Living Anatomy Flashcards
Which abdominal organs are protected by the ribcage?
1) Kidneys
2) Liver
3) Spleen
4) Most of stomach
What is the superior margin of the abdominal wall?
The xiphoid process, along the costal margin to the 12th rib posteriorly
What is the inferior margin of the abdominal wall?
Pubic tubercle and crest, along the inguinal ligament to the ASIS
The linea alba and linea semilunaris mark the boundaries of which structure?
Rectus abdominis muscle
What Is the significance of the linea alba in surgery?
Median incision through the linea alba is a common surgical approach because It consists mostly of connective tissue and doesn’t contain any primary nerves or blood vessels
How many regions is the abdominal wall divided into during clinical examination and which lines divide it?
2 vertical and 2 horizontal lines
1) 2 vertical lines in the midclavicular lines
2) Horizontal line called the subcostal line which joins the most inferior parts of the costal margin
3) Horizontal line called the transtubercular line passes through the tubercles of the iliac crest (about 5cm posterior to the ASIS)
What are the regions of the abdomen?
1) Right hypochondrium - Epigastrium - Left hypochondrium
2) Right lumbar - Umbilical - Left lumbar
3) Right iliac - Hypogastric (suprapubic) - Left iliac
At what vertebral level does the subcostal line lie?
L3
At what vertebral level does the transtubercular line lie?
L5
Where does the transpyloric plane lie in relation to other structures?
Halfway between the manubrium and the pubis
At what vertebral level does the transpyloric plane lie and what structures does it pass through in the abdomen?
L1
1) Pylorus of stomach
2) Hila of kidneys
3) Duodenaljejunal junction
4) Neck of the pancreas
What are the 3 stages palpation is performed in?
1) Light palpation
2) Deep palpation
3) Organ specific palpation
When performing an abdominal examination what is guarding?
Reflex tensing of the abdominal muscles over the painful area
What is light palpation useful for?
Determining if there are any signs of tenderness
What is deep palpation useful for?
To locate any abnormal swellings
What is a solid mass felt in the left lumbar region during deep palpation likely to be?
Faeces in the sigmoid colon
What is tenderness at McBurney’s point during deep palpation indicate?
Appendicitis
Why is palpation of the kidneys, liver and spleen not normally possible in a healthy individual?
They are protected by the thoracic cage
What is hepatomegaly?
Enlarged liver
Where does the liver enlarge towards in hepatomegaly?
The right iliac fossa
Why should palpation of the liver be synchronised with respiration?
Position of the liver changes with respiration
Can move 4-8 cm down in midline
Can move 6-12 cm down in right midclavicular line
What is Murphy’s sign and what does it indicate?
Arrest of inspiration when 2 fingers are layered over the RUQ and the patient is asked to inspire. Pain and arrest of inspiration occurs as the gall bladder impinges on your fingers
May indicate cholecystitis
In what direction does the spleen enlarge?
Towards the right iliac fossa, crossing the abdomen diagonally
By how much must the spleen enlarge to be palpable?
3 fold - if palpable, always indicative of splenomegaly
