Test 2 chapter 16 and part 1 of 17 Flashcards
Abdominopelvic Cavity has two parts
Superior-larger abdominal cavity
Inferior-smaller pelvic cavity
Abdominal cavity is located where
Diaphragm to superior aspect of bony pelvis
Abdominal cavity includes
- Stomach
- Large and Small Intestines
- Liver
- Gallbladder
- Spleen
- Pancreas
- Kidneys
Pelvic cavity is located where
Within the boney Pelvis
Pelvic cavity includes
- Rectum
- Sigmoid
- Urinary bladder
- Reproductive organs
Abdominopelvic cavity is enclosed by a double-walled sac called
Peritoneum
The outer portion of the sac, closest to the abdominal wall and diaphragm
Parietal peritoneum
The inner portion of the sac, over/around the actual organs
Visceral peritoneum
The two peritoneum fold
Mesentary and Omenta
Purpose of Mesentary and Omenta
Support the viscera
Space between layers of peritoneum containing serous fluid
Peritoneal cavity
Cavity behind the peritoneum
Retroperitoneum
The retroperitoneum is found where and contains what
Medial and posterior to the abdominal cavity
Contains the pancreas and the kidneys
Abdominal Aortic Aneurysm (AAA)
Localized dilation of abdominal aorta
Bowel Obstruction
Blockage of bowel lumen
Ileus
Failure of bowel peristalsis
Pneumoperitoneum
Air in the peritoneal cavity
NPO
Nil per os - nothing by mouth
What is the largest gland in the body
Liver
The diaphragm’s surface is
Convex
The liver eliminates waste from what
RBC’s
The position of this gland will vary depending on a persons body habitus
Gallbladder
The head of the Pancreas is embedded in the
Duodeum
What gland regulates sugar metabolism
Pancreas
The Spleen stores
Dying or dead RBC’s
This can be viewed with or without contrast
Spleen
What are the two part of the Digestive System
Alimentary Canal
Accessory Glands
Where is the Alimentary canal located and what does it contain
Extends from the mouth to the anus, includes:
- mouth
- pharynx
- esophagus
- stomach
- small intestine and large intestine
What are the Accessory glands and what do they do
Secrete enzymes into the Alimentary canal, includes:
- Liver
- Gallbladder
- Salivary glands
- Pancreas
The Diaphragmatic surface of the liver is
Convex and conforms to the undersurface of the diaphragm
The Visceral surface of the liver is
Concave and rests on the right kidney
What divides the liver into the large right and smaller left lobes
Falciform ligament
The 2 minor lobes of the liver, located on the medial side of the right lobe (near the gallbladder) are
Caudate lobe-posterior surface
Quadrate lobe-inferior surface
Blood vessels enter and exit the liver through this
Porta Hepatis aka Hilum of the liver
Porta hepatis/ Hilum is located
transversely between the minor lobes
The Liver and Biliary system have this type of blood supply
Dual blood supply
Dual blood is supplied through the
Portal vein and Hepatic artery
Where do the Portal vein and Hepatic artery enter the liver
At the Porta Hepatis/ Hilum and branch out
Portal Vein ends
In the Sinusoids
Hepatic Artery ends
In the Capillaries that communicate with the sinusoids
How does the Portal System work
Nutrient and bacteria-rich blood from the intestines, gallbladder, pancreas, and spleen converge to liver where liver modifies the blood and sends blood to the inferior vena cava via the haptic veins
Liver Functions
- Formation of Bile (1-3 pints per day)
- Eliminates waste from RBC’s
- Aids in emulsification and assimilation of fats
- Produces Glycogen from Glucose
- Removes poison and bacteria from blood
Biliary System
Excretory system
consists of Bile ducts and Gallbladder
2 main ducts in Biliary system
Common Hepatic Duct and Cystic Duct
Common Hepatic and Cystic ducts together form
The Common Bile Duct
Common Bile Duct meets the Pancreatic Duct at
Hepatopancreatic Ampulla or Ampulla of Vater
The Hepatopancreatic ampulla opens into
The duodenum
What happens to bile during interdigestive periods
Most of the bile goes to the gallbladder
What happens to bile during digestion
The sphincter relaxes and permits bile to flow into the duodenum
This gland is thin-walled and pear shaped sac
Gallbladder
Gallbladder is located
small fossa of the visceral surface of right liver
What is the capacity of the Gallbladder
2 oz.
