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GAR > Week 3 > Flashcards

Week 3 Flashcards

1
Q

List abdominal wall layer

A
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2
Q

Symptoms of appendicitis

A

Periumbilical or epigastric pain that migrates to the right lower quadrant of the abdomen

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3
Q

External Oblique Action

A

Compress, flex, rotate

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4
Q

External Oblique Innervation

A

Lower 6 thoracic nerves

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5
Q

How do external oblique muscle fibers run?

A

Lateral to medial (Superior to inferior)

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6
Q

Internal oblique action and innervation

A

compress, flex, rotate
lower 6 thoracic nerves and L1

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7
Q

Transversus abdominus action and innervation

A

compress and support
lower 6 thoracic nerves and L1

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8
Q

How do transversus abdominus muscle fibers run?

A

horizontal

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9
Q

Rectus abdominus action and innervation

A

flex
T7-T11

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10
Q

How do rectus abdominus muscle fibers run?

A

vertical

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11
Q

What does the rectus sheath do?

A

covers rectus abdominus
allows attachment of oblique muscles

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12
Q

What is the arcuate line?

A

Demarcation of where the fibers of the posterior rectus sheath stops
Can be a weak spot in abdominal wall where hernias can form
where you can find Inferior epigastric artery and vein without destroying fascia

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13
Q

What 2 arteries are the main arteries of the abdominal wall and anastamose at the umbilicus?

A

superior epigastric artery
inferior epigastric artery

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14
Q

Superior epigastric artery comes from what artery?

A

Internal thoracic artery

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15
Q

Inferior epigastric artery comes from what artery?

A

Iliac artery

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16
Q

What does the lateral umbilical fold contain?

A

inferior epigastric vessels

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17
Q

What did the medial umbilical fold used to be?

A

umbilical artery

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18
Q

What did the median umbilical fold used to be?

A

urachus

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19
Q

Inguinal ligament is formed by ?

A

external abdominal oblique aponeurosis

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20
Q

Where is the inguinal canal found and what runs through it?

A

Just above the medial half of the inguinal ligament
Allows passage of spermatic cord in men
Allows passage of round ligament of uterus in women

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21
Q

what is Deep ring of inguinal canal?

A

opening in the transversalis fascia that serves as the opening to the inguinal canal

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22
Q

What is the superficial ring of the inguinal canal?

A

defect in the aponeurosis of external oblique
serves as exit to the inguinal canal

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23
Q

What are boundaries of inguinal canal?

A
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24
Q

Which ring of inguinal canal can be accessed to look for hernias?

A

Superficial ring

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25
Q

What muscle covers the spermatic cord?

A

Cremaster muscle

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26
Q

What is course of spermatic cord?

A

runs through the inguinal canal and exits the superficial ring

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27
Q

Cremaster muscle innervation

A

genital branch of the genitofemoral nerve

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28
Q

What is cremaster reflex?

A

When inner thigh is stroked, sensory fibers of the femoral branch of the genitofemoral nerve and the ileoinguinal nerve are stimulated.
These synapse in the spinal cord and activate the motor fibers of the genital branch of the genitofemoral nerve which cause the cremaster muscle to contract and elevate testis

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29
Q

What does scrotum contain?

A

Testes
epididymis
lower part of spermatic cord (vas deferens and blood vessels)

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30
Q

What is raphe?

A

line dividing scrotum into two compartments
runs along under side of penis and continues along midline of perineum and anus

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31
Q

What supplies blood to scrotum?

A

posterior scrotal arteries

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32
Q

What are the layers of fascia around testes?

A

Tunica vaginalis (parietal and visceral)
Tunic albugenia

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33
Q

What is the ligament that occurs between the tunica vaginalis and the tunic albugenia?

A

gubernaculum

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34
Q

What role does the gubernaculum play?

A

pulls the testes down from abdominal cavity into scrotum during development

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35
Q

where does lymph from testes drain to?

A

Lumbar (lateral aortic) nodes

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36
Q

What are the main abdominal incisions?

A
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37
Q

what is targeted during liposuction?

A

Camper’s fascia

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38
Q

what is rectus diastasis?

A

a conditionin which the area along linea alba widens and the right and left rectus abdominus separate

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39
Q

what is umbilical hernia

A

condition in which the intestines protrude through the abdominal muscles at the belly button

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40
Q

What is Caput Medusae?

