Term
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Definition
| Serous membrane, lines the abdominal cavity, forms a protective cover for abdominal structures, double folds form greater and lesser omentum |
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Term
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Definition
| fan-shaped fold of peritoneum, covers most small intestine and anchors it to the posterior abdominal wall |
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Term
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Definition
| 27 feet long tube from mouth to anus, functions to ingest and digest food, absorb nutrients, electrolytes and water, and excrete waste |
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Term
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Definition
| Collapsible tube about 10 inches long, connects the pharynx to stomach, positioned posterior to the trachea, enters stomach at cardiac orifice |
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Term
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Definition
| three sections, secretes HCl and digestive enzymes |
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Term
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Definition
| section of the stomach above and to the left of the cardiac orifice |
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Term
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Definition
| section of stomach that consists of middle 2/3 |
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Term
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Definition
| section of stomach that is most distal and narrows into sphincter |
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Term
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Definition
| secreted by stomach, digests proteins |
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Term
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Definition
| secreted by stomach, digests fats |
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Term
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Definition
| 21 feet long, joins large intestine at ileocecal valve, has three sections |
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Term
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Definition
| C-shaped curve around the head of the pancreas, first 12 inches of small intestine, contains opening of common bile and pancreatic ducts |
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Term
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Definition
| opening of common bile and pancreatic ducts, located 3 inches below pylorus of the stomach |
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Term
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Definition
| 8 feet of small intestine after duodenum, gradually gets larger |
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Term
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Definition
| Last 12 feet of small intestine, ends at ileocecal valve |
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Term
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Definition
| begins at cecum, consists of ascending, transverse, descending and sigmoid sections, 4.5-5 feet long, 2.5 inch diameter, functions to absorb water and transport waste |
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Term
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Definition
| blind pouch of large intestine, 2-3 inches long |
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Term
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Definition
| located in RUQ, below diaphragm, above gallbladder, right kidney and hepatic flexure of colon |
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Term
| What is the heaviest organ in the body? |
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Definition
| Liver- weighs 3 pounds in adults |
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Term
| What is the function of the liver? |
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Definition
| Metabolism of carbohydrates, fats and proteins, converts glucose to glycogen for storage, converts amino acids to glucose (gluconeogenesis), fats are oxidized to enter TCA cycle, cholesterol is used to make bile salts, proteins are broken down to amino acids and excreted as urea, stores vitamins and iron, detoxification, production of antibodies, conjugation and excretion of steroid hormones, production of clotting factors and plasma proteins |
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Term
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Definition
| saclike, pear-shaped organ, 4 inches long, located in inferior surface of liver |
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Term
| What is the function of the gallbladder? |
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Definition
| concentrates and stores bile, responds to cholecystokinin |
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Term
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Definition
| produced in duodenum, causes gallbladder to release bile |
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Term
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Definition
| composed of cholesterol, bile salts and pigments, maintains the pH of small intestine for emulsification of fats and absorption of lipids |
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Term
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Definition
| behind and beneath stomach, head rests in the curve of the duodenum, tail almost touches spleen |
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Term
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Definition
| acinar cells produce digestive enzymes, islet cells produce insulin and glucagon |
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Term
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Definition
| LUQ, above left kidney, below diaphragm |
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Term
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Definition
| consistutes most of the spleen, functions as part of reticuloendothelial system to filter blood and make lymphocytes and monocytes |
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Term
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Definition
| contains capillary network and venous sinus system of spleen, functions to store and release blood, can hold several hundred milliliters |
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Term
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Definition
| located in retroperitoneal space of upper abdomen, T12-L3, right is slightly lower than the left, covered in fat and fascia |
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Term
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Definition
| each recieves 1/8 of the cardiac output |
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Term
| Glomeruli filtration rate |
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Definition
| 125ml/min in adult male, 110ml/min in adult female |
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Term
| What is the capacity of the bladder? |
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Definition
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Term
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Definition
| Urine production, renin release to control aldosterone secretion, erythropoietin production, synthesizes prostaglandins and the active form of vitamin D |
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Term
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Definition
| tendinous band between the rectus abdominus muscles, extands from xiphoid process to pubic symphysis |
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Term
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Definition
