ( accompanied with a colostomy)

Question 27

The _____ is the most frequently injured organ in the abdomen

Answer 27

spleen

Question 28

Describe ERCP

Answer 28

A fiberoptic endoscope is passed through the mouth, esophagus, and stomach. The duodenum is entered and a cannula is inserted into the major duodenal papilla and advanced under fluoroscopic control into the duct of choice

Question 29

______ involving the pancreatic head accounts for most cases of extra hepatic obstruction of the biliary ducts

Answer 29

Cancer

Question 30

Most people with pancreatic cancer have _____ ________

Answer 30

ductular adenocarcinoma

Question 31

What is removed in a Whipple procedure?

Answer 31

part of the head of the pancreas, part of the duodenum, and the gallbladder

Question 32

______ ______ are more common on the right side because of the frequency of ruptured appendices and perforated duodenal ulcers

Answer 32

subphrenic abscess

Question 33

The most common source of an aberrant right hepatic artery is the ____

Answer 33

SMA

Question 34

Cancer cells may pass to the liver, especially from the ____ _____ because of the communications between the thoracic lymph nodes and the lymphatic vessels draining the bare area of the liver

Answer 34

right breast

Question 35

How is portal hypertension treated surgically?

Answer 35

Shunts are used( depends on the patients anatomy and scarring as to which vessels are used) to re-organize the blood flow to decreased HTN

Question 36

_______ are involuntary, spasmodic contractions of the diaphragm that results from the irritation or afferent or efferent nerve endings or medullary centers in the brainstem that control muscles of respiration

Answer 36

hiccups

Question 37

Where is pain from the diaphragm referred to?

Answer 37

shoulder region and the skin over the costal margins of the anterolateral abdominal wall

Question 38

If a patient is having pain in the posterior abdominal wall, specifically the iliopsoas muscle, what organs are you worried about because of their relationship with the iliopsoas muscle?

Answer 38

Kidneys, ureters, cecum, and appendix

Question 39

The _____ is in danger of being damaged in a hysterectomy because of its proximity to the uterine artery

Answer 39

ureter

Question 40

The ________ nerve is vulnerable during surgeries of the lateral abdominal wall and may cause painful spasms in the adductor muscles

Answer 40

obturator

Question 41

During a ______, part of the ductus deferens is ligated and excised through an incision on the superior part of the scrotum

Answer 41

vasectomy

Question 42

In benign prostate hypertrophy, the _____ lobule enlarges the most and obstructs the internal urethral orifice

Answer 42

middle

Question 43

In a hysterectomy, describe the ligation of the uterine artery

Answer 43

Performed distal to the vaginal artery and vaginal branches to enable maximal blood flow to the superior end of the vagina

Question 44

An ______ _______ is when an anesthetic block is administered with a catheter into the epidural space between the L3 and L4 vertebral level. The anesthesia bathes the spinal nerve roots, including the pain fibers from the uterine cervix and superior vagina and afferent fibers from the pudendal nerve

Answer 44

epidural block

Question 45

______ _______ is when an anesthetic agent is introduced to the dura and arachnoid mater with a needle into the subarachnoid space at L3-L4 to produce a complete anesthesia inferior the waist level

Answer 45

Spinal anesthesia

Question 46

A ______ ______ ______ provides local anesthesia over the S2-S4 dermatomes and the inferior quarter of the vagina

Answer 46

pudendal nerve block

Question 47

A ________ is the prolapse of the lower anterior vaginal wall that involves the urethra

Answer 47

urethrocele

Question 48

A _______ is the prolapse of the anterior vaginal wall involving the bladder

Answer 48

cystocele

Question 49

A ______ is the prolapse of the uterus, cervix, or upper vagina

Answer 49

uretovaginal prolapse

Question 50

A ______ is the prolapse of the lower posterior vaginal wall involving the rectum

Answer 50

rectocele

Question 51

An ______ is the prolapse of the upper posterior vaginal wall involving the rectovaginal pouch

Answer 51

enterocoele

Question 52

What are the 4 degrees of prolapse?

Answer 52

1. prolapse of the organ halfway to the hymen 2. prolapse of the organ to the hymen 3. prolapse of the organ past the hymen 4. maximum descent of the organ

Question 53

Fractures of the pelvic girdle, especially those that result from eh separation of the pubic symphysis and the puboprostatic ligaments, often cause a rupture of the _______ _______ of the ________

Answer 53

intermediate part of the urethra

Question 54

What is the common site of urethral rupture in males?

Answer 54

Rupture of the spongy urethra and extravasation of the urine in the bulb of the penis

Question 55

If a person is in a severe state of starvation, what is likely to occur and why?

Answer 55

Rectal prolapse secondary to the reserves of fat that are presence in the ischial-anal canal disappears and the rectum prolapses

Question 56

Internal hemorrhoids are associated with which blood vessels?

Answer 56

Internal rectus venous plexus

Question 57

External hemorrhoids are associate with which blood vessels?

Answer 57

External rectus venous plexus

Question 58

_________ ________ is common with stretching of the pudendal nerve

Answer 58

anorectal incontinence

Question 59

In the urethral catheterization of a male, which portion of the urethral is unprotected?

Answer 59

The intermediate part of the urethra that is unprotected; there is also an angle due to the penis

Question 60

________ is a common congenital anomaly. The external urethra orifice is on the ventral aspect of the glans penis

Answer 60

Hypospadias

Question 61

What is the embryological issue that occurred with hypospadias?

Answer 61

The urogenital folds did not close

Question 62

Define bartholinitis.

Answer 62

The inflammation of the greater vestibular bartholin glands

Question 63

To abolish the sensation from the anterior part of the peritoneum, an _________ _______ ______ is performed

Answer 63

ilii-inguinal nerve block

Question 64

________ is defined as involuntary muscle spasms that occur when vaginal penetration is attempted

Answer 64

vaginismus