A

appearance of distended and engorged superficial epigastric veins which are seen radiating from the umbilicus across the abdomen
Caused from LIVER dz (anything that causes liver fibrosis)
any vessels draining into the portal vein cant empty easily

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41
Q

If a patient with liver cirrhois needs paracentesis because they have abdominal ascites, what veins do you need to be careful not to cut?

A

superficial epigastric veins

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42
Q

What nerves allow the cremaster muscle to move the scrotum up and down?

A

genitofemoral
ileoinguinal
pudendal
posterior femoral cutaneous

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43
Q

What is a testicular variocele?

A

when veins in the scrotum (pampiniform plexus) become abnormally enlarged because the valves in the veins aren’t working properly

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44
Q

What is nutcracker syndrome?

A

compression of the left renal vein between the aorta and the superior mesenteric artery which results in elevated left renal vein pressure and possible collateral vein development

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45
Q

What are symptoms of nutcracker syndrome?

A

Intermittent hematuria with or without left flank pain or abdominal pain or varicocele

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46
Q

where does blood from the pampiniform plexus drain into?

A

left renal vein

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47
Q

What is testicular hydrocoele?

A

fluid in scrotum

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48
Q

What is cut in vasectomy?

A

vas deferens

49
Q

What happens in patent proccessus vaginalis?

A

tunica vaginalis of scrotum has a defect which allows the intestines to enter into scrotum

50
Q

What artery is medial to the deep ring of the inguinal canal?

A

inferior epigastric artery

51
Q

What is inguinal hernia?

A

portion of small intestine enters inguinal canal

52
Q

what part of the surface anatomy of the inguinal area should be examined when investigating for hernia?

A

Inguinal (hesellbach’s) triangle
will bulge in certain types of hernias

53
Q

what age group are indirect inguinal hernias found in?

A

any age but more common in young

54
Q

what age group are direct inguinal hernias found in?

A

elderly

55
Q

Indirect inguinal hernia via ?

A

deep inguinal ring and along inguinal canal

56
Q

direct inguinal hernia via?

A

via transversalis fascia (hesselbachs triangle)

57
Q

What type of hernia enters the scrotum

A

indirect inguinal hernia (complete)

58
Q

What type of hernia does not enter the scrotum?

A

direct inguinal hernia (incomplete)

59
Q

What causes indirect inguinal hernia?

A

patent or reopened proccessus vaginalis

60
Q

What causes direct inguinal hernia?

A

weakened abdominal wall

61
Q

How does a direct inguinal hernia run in relation to the inferior epigastric artery?

A

direct hernia passes medially to the inferior epigastric artery and enters somewhere along the defect in the wall of the inguinal canal and comes through the superficial ring of inguinal canal

62
Q

how does a indirect inguinal hernia run in relation to the inferior epigastric artery?

A

indirect inguinal hernia runs laterally to the inferior epigastric artery and enters the deep ring of inguinal canal

63
Q

Where do you see a direct inguinal hernia?

A

Hesselbachs triangle

64
Q

Where do you see an indirect inguinal hernia?

A

scrotum

65
Q

how do you find hernia on PE

A

put finger in superficial inguinal ring and have patient cough

66
Q

If you feel hernia at fingertip on PE, what type hernia?

A

indirect inguinal hernia

67
Q

If you feel hernia along side of finger on PE, what type hernia?

A

direct inguinal hernia

68
Q

What is a femoral hernia?

A

abdominal tissue herniates through femoral canal
more common women

69
Q

General disposition of the abdominal visceral

A
70
Q

What is the greater sac in the peritoneal cavity?

A

all the space that is between the parietal and visceral layers of peritoneum and is filled with peritoneal fluid

71
Q

What is the peritoneal cavity?

A

a potential space that is between the parietal and visceral peritoneum

72
Q

What is the lesser sac in the peritoneal cavity?

A

a contained area between the pancreas, the liver, posterior wall of stomach, and between the layers of omentum
also filled with peritoneal fluid

73
Q

How do the greater and lesser sac communicate with each other?

A

epiploic foramen of Winslow

74
Q

What innervates parietal peritoneum?

A

Somatic nerves

75
Q

What innervates visceral peritoneum?

A

Visceral afferents

76
Q

What is mesentery?

A

double layer of visceral peritoneum that extends from the posterior abdominal wall

77
Q

Parietal vs visceral pain

A

Parietal pain can be located (point to one area)
Visceral pain is more dull and generalized

78
Q

Retroperitoneal vs Intraperitoneal

A

Retroperitoneal refers to structures located posterior to peritoneum
Kidneys, aorta, etc

Intraperitoneal refers to structures suspended from abdominal wall by mesentery
intestine, stomach, liver

79
Q

What does secondary retroperitoneal mean?

