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Anatomy -Sarah > Blue Boxes Exam 2 Foregut/Pancreas > Flashcards

Blue Boxes Exam 2 Foregut/Pancreas Flashcards

1
Q

True or false: Anesthetic agents may be injected into the peritoneal cavity by intraperitoneal injection.

A

True

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2
Q

Peritoneal dialysis

A

Soluble substances and excess water are removed from the system by transfer across the peritoneum using a dilute sterile solution that is introduced into the peritoneal cavity on one side and then drained from the other side. Diffusible solutes and water are transferred between the blood and the peritoneal cavity as a result of concentration gradients between the two fluid compartments.

Tenporary

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3
Q

True or false:

The greater omentum prevents the visceral peritoneum from adhering to the parietal peritoneum.

A

True

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4
Q

Abscess

A

Circumscribed collection of purulent exudate or pus

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5
Q

Pancreatic pseudo-cyst

A

An inflamed or injured pancreas can also result in the passage of pancreatic fluid into the bursa, forming a pancreatic pseudo-cyst

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6
Q

What is the clinical significance of an intestine in the omental bursa?

A

It can bcome strangulated by the edges of the foramen. None of the boundaries of the foramen can be incised because each contains blood vessels, so the intestine must be decompressed using a needle so it can be returned to the greater sac of the peritoneal cavity through the omental foramen.

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7
Q

What is important part of a cholecystectomy?

A

The cystic artery must be ligated or clamped and then severed. The artery is found in the triangle of calot (triangle of calot not in book)

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8
Q

At least one location blood flows if the hepatic portal vein is blocked

A

Through esophageal tributaries which forms esophageal varices. If these burst it is difficult to control surgically.

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9
Q

Other names for heartburn

A

Pyrosis;

Gastroesophageal reflux disorder (gerd)

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10
Q

Where would paracentesis be performed?

A

Superior to the urinary bladder, in a location that avoids the inferior epigastric artery, through the anterolateral abdominal wall into the peritoneal cavity through the linea alba

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11
Q

What is one protective mechanism of the female reproductive tract?

A

A mucous plug effectively blocks the external os (opening) of the uterus to most pathogens, but not to sperms

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12
Q

The patency of the uterine tubes can be tested using ___.

A

hysterosalpingography

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13
Q

Hysterosalpingography

A

Air or radiopaque dye is injected into the uterine cavity, from which it normally flows through the uterine tubes into the peritoneal cavity

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14
Q

laparotomy

A

incisions of the peritoneum

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15
Q

serosa

A

covering of the peritoneum

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16
Q

infection and inflammation of the peritoneum

A

peritonitis

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17
Q

excess fluid in the peritoneal cavity

A

ascitic fluid (ascites is the condition of having fluid in the peritoneal cavity)

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18
Q

Paridoxical abdominothoracic rhythm

A

The abdomen is drawn in as the chest expands, a sign that either peritonitis or pneumonitis may be present

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19
Q

When the intestine becomes twisted around an adhesion

A

volvulus

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20
Q

adhesiotomy

A

The surgical separation of adhesions.
These adhesions may form if the peritoneum is damaged, because the paritoneal surfaces become inflamed and sticky with fibrin. The fibrin may be replaced by fibrous tissue.

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21
Q

Surgical puncture of the peritoneal cavity for the aspiration or drainage of fluid

A

paracentesis

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22
Q

paracentesis

A

surgical puncture of the peritoneal cavity for the aspiration or drainage of fluid

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23
Q

Types of hiatal hernias

A

Sliding hiatal hernia - common, the 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 of stomach contents into the esophagus is possible because the clamping action of the right crus of the diaphragm on the inferior end of the esophagus is weak

Para-esophageal hiatal hernia - the cardia remains in its normal position and a pouch of peritoneum containing the fundus of the stomach (often) extends through the esophageal hiatus anterior to the esophagus.

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24
Q

Failure of the smooth muscle fibers encircling the most distal part of the stomach to relax normally

A

Pylorospasm

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25
Q

Pylorospasm

A

Failure of the smooth muscle fibers encircling the pyloric canal to relax normally

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26
Q

Congenital hypertrophic pyloric stenosis

A

A marked thickening of the smooth muscle in the pylorus.
The elongated overgrown pylorus is hard and the pyloric canal narrow, resisting gastric emptying. Proximally the stomach may become secondarily dilated because of the pyloric stenosis. Genetic factors probably involved.

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27
Q

A marked thickening of the smooth muscle in the pylorus.

The elongated overgrown pylorus is hard and the pyloric canal narrow, resisting gastric emptying.

A

Congenital hypertrophic pyloric stenosis

28
Q

What would have to be removed to ensure splenic lymph nodes were removed?

A

Spleen, gastrospelnic and splenorenal ligaments, and the body and tail of the pancreas

29
Q

Total removal of the stomach

A

Total gastrectomy

30
Q

Common gastric carcinoma location

A

Pylorus

31
Q

Lymph nodes requiring removal in carcinoma of stomach in pylorus

A

Pyloric lymph nodes and right gastro-omental lymph nodes

32
Q

Gastric ulcer

A

Open lesions of the mucosa of the stomach, mostly associated with helicobacter pylori

33
Q

Peptic ulcer

A

Lesions of the mucosa of the pyloric canal, or more often the duodenum, mostly associated with helicobacter pylori.

34
Q

Why might a vagotomy be performed?

A

To reduce the production of acid in persons with chronic or recurring ulcers

35
Q

Resection of an ulcerated area

A

Antrectomy (this is specifically for resection of the pyloric antrum)

36
Q

Antrectomy

A

Resection of ulcerated area (of the pyloric antrum)

37
Q

A meckel diverticulum is also known as an ____ and is a remnant of the ______.

