LRA-214 Chapter 3 Abdomen Flashcards
what are the clinical indications for an acute abdominal series?
- bowel obstruction
- free intraperitoneal air (air outside digestive tract)
- ascites (fluid in the abdomen/peritoneal cavity)
- intra-abdominal mass
why is an acute series taken with multiple positions?
taken in different positions to demonstrate air-fluid levels, free air, or both within the abdominal cavity
what are the most important organs in the abdominal cavity/radiography?
- right and left hemi-diaphragms
- right and left, minor and major psoas muscle
where is the right hemidiaphragm located?
attached anteriorly to the fifth rib and posteriorly at the level of the tenth rib
where is the left hemidiaphragm located?
located near the first intercostal space.
where are the psoas muscles located?
located laterally to the lumbar vertebrae.
what organ is an umbrella shaped muscle that separates the abdominal cavity from the thoracic cavity?
diaphragm
when imaging, should the diaphragm be mobile or motionless?
motionless. can be done with proper breathing instructions
what muscles must be laterally to the lumbar spine to indicate a proper exposure technique has been used?
two psoas major and minor muscles
what are the main organs of the digestive system?
- oral cavity
- pharynx
- esophagus
- stomach
- small intestine
- large intestine
what are the accessory organs of the digestive system?
- liver
- gallbladder
- pancreas
what system fills much of the abdominal cavity?
digestive system
what two organs/structures are common in both the respiratory and digestive system?
- oral cavity
- pharynx (oropharynx and laryngopharynx)
what structure is located in the mediastinum of the thoracic cavity?
esophagus
what are the three digestive organs within the abdominal cavity?
- stomach
- small intestine
- large intestine
what is the first organ of the digestive system that is located entirely within the abdominal cavity?
stomach
what organ is an expandable reservoir for swallowed food and drinks?
stomach
gastro- means-
stomach
what system involves the entire digestive system, starting with the stomach and continuing through the small and large intestine?
gastrointestinal tract (GI)
what are the three parts of the small intestine?
- duodenum
- jejunum
- ileum
what portion of the small intestine is the smallest, but the widest?
duodenum
the proximal portion of the duodenum is the-
duodenal bulb/cap
true or false: Ducts from the liver, gallbladder, and pancreas drain into the duodenum to aid in digestive functions.
true
what is the orifice (valve) between the distal ileum and the cecum portion of the large intestine
ileocecal valve
the sixth and last organ of the digestive system is the -
large intestine
what organ begins in the lower right quadrant at the junction of the small intestine and the ileocecal valve?
large intestine
The portion of the large intestine below the ileocecal valve is a saclike portion named the-
cecum
what attached posteromedial to the cecum?
appendix/ vermiform appendix
what portion of the large intestine is part of the right colic flexure?
- ascending and transverse colon
- right colic is the point where they meet, where it bends (corner)
what portion of the large intestine is part of the left colic flexure?
transverse and descending colon
what are the alternative names for the right and left colic flexure?
- hepatic flexure (right)
- splenic flexure (left)
what comes after the descending colon?
sigmoid colon
what is the shape of the sigmoid colon?
s-shaped
what is the last 6 inches in the large intestine?
rectum, ending with the anus
what body habitus has the transverse colon located at a higher area in the abdomen?
hypersthenic
what body habitus has the transverse colon located at a lower area in the abdomen?
hyposthenic and asthenic
what body systems is the spleen a part of?
lymphatic and circulatory system
what quadrant does the spleen take up?
- left upper quadrant
- posterior to the left of the stomach
what’s the purpose of the accessory organs in the digestive system?
outside the digestive tract but aid in digestion via the materials they secrete into the digestive tract.
the _____ is an elongated gland that is located posterior to the stomach and near the posterior abdominal wall, between the duodenum and the spleen.
pancreas
the relationship of the duodenum and the head of the pancreas sometimes is referred to as-
the romance of the abdomen
true or false: the pancreas is part of the endocrine (internal) and exocrine (external) secretion system
true
The ______ portion of the pancreas produces essential hormones, such as insulin, which aids in controlling the blood sugar level of the body.
endocrine
The _____ portion of the pancreas produces large amounts (1½ quarts [1500 mL] daily) of digestive juices that move to the duodenum, through a main pancreatic duct, as needed for digestion.
exocrine
what is the largest solid organ of the body?
liver
what organ takes up majority of the right upper quadrant of the abdomen?
liver
what is the function of the liver?
production of bile that assists in the emulsification (breakdown) of fats.
what organ is a pear-shaped sac located posterior and inferior to the liver.
gallbladder
what does the gallbladder do with the bile if fat emulsification is not needed in the liver?
it is stored and concentrated for future use
how does the gallbladder release bile?
contracts and releases the stored bile when stimulated by an appropriate hormone (cholecystokinin)
_______ is the presence of one or more calculi (gallstones) in the gallbladder
cholelithiasis
what are gallstones composed of?
cholesterol, or pigment made of bile salts, phosphate and carbonate
what type of gallstone is more common in the US?
cholesterol-based
what type of gallstone is more common in Asia?
pigment-based
are the majority of gallstones radiolucent or radioopaque?
radiolucent
what alternative imaging modality detect the presence and location of radiolucent gallstones?
diagnostic ultrasound
what are the organs of the urinary system?