A

intraperitoneal structures whose mesentery fuses with to posterior abdominal wall
ascending/descending colon, pancreas, duodenum

80
Q

What is function of mesentery?

A

support viscera
store fat
serve as route for vessels, nerves, and lymphatics to travel to and from the gut

81
Q

What is omentum?

A

mesentary that is attached mostly to stomach

82
Q

What does the hepatoduodenal ligament contain?

A

hepatic artery proper, common bile duct, and portal vein
(portal triad)

83
Q

What is the hepatoduodenal ligament made of?

A

lesser omentum

84
Q

What is hepatogastric ligament ?

A

lesser omentum connects the liver to the lesser curvature of the stomach. It contains the right and the left gastric arteries. In the abdominal cavity, it separates the greater and lesser sacs on the right.

85
Q

Greater omentum comes off of where?

A

The greater curvature of stomach to transverse colon

86
Q

What is function of the greater omentum?

A

It adheres to inflammed or injured peritoneal lined structures and creates adhesions which separate the injured structures from access to the periotoneal cavity so less chance of spread of infection

Surgeons also use the greater omentum to wrap around injured structues

87
Q

What is the clinical importance of the right lateral pericolic gutter?

A

important for reabsorption of peritoneal fluids

88
Q

If you are laying down, where will peritoneal fluid accumulate?

A

Hepatorenal recess (aka right posterior subphrenic space) and pelvic cavity

89
Q

Another name for the pharynx

A

throat

90
Q

what separates pharynx from esophagus

A

upper esophageal sphincter

91
Q

What is function of stomach?

A

receive bolus
produce and release chyme into duodenum
secrete HCL (parietal cells)
secrete pepsinogen (chief cells)
digestion of protein begins
very limited absorption

92
Q

function of pylorus

A

allow food from the stomach into the duodenum

93
Q

Function of rugal folds in stomach

A

direct liquid quickly towards pyloric region of stomach

94
Q

Rugal folds are formed from ?

A

oblique muscle layer of stomach

95
Q

does duodenum have mesentery

A

no

96
Q

what type of structure is duodenum

A

secondary retroperitoneal

97
Q

function of duodenum?

A

neutralizes chyme
bicarbonate from pancreas and Brunners glands
secretes mucus
continues digestion
bile from gallbladder and pancreatic enzymes
lipase, protease, nuclease, amylase
limited absporption (absorbs iron)

98
Q

why are ulcers most common in the first part of duodenum?

A

lack of Brunners glands

99
Q

describe the interior of the duodenum

A

bulb (first part of the duodenum) is smooth

rest of duodenum has plica circulara
there is also major and minor papillae (drainage ducts from bile ducts and pancreas)

100
Q

What sits in the c shape of the duodenum?

A

head of pancreas

101
Q

What holds up the duodenal-jejunal junction

A

suspensory ligament of Treitz

102
Q

What makes up the small intestine?

A

duodenum
jejunum
ileum

103
Q

after digestion and absorption is completed in the small intestine, watery nutrient poor material is passed to?

A

through the ileocecal valve to the cecum

104
Q

what parts of the small intestine have mesentery

A

jejunum and ileum

105
Q

What is Meckel’s diverticulum?

A

remnant of yolk sac present in 2% of population

106
Q

What is function of large intestine

A

absorb water (2L/day)
absorb salt
secrete mucus
produce stool
store stool

107
Q

where is appendix found

A

coming off cecum

108
Q

what are teniae coli

A
109
Q

Parts of large intestine

A
110
Q

function of rectum

A

store feces

111
Q

what structures support the weight of feces in the rectum?

A

rectal folds of Houston

112
Q

what muscles allow pooping to occur

A

levator ani muscles

113
Q

Where will patient with appendicitis complain of pain

A

pain in lower right abdomen at McBurney’s point

114
Q

Radiological findings in a patient with appendicitis

A

air in bowel
fluid around appendix
thick appendix

115
Q

What is a possible complication of appendicitits?

A

peritonitis

116
Q

What is peritonitis?

A

inflammation of peritoneum which occurs when it comes in to contact with irritating substances

117
Q

Difference between gastric and duodenal peptic ulcer disease

A
118
Q

what is volvulus?

A

rotation of gut on its mesentery

GAR (11 decks)

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