A

Ileal diverticulum,

Proximal part of the omphaloenteric duct

38
Q

Different types of vagotomies

A

Truncal – surgical section of the vagal trunks
Selective gastric – stomach devervated but the vagal branches to the pylorus, liver and biliary ducts, intestines, and celiac plexus are preserved
Selective proximal vagotomy – denervates the area in which the parietal cells are located

39
Q

When a patient has a posterior gastric ulcer, what is a concern?

A

Erosion of the splenic artery that results in severe hemorrhage into the peritoneal cavity.

40
Q

True or false: Pain impulses from the stomach may persist after a complete vagotomy.

A

True. Pain impulses are carried by visceral afferent fibers that accompany sympathetic nerves. The vagal nerve is part of the parasympathetic system.

41
Q

Rebound tenderness

A

when digital pressure is applied to the anterolateral abdominal wall over the site of inflammation and suddenly removed and extreme localized pain is felt. Indicates parietal peritoneum pain (as opposed to visceral. Not that you can’t have both)

42
Q

Most common location of peptic/dudoenal ulcers

A

The posterior wall of the superior duodenum within 3 cm of the pylorous. (Hemorrhage of the gastroduodenal artery is a concern when peptic ulcers are present.)

43
Q

Know the dermatomes for referred pain.

A

Pg. 257

Some pain corresponds to location pretty well.
The gallbladder comes up the back quite a bit, as well as the stomach. The liver is a bit farther down on the back.
Pain arising from foregut derivatives – esophagus, stomach, pancreas, duodenum, liver, and biliary ducts – localizes in the epigastric region.
Pain arising from midgut derivatives – the small intestine distal to bile duct, cecum, appendix, ascending colon, and most of the transverse colon – localizes in the peri-umbilical region
Pain arising from hindgut derivatives – the distal part of the transverse colon, descending colon, sigmoid colon, and rectum – localizes in the hypogastric region
Liver, gallbladder, and duodenum may irritate diaphragm and cause pain near the right shoulder

44
Q

The liver, gallbladder, and duodenum may irritate the diaphragm and cause pain near the ___.

A

Right shoulder

45
Q

Paraduodenal hernia

A

Intestine becomes strangulated in the paraduodenal fold and/or fossa to the left of the ascending part of the duodenum (The strangulation is the problem, otherwise benign). Upon removal, care must be taken not to injure the branches of the inferior mesenteric artery.and vein or ascending branches of the left colic artery

46
Q

McBurney’s point location

A

a third of the way along the oblique line joining the right anterior superior iliac spine to the umbilicus

47
Q

volvulus

A

Twisting of the intestine

48
Q

Another word for proximal

A

orad

49
Q

Another word for distal

A

aborad

50
Q

Ischemia of intestine

A

occlusion of the vasa recta can occur (by emboli) and result in ischemia of the part of the intestine concerned. Necrosis can occur and ileus of the paralytic type can occur. Ileus is accompanied by a severe colicky pain, along with abdominal distension, vomiting, and often fever and dehydration.

51
Q

Ileus

A

obstruction of the intestine. Accompanied by severe colicky pain, along with abdominal distension, vomiting, and often fever and dehydration

52
Q

Obstruction of the intestine

A

ileus

53
Q

Ileal diverticulum

A

AKA Meckel diverticulum, congenital anomaly that occurs in 1-2% of population. A remnant of the proximal part of the embryonic omphaloenteric duct, appears as a finger-like pouch. May also include areas of gastric tissue, pancreatic tissue, or jejunal or colonic mucosa. May mimick appendicitis.

54
Q

Alternate positions of appendix

A

retrocecal = extends superiorly toward the right colic flexure and is usually free
May project inferiorly toward or across the pelvic brim

55
Q

Organs associated with a positive psoas sign

A

kidneys, ureters, cecum, appendix, sigmoid colon, pancreas, lumbar lymph nodes and nerves of the posterior abdominal wall

56
Q

In most people, the right hepatic artery crosses ___ to the hepatic portal vein.

A

anterior

57
Q

In most people, the right hepatic artery runs ___ to the common hepatic duct.

A

posterior

58
Q

Portosystemic shunts

A

Between hepatic portal vein and IVC (portocaval anastamosis or portosystemic shunt), joid kn splenic vein and left renal vein (splenorenal anastamosis or shunt)
reduces portal hypertension

59
Q

Transplanted kidneys are placed in the ____ of the greater pelvis due to the lack of ___, and also the availability of ___.

A

iliac fossa,
inferior support in the lumbar region,
major blood vessels and convenient access to the nearby bladder.

60
Q

primordium of the renal pelvis and ureter (embryonic origin)

A

ureteric bud

61
Q

rectocaval ureter

A

ureter leaves the kidney and passes posterior to the IVC

62
Q

lithotripsy

A

a technique that focuses a shockwave through the body that breaks the calculus into small fragments that pass with the urine.

63
Q

foramen of Bochdalek

A

or congenital diaphragmatic hernia; part of the stomach and intestine herniate through a large posterolateral defect in the region of the lumbocostal trigone of the diaphragm

76% mortality rate because of the consequent pulmonary hypoplasia

64
Q

Organs associated with a positive psoas sign

A

kidneys, ureters, cecum, appendix, sigmoid colon, pancreas, lumbar lymph nodes and nerves of the posterior abdominal wall

65
Q

Collateral routes of IVC

A

Superior and inferior epigastric veins; the thoraco-epigastric vain; epidural venous plexus insid ethe vertebral column —> lumbar veins —> azygous system of veins

Anatomy -Sarah (12 decks)

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