US of Abdominal Wall- Dey Flashcards
what structures are at the level of the transpyloric plane
pylorus
gall bladder
pancreas
what structures must be put back together in a certain order when closing a paramedian incision above the arcuate line
a
what structures must be put back together in a certain order when closing a paramedian incision below the arcuate line
a
what lymph nodes are affected by melanoma on the left lateral region of the abdominal wall
a
what lymph nodes are affected by testicular carcinoma
a
what is the advantage of a paramedic and midline incision compared to a pararectus incision?
a
what complications come from severing or compressing a nerve on the anterior abdominal wall
a
what position should the patient be in for an abdominal exam and why
supine with relaxed abdomen and knees bent to relax the fascia between the legs and the abdomen
what is the elicited reflex
stroking the abdomen lateral to medial, should see a contraction
what is a guarding reflex
involuntary reflex with pain in the abdomen, commonly seen with appendicitis
what are the 6 Fs causing abdominal distension and the other cauess
food fat fluid feces flatus fetus tumors enlarged organs reduced muscle tone (age, lack of exercise, paralysis)
what structures are in the RUQ
R liver gallbladder stomach duodenum pancrease R kidney R colic flexture transverse and ascending colon
what structures are in the LUQ
L liver spleen pancreas stomach L kidney L colic flexture transverse and descending colon
what structures are in the RLQ
cecum appendix ileum ascending colon R ovary and uterine tube uterus R ductus deferns and spermatic cord full bladder
what structures are in the LLQ
sigmoid colon descending colon L ovary and uterine tube full bladder uterus L ductus deferns and spermatic cord
what are the planes that divide the abdomen into 9 quadrants
midclavicular/midinguinal lines
subcostal plane L2-3
transtubercular plane at L5
where is the transpyloric plane
crosses at pylorus of stomach at the midpoint between sternal notch and pubic symphysis around L1
what are the 9 regions of the abdomen
R/L hypochondriac epigastric R/L lateral umbilicus R/L inguinal pubic (hypogastric)
where are the parts of the pancreas
head- right L2/3
body- L1
tail- left T12
where is the duodenum-jejunal junction
L2/3
where is the bifurcation of the aorta
L4 (sternal angle)
what are the 3 arteries supplying the abdomen and where do they come off of the abdominal aorta
celiac- T12
superior mesenteric- L1
inferior mesenteric- L3
what level are the iliac crests
L4
what are the iliac crests used as a landmark for
lumbar puncture
where is the liver
under ribs and diaphragm- pushed down when diaphragm contracts
where is the gallbladder
at the midclavicular line
what ligaments are on the anterior liver surface
falciform ligament
round ligament
how is the falciform ligament formed and what does it do
fused periotoneal reflections from the left and right sides of the liver that extend anteriorly
divides liver into left and right lobes
how is the round ligament formed and what does it do
obliterated umbilical vein that extends from the free margin of the liver, inferior to the falciform ligament
what part of the gallbladder is visible from an anterior view of the liver
fundus
what structures are in the porta hepatis
hepatic portal vein
proper hepatic artery
common hepatic duct
what surrounds the structures in the portal hepatis
hepatoduodenal ligament
what are the 4 lobes of the liver
right
left
quadrate
cuadate
where is the quadrate lobe of the liver
between the falciform ligament and the gallbladder
where is the caudate lobe of the liver
between the inferior vena cava and the ligamentum venosum
where is the ligamentum venosum
directly behind the falciform ligament in the main lobar fissure
where do all hepatic veins drain into
inferior vena cava
where is the bare area of the liver
on the visceral aspect, area that is directly against the diaphragm that is not covered by peritoneum
where is the coronary ligament and how is it formed
reflection of the peritoneum at the bare area
what forms the left and right triangular ligament
where the peritoneum reflections from the coronary ligament layers meet
what is the difference between the hepatic vein and portal vein
portal vein- delivers blood to the liver to be filtered
hepatic vein- drains blood into the IVC that supplies nutrients to the liver and what is brought to it by the portal vein
where does the blood from the GI tract go
portal venous system
what arteries go to the liver from the celiac artery
common hepatic artery which branches into the proper hepatic arteries (left and right)
path of bile
hepatic duct- exits liver
cystic duct- enters/exits gallbladder
common bile duct- forms from intersection of hepatic and cystic ducts and empties into the duodenum
what is bile for
digest fats
what is in the portal triad
portal vein
bile duct
hepatic artery
what is the shape of the gallbladder on US
exclamation point- gall bladder is the long part, the portal triad is the dot
what is the shape of the portal triad on US
mickey mouse
portal vein is the head
hepatic artery and common bile duct are ears
where is the spleen
posteiror to th emidaxillary line on the left
what is Traub’s space
left hypochondriac region between lung nd spleen
what is splenomegaly
enlarged spleen that fills Traub’s space
what are the 3 spaces in the peritoneal cavity
subphrenic (subdiaphragmatic)
perisplenic
hepatorenal
where is the subphrenic space
between the liver and diaphragm
connected to the hepatorenal recess
infections here cause referred shoulder pain because the phrenic nerve is supplied by C3,4,5 which also go to the shoulder
where is the perisplenic space
between the spleen and diaphragm
connected to the pelvic cavity via the left colic gutter
where is the hepatorenal space
between the liver and right kidney
in contact with subphrenic space
drains into pelvic vacuity via right colic gutter
what are the lower points peritoneal spaces in the supine position
hepatorenal space and pelvic cavity–where all the fluid pools
