major clinical: abdomen Flashcards
what are the 5 F’s for abdominal protrusions
fat, feces, fetus, flatus and fluid (+tumors)
where is the gallbladder found via surface anatomy
at the intersection of the semilunar line and the 9th costal cartilage
where is the spleen located (surface anatomy)
under the 9th-11th ribs on the left side of the midaxillary line
where are the kidneys located (surface anatomy)
along the scapular line
what is the dermatome for the xiphoid process
T6
what is the dermatome for the umbilicus
T10
what is the dermatome for the inguinal ligament
L1
how is the cremaster reflex elicited
by stroking the medial aspect of the upper thigh
what spinal cord level does the cremaster reflex test
L1-2
who are direct inguinal hernias most common in
older men with weak abdominal muscles
where do direct inguinal hernias exit the abdomin
medial to the inferior epigastric vessels through Hesselbach’s trinagle
what is hesselbachs triangle bound by
rectus abdominis, inguinal ligament and inferior epigastric vessels
what are the most common type of abdominal hernias
indirect inguinal hernias
where do indirect inguinal hernias leave the abdomen
lateral to the inferior epigastric vessels via the deep inguinal ring
where do epigastric hernias occur
in the midline between the xiphoid and umbilicus
where do Grynfeltt’s hernias occur
at superior lumbar triangle
where doe Petit’s hernias occur
inferior lumbar trinagle
what are common signs/symptoms of torsion of the testes
sudden testicular enlargement and pain, nausea/vomiting, abnormal cremaster reflex and abnormal positioning of epididymis
what is a collection of blood in the cavity of the tunica vaginalis; trauma to testicular veins
hematocele of testis
where do the testes drain their lymph
to lumbar (para-aortic) nodes
where does the scrotum drain its lymph
superficial inguinal nodes
what is another name for inflammation of the testes
orchitis
what is the accumulation of serous fluid within the peritoneum
ascites
what is culdocentesis
removal of fluid from the recto-uterine pouch
when it peritoneal dialysis done
with renal failure
what is compression of the 3rd part of the duodenum between the SMA and aorta creating an obstruction; due to insufficient intra-abdominal fat; more common in young, anorexic women
wilkie’s (SMA) syndrome
what is a chronic inflammatory disease of the intestine that typically leads to fibrosis and obstructive symptoms (abdominal pain and diarrhea)
crohn;s disease
what is indicated at the middle third of a line connecting the ASIS and the umbilicus; used to surgically remove the appendix
McBurney’s point
what is a telescoping of a proximal gut segment into the lumen of an adjacent segment; most common in ileocolic region (can result in necrosis)
intussusception
what occurs with weakness in puborectalis and pubovaginalis muscles that can result in bulging of the rectal wall into the posterior vaginal wall
rectocele
what color are stools in upper GI bleed and what are common causes
stool is black; common causes are stomach cancer, ulcers, gastritis, esophageal varices
what color are the stools with lower GI bleed
red or maroon
what is the most common site of bowel ischemia
splenic flexure
where does most of the lymph from the liver drain
hepatic nodes which in turn drain into celiac nodes
where does lymph from the bare area of the liver drain
phrenic nodes and then to posterior mediastinal nodes
where does lymph from falciform ligament drain
parasternal nodes
where does typhoid from round ligament drain
around the umbilicus and anterior abdominal wall
what are the boundaries of Calot’s triangle
cystic duct, common hepatic duct, and base of liver
what is pringle’s maneuver
clamping vessels of the portal triad to control bleeding during hepatic procedures
what does blockage of hepatopancreatic ampulla result in
blockage of hepatic and pancreatic secretions
what occurs when there is a tear in the intimal/inner layer of the aorta and hemorrhage between the layers of the vessel
aortic dissection
what are the alternative routes for venous return if IVC obstructed
inferior to superior epigastric, superficial epigastric to lateral thoracic, vertebral/lumbar veins to azygos system
what is a test used to diagnose dysfunction/contracture of the posts major muscle
thomas test
what nerve is most commonly injured in inguinal hernia surgery, hysterectomy, appendectomy, abdominal muscle tears and pregnancy
iliohypogastric nerve
what nerve is most commonly injured during inguinal hernia or other abdominal surgery, pregnancy or placement of femoral catheter
ilioinguinal
what nerve is most commonly injured during hernia repair, appendectomy, retroperitoneal hematoma
genitofemoral nerve
where are renal transplants typically placed
along the iliac fossa
what are the transplanted renal arteries in a transplant anastomosed with
internal iliac artery
what occurs when there is inferior displacement of the kidney due to insufficient peri-renal adipose tissue; may be associated with flank or groin pain and hematouria
nephroptosis
where are the ureters constricted (where kidney stone can get lodged)
junction of renal pelvis and ureter, crossing the pelvic inlet, passage through wall of bladder
what side does the material supply to the abdominal ureter come from
medial side
where does arterial supply of the pelvic ureter come from
lateral side
what is the sympathetic innervation of upper and lowe esophagus
lower is T5-8; upper is T1-4
what is the sympathetic for the stomach/duodenum
T5-9
what is the sympathetic innveration for the liver and gallbladder
T6-9 (right side)
what is the sympathetic innervation for the spleen
T7-9
what is the sympathetic innervation for the pancreas
T7-9
what is the sympathetic innervation for adrenal medullaT
T11-12
what is the sympathetic innervation for the midgut
T9-11
what is the sympathetic innervation for the kidney and upper ureter
T10-11
what is the sympathetic innervation for the testes
T10-11
what is the sympathetic for the pelvic organs
L1-2
what is the dermatome for the suprapubic area
T12
what is the vertebral level associated with origin of SMA
L1
what is the vertebral level associated with origin of renal and gonadal arteries
L2
what structure forms the deep inguinal ring
transversals fascia
what is the communication between the greater and lesser sacs of the abdomen
epiploic foramen
what does the hepatoduodenal ligament contain
portal vein, hepatic artery, bile duct
what ducts join to form common bile duct
cystic and common hepatic
what is the origin of the cystic artery
right hepatic artery
what veins unite to form portal vein
splenic and SMV
what structures lie posterior to SMA near its origin
left renal vein, duodenum
what is the termination of the left gonadal vein
left renal vein
what is the termination of the right gonadal vein
IVC
what is the location of initial pain of the appendicitis
umbilical region