Purpose of the Gallbladder
Concentrates and stores bile, contracts and releases the bile during digestion
Radiographically what is the most important info obtained from the Liver?
Bile.
Elongated gland on posterior abdominal wall extending from the duodenum to the spleen
Pancreas
Pancreatic head is located
Enclosed in the duodenum at L-2-3
Pancreatic neck and body location
Transverse behind the stomach, in front of the left kidney and terminates near the spleen
Can the Pancreas be seen on plain radiographs?
No, possibly CT
Pancreas is what kind of gland
Exocrine, Endocrine
Pancreatic Exocrine functions
Lobules with duct system
-Produces pancreatic juices
Pancreatic Endocrine functions
Clusters of Islet cells-Islet of Langerhans
- Produce insulin and glucagon
- Does NOT communicate with ducts
This organ is not a gland but belongs to the lymphatic system
Spleen
Ductless, gland-like organ
Spleen
What does the spleen produce
Lymphocytes
This organ stores and removes dying or dead RBC’s
Spleen
Where is the Spleen located
Oblique position in the LUQ (left upper quad) below diaphragm and behind the stomach and above the left kidney
Biliary Stenosis
Narrowing of bile ducts
Cholecystitis
Inflammation of gallbladder
Choledocholithiasis
Calculus in common bile duct
Cholelithiasis
Gallstones
Pancreatitis
Inflammation of pancreas
Chole-
Relationship with bile
Cysto-
Bag or sac
Choledocho-
Common bile duct
Cholangio-
Bile ducts in general
Cholecyst-
Gallbaldder
What modality is good for imaging gallstones?
Ultrasound
Cholegraphy
Radiographic study of biliary system
Cholecystography
Radiographic study of the gallbladder
Cholangiography
Exam of the biliary ducts
All imaging of biliary tract is done with what type of breathing
Suspended respiration
Nuc-Med studies
The function of anatomy
What instructions are patients given before a gallbladder ultrasound?
NPO nothing by mouth
Pre-operative radiologic exam of the biliary tree is called
PTC- Percutaneous (through the skin) Transhepatic (through the liver) Cholangiography (exam of the biliary ducts)
PTC’s are used for
Patients with Jaundice and a CT or ultrasound has shown dilation
How is a PTC performed?
- Patient is placed supine
- Right side prepped (sight of entrance)
- Local anesthetic
- Chiba needle (long thin) placed intercostally (between the ribs)
- Needle is withdrawn under fluro until contrast fills the biliary tree
Postoperative (T-Tube) Cholangiography
Exams of the biliary tracts using a T-shaped catheter left in the common hepatic and bile duct for post-op drainage
When taking a scout KUB during a Post-Op Cholangiogram what do you do differently from a plain radiograph?
Center higher than a normal KUB to be sure you included the Liver
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Used to diagnose biliary and pancreatic conditions.
How is an ERCP performed?
Endoscope is passed through the mouth and into the duodenum under fluro.
-Pt must be NPO 1-10 hours AFTER the procedure
An allergy to iodinated contrast is not a contraindication for ERCP, why?
You’re putting the contrast into the biliary not the blood stream. You are less likely to have a reaction when the contrast is not going to enter your blood stream
Why might you see a “stump” during an ERCP with contrast?
The gallbladder is gone.
Right and Left Hepatic form
The common hepatic duct
What does the Portal Vein do
Bring blood from the bowels to the liver