- two kidneys
- two ureters
- one urinary bladder
- one urethra
true or false: Each kidney drains via its own ureter to the single urinary bladder
true
what is the function of the urinary bladder?
stores urine
Under voluntary control, the stored urine passes to the exterior environment via the ____
urethra
where are the suprarenal/adrenal glands located?
superomedial portion of each kidney
where are the kidneys located?
located on either side of the lumbar spine
why is the right kidney lower than the left kidney?
the presence of the liver on the right side
how are waste materials and excess water eliminated in the body?
through blood by the kidneys and are transported through the ureters to the urinary bladder
what are the terms that describe the abdominal cavity?
- peritoneum
- mesentery
- omentum
- mesocolon
___ is a large serous, double walled, sac-like membrane
peritoneum
what are the 2 types of peritoneum?
parietal and visceral
____ peritoneum is a two layered peritoneum that adheres to the abdominal cavity wall
parietal
_____ peritoneum is a portion that covers an organ
visceral
______ is the space or cavity between the parietal and visceral portions of the peritoneum
peritoneal cavity
what fluid does the peritoneum contain in order to allow organs to move against each other without friction?
serous lubricating-type fluid
what pathology is the abnormal accumulation of serous fluid in the abdomen?
ascites
a layer of ______ peritoneum only ______ covers certain organs that are more closely attached to the posterior abdominal wall
visceral ; partially
what structures are partially covered by the visceral peritoneum?
- ascending colon
- descending colon
- aorta
- inferior vena cava
define mesentery
- a double fold that holds the small intestine in place
- double fold of peritoneum that extends anteriorly from the posterior abdominal wall to completely envelop a loop of small bowel.
- double fold of peritoneum that loosely connects the small intestine to the posterior abdominal wall
_______ refers to a specific type of double-fold peritoneum that extends from the stomach to another organ
omentum
what are the two types of omentum?
- greater omentum
- lesser omentum
The _______ extends superiorly from the lesser curvature of the stomach to portions of the liver
lesser omentum
the ________ connects the transverse colon to the greater curvature of the stomach inferiorly. It drapes over the small bowel, then folds back on itself to form an apron along the anterior abdominal wall.
greater omentum
Varying amounts of fat are deposited in the greater omentum, which serves as a layer of insulation between the abdominal cavity and the exterior. This is sometimes called the _______
fatty apron
The peritoneum that attaches the colon to the posterior abdominal wall is the
mesocolon
what does the prefix messo- mean?
refer to mesentery-type folds from which other abdominal organs are suspended.
what are the four types of mesocolon?
- ascending mesocolon
- transverse mesocolon
- descending mesocolon
- sigmoid/pelvic mesocolon
what is another name of the peritoneal cavity?
greater sac
the major portion of the peritoneal cavity is the-
greater sac
A smaller portion of the upper posterior peritoneal cavity located posterior to the stomach is the
lesser sac
what is another name for lesser sac?
omentum bursa
what does retroperinotneal mean?
backward or behind
what does infraperitoneal mean?
under or beneath
what’s the difference between retroperitoneal and infraperitoneal?
retroperitoneal structures are less mobile within the abdomen
what does intraperitoneal mean?
organs within the abdominal cavity that are partially or completely covered by some type of visceral peritoneum, but are not retro or infra
is the lower aspect of the peritoneum a closed sac in males or females?
males
In ______ the lower peritoneal sac lies above the urinary bladder, totally separating the reproductive organs from the organs within the peritoneal cavity. In ______ the uterus, uterine (fallopian) tubes, and ovaries pass directly into the peritoneal cavity
males; females
the abdomen may be divided into ___ quadrants or ____ regions.
four; nine
the transverse plane would pass through the-
level of the umbilicis/navel, which is at the level of the intervertebral disk between L4-L5
the vertical plane would go through the-
MSP, umbilicus/navel, and pubis symphysis
both the transverse and vertical plane divides the abdominal cavity into what four quadrants?
- RUQ (right upper quadrant)
- RLQ (right lower quadrant)
- LUQ (left upper quadrant)
- LLQ (left lower quadrant)
what are the 2 transverse/horizontal lines that break down the abdominopelvic region into 9 regions?
- transpyloric plane
- transtubercular plane
what level/landmark is the transpyloric plane?
lower border of L1
what level/landmark is the transtubercular plane?
level of L5
what are the two vertical lines that break up the abdominal region into 9 regions?
right and left lateral planes
what level are the right and left lateral planes?
are parallel to the midsagittal plane and are located midway between it and each anterior superior iliac spine (ASIS).
list the nine regions of the abdominopelvic region
- right hypochondriac
- epigastric
- left hypochondriac
- right lateral/lumbar
- umbilical
- left lateral/lumbar
- right inguinal/iliac
- pubic/hypogastric
- left inguinal/iliac
list the seven topographic landmarks
- xiphoid process (T9-T10)
- inferior costal (rib) margin (L2-L3)
- iliac crest (L4-L5)
- anterior superior iliac spine
- greater trochanter
- symphysis pubis
- ischial tuberosity
should gonadal shielding be used in women or men when doing an abdomen exam?
men only in the pubic symphysis