Case 10 SBA Flashcards
Vertical quadrant line
midline from xiphoid process to pubic symphysis
Horizontal quadrant line
through the umbilicus
RUQ contents
right lobe of the liver, gallbladder, pylorus of the stomach, first 3 parts of the duodenum, head of the pancreas, right kidney and adrenal gland, distal ascending colon, hepatic flexure of colon, and right half of the transverse colon
LUQ contents
left lobe of the liver, spleen, stomach, jejunum, proximal ileum, body and tail of the pancreas, left kidney and adrenal gland, left half of the transverse colon, splenic flexure of the colon, superior part of the descending colon
RLQ contents
majority of the ileum, caecum, vermiform appendix, proximal ascending colon, right ureter, part of the bladder, uterus, ovary and uterine tube (female) or ductus deferens (male).
LLQ contents
distal descending colon, sigmoid colon, left ureter, part of the bladder, uterus, ovary and uterine tube (female) or ductus deferens (male)
Vertical division lines
two lines between the midclavicular and mid-inguinal point on each side
Superior horizontal line
subcostal or transpyloric plane (L1)
Inferior horizontal line
line between tubercles of the iliac crest on each side (intertubercular plane)
Right hypochondrium
top right. Liver, gallbladder, small intestine, ascending colon, transverse colon, right kidney.
Epigastric region
top middle. Oesophagus, stomach, liver, spleen, pancreas, small intestine, transverse colon, parts of the left and right kidney, adrenal glands and ureters.
Left hypochondrium
top left. Stomach, part of the left lobe of the liver, left kidney, spleen, tail of the pancreas, parts of the small intestine, transverse colon, descending colon
Right flank/lumbar
middle right. Part of the liver, gallbladder, small intestine, ascending colon, right kidney.
Umbilical region
middle middle. Stomach, pancreas, small intestine, transverse colon, parts of the kidneys and ureters, cisterna chyli.
Left flank/lumbar
middle left. Small intestine, part of the descending colon, part of the left kidney.
Right iliac fossa/groin
bottom right. Small intestine, appendix, caecum, ascending colon, right ovary and uterine tube (female), ductus deferens (male).
Hypogastric/suprapubic
bottom middle. Small intestine, sigmoid colon, rectum, urinary bladder, right and left ureters, uterus (female), ovaries and uterine tubes (female), ductus deferens, seminal vesicle and prostate (male).
Left iliac fossa/groin
bottom left. Small intestine, descending colon, sigmoid colon, left ovary and uterine tube (female), ductus deferens (male).
What are gallstones made of?
Components of bile
What three ways can gallstones be formed?
cholesterol supersaturation, mucin acting as a nidus for crystal formation, or changes in gallbladder motility
Cholesterol stones
white stones made from cholesterol, 60-80% of gallstones, 10-15% of UK adults will have them at some point in their lives. Occur as solitary stones, in pairs, or as multiple mulberry stones. Associated with high cholesterol, pregnancy, diabetes, and the oral contraceptive pill.
Pigment stones
small, black, irregular, multiple, gritty, and fragile. Associated with increase haemolysis. Results in increased unconjugated bilirubin in circulation and in bile β in bile it complexes with calcium and gives calcium bilirubinate precipitates