Ch. 17 The Peritoneal Cavity and Abdominal Wall Flashcards
Loops of the digestive tract are anchored to the posterior wall of the abdominal cavity by this large double fold of peritoneal tissue
Mesentery
Space anterior to the right kidney and posterior to the inferior border of the liver where ascites of fluid may accumulate or an abscess may develop
Morison’s pouch
Pouchlike extension of the visceral peritoneum from the lower edge of the stomach, part of the duodenum, and the transverse colon
Omentum
Inferior of the liver
Subhepatic
Below the diaphragm
Subphrenic
Localized collection of pus
Abscess
Accumulation of serous fluid in the peritoneal cavity
Ascites
Most dependent areas inthe flanks of the abdomen and pelvis where fluid collection may accumulate
Gutters
Collection of blood
Hemorrhage
Increase in the number of leukocytes (white blood cells)
Leukocytosis
Inflammation of the peritoneum
Peritonitis
Pus producing
Pyogenic
Sonographic sign that you see when a vessel or organ is surrounded by a tumor on either side
Sandwich sign
Spread of an infection from its initial site to the bloodstream
Sepsis
Infection in the blood
Septicemia
Cyst containing urine
Urinoma
Because of the ________ ligament attachments, collections in the right posterior subphrenic space cannot extend between the bare area of the liver and the diaphragm
Coronary
The pleural fluid tends to distribute ________ in the chest
Posteromedially
Subcapsular liver and splenic collection are seen when they are _________ to the diaphragm unilaterally and conform to the shape of an organ capsule
Inferior
A mass is confirmed to be within the retroperitoneal cavity when anterior renal displacement or anterior displacement of the dilated ________ can be documented
Ureters
The mass interposed ____________ or superiorly to the kidneys can be located either intraperitoneally or retroperitoneally
Anteriorly
Fatty and collagenous connective tissues in the perirenal or anterior pararenal space produce echoes that are best demonstrated on _________ scans
Sagittal
Retroperitoneal lesions displace echoes _________ and cranially
Ventrally
Hepatic and subhepatic lesions produce _____________ and posterior displacement
Inferior
A large, right-sided retroperitoneal mass rotates the intrahepatic portal veins to the _______
Left
The peritoneal cavity is made up of multiple peritoneal ligaments and folds that connect the _________ to each other and to the abdominopelvic __________
Viscera, walls
Within the cavity are found the lesser and greater _________, the ___________, and multiple fluid spaces (lesser sac, perihepatic and subphrenic spaces)
Omentum, mesenteries
The _________ is a smooth membrane that lines the entire abdominal cavity and is reflected over the contained organs
Peritoneum
The part that lines the walls of the cavity is the ___________ peritoneum, whereas the part covering the abdominal organs to a greater or lesser extent is the ___________ peritoneum
Parietal, visceral
The general peritoneal cavity is known as the _________ sac of the peritoneum
Greater
With the development of the stomach and the spleen, a smaller sac, called the __________ sac (omental bursa), is the peritoneal recess posterior to the stomach.
Lesser
This sac communicates with the greater sac through a small vertical opening known as the ___________ foramen
Epiploic
When the patient is lying supine, the lowest part of the body is the __________
Pelvis
A double layer of peritoneum extending from the liver to the lesser curvature of the stomach is known as the __________ omentum
Lesser
The _________ omentum is an apron-like fold of peritoneum that hangs from the greater curvature of the stomach
Greater
Ligaments on the right side of the liver from the _________ and ___________ spaces
Subphrenic,and subhepatic
The ______________ hepatis ascends from the umbilicus to the umbilical notch of the liver within the free margin of the falciform ligament before coursing within the liver
Ligamentum teres
The paired _________ abdominis muscles are delineated medially in the midline of the body by the linea alba
Rectus
The amount of intraperitoneal fluid depends on the ________, ___________, and patient ___________
Location, volume and position
The ascitic fluid first fill the _____________ then the lateral paravesical recesses before is ascends to both paracolic gutters
Pouch of Douglas
The small bowel loops __________ or ___________ in the surrounding ascitic fluid, depending of relative gas content and amount of fat in the mesentery
Floats or sinks
Inflammatory or malignant ascites appears with ____________ echoes; loculation ; unusual distribution, matting, or clumping of the bowel loops; and thickening of interfaces between the fluid and neighboring structures
Fine or coarse internal
A cavity formed by necrosis within a solid tissue or a circumscribed collection of purulent material is a
Abscess
Name the five major pathways through which bacteria can enter the liver and cause abscess formation
- Through the portal system
- By way of ascending cholangitis of the common bile ducts
- Via the hepatic artery secondary to bacteremia
- By direct extension from an infection
- By implantation of bacteria after trauma to the abdominal wall
Extrahepatic loculated collections of bile that may develop because of iatrogenic, traumatic, or spontaneous rupture of the biliary tree are _____________
Lipomas
As abscess that forms within the renal parenchyma is a ___________ . Clinical symptoms vary from none to fever, leukocytosis, and flank pain
Renal carbuncle
The most common abdominal pathologic process is _____________ which requires immediate surgery
Acute appendicitis
A mass or lesion within the mesentery and omentum may have solid or cystic characteristics, whereas a mass within the peritoneum may show a __________ pattern
Infiltrative
Mesenteric and omental cysts may be uniloculated or _____________ with smooth walls and thin internal septations
Multiloculated
An incomplete regression of the urachus during development is an ________ cyst
Urachal
An encapsulated collection of urine, or ____________ may result from a closed renal injury, from surgical intervention, or it may arise spontaneously secondary to an obstructing lesion
Urinoma
The most common primary sites of peritoneal metastases are the _________, __________, and ________
Ovaries, stomach and colon
The __________ sign of lymphoma represents a mass infiltrating the mesenteric leaves and encasing the superior mesenteric artery
Sandwich
A key factor in determining if an abdominal wall mass is present is the _____________ of the rectus sheath muscles
Symmetry
A collection of fluid that occurs after surgery in the pelvis, retroperitoneum , or recess cavities is known as a __________
Lymphocele
Extraperitoneal rectus sheath ___________ are acute or chronic collections of blood lying either within the rectus muscle or between the muscle and its sheath
Hematomas
An abdominal ____________ is the protusion of a peritoneal-lined sac through a defect in the weakened abdominal wall
Hernia
A variant of the ventral hernia that is found more laterally in the abdominal wall is a _______ hernia
Spigelian
List the four sonographic criteria for a hernia
- Demonstration of an abdominal wall defect
- Presence of bowel loops or mesenteric fat within a lesion
- Exaggeration of the lesion with strain (valsalva)
- Reducibility of the lesion by gentle pressure