| also called Poupart ligament, extends from ASIS to pubis |
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Term
| Development of abdominal organs |
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Definition
| pancreatic buds, liver and gallbladder all begin to form by week 4 of gestation, amniotic fluid begins to be swallowed at 17 weeks, meconium is produced shortly after, reaches adult functioning and control by 2-3 years of age |
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Term
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Definition
| forms RBCs by week 6, synthesizes glucagon by week 9, produces bile by week 12 |
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Term
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Definition
| islet cells are developed at week 12 and produce insulin, helps in blood formation during fetal and first year of life |
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Term
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Definition
| begins in second month, can produce urine by 12 weeks, nephrons are fully formed by 36 weeks, nephrons enlarge after birth, GFR is 0.5ml/min before 34 weeks |
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Term
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Definition
| line of pigmentation at midline during pregnancy |
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Term
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Definition
| separation of rectus abdominus muscles during pregnancy |
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Term
| Abdominal changes during pregnancy |
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Definition
| Increased GI transit time causes constipation, decreased LES tone causes heartburn, gallbladder tone is changed and bile stasis is common causing increased gallstone formation, kidneys increase by 1cm in length, changes in urinary system cause urinary stasis and pyelonephritis (can last 3-4 months after delivery), bladder has increased sensitivity and compression, trigone is deeper and wider resulting in microhematuria, venous pressure increases leading to hemorrhoids |
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Term
| Uterus change after delivery |
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Definition
| involutes to the size of 20 weeks of pregnancy immediately after delivery, after 1 week- size of 12 weeks, muscles regain strength in 6-7 weeks |
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Term
| Abdominal changes in elderly |
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Definition
| Decreased motility due to changes in neurons and collagen, reduced circulation, secretion of digestive enzymes and mucus is decreased, bacterial flora become less active, liver size and blood flow decrease, higher risk of nonalcoholic seatohepatitis, no physiologic changes in pancreas, increase in biliary lipids and formation of gallstones |
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Term
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Definition
| Sex with infected individual, men who have sex with men, international travel, live in areas where kids aren't vaccinated, day care kids and employees, IV drug users |
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Term
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Definition
| Sex with infected individual, men who have sex with men, sex with multiple partners, interntaional travel, infants with infected mothers, transfusion before 1987, hemodialysis, injection drug users, health care workers |
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Term
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Definition
| Sex with infected individual, men who have sex with men, sex with multiple partners, infants with infected mothers, clotting factors before 1987, transfusion before 1992, hemodialysis, injection drug user, health care workers |
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Term
| Colon cancer risk factors |
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Definition
| over 50, family history of FAP, HNPCC, Peutz-Jeghers, juvenile polyposis, personal history of IBS, FAP, HNPCC, ovarian or endometrial cancer, Ashkenazi Jew, low-fiber, high-fat diet, low fruit and vegetable intake, obesity, smoking, sedentery, alcohol intake |
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Term
| What do you examine last during abdominal exam? |
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Definition
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Term
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Definition
| above umbilicus, drainage is toward head; below umbilicus, drainage is toward feet |
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Term
| What to consider if you see scars? |
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Definition
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Term
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Definition
| glistening, taut appearance to skin |
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Term
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Definition
| ecchymosis around umbilicus, seen in hemoperitoneum, pancreatitis, ectopic pregnancy |
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Term
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Definition
| appear in pregnancy and weight gain, also with tumors or ascites, start off pink or blue, then become silvery white; appear purple in Cushing's disease |
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Term
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Definition
| pearl-like, enlarged umbilical node |
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Term
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Definition
| common in well-muscled athletic adults |
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Term
| Rounded or conves contour |
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Definition
| characteristic of young children, but also seen in adults with subcutaneous fat or poor muscle tone |
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Term
| Scaphoid or concave contour |
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Definition
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Term
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Definition
| seen in diuretic use, causes abdominal distension, bowel sounds are hypoactive, no pain or masses, steroids can cause same presentation |
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Term
| Abdominal distension below umbilicus |
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Definition
| ovarian tumor, uterine fibroids, distended bladder |
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Term
| Abdominal distension above umbilicus |
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Definition
| carcinoma, pancreatic cyst, gastric dilation |
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Term
| Asymmetric abdominal distension |
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Definition
| hernia, tumor, cysts, bowel obstruction, muscle or soft tissue hematoma, organomegaly |
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Term
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Definition
| reducible- contents are easily replaced, if not- it is nonreducible or incarcerated (blood supply is obstructed, surgical emergency) |
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Term
| Respiration effect on abdomen |
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Definition
| men- abdominal movement during breathing, women- costal movement during breathing |
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Term
| Surface motion in abdomen |
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Definition
| may indicate intestinal obstruction, is also seen in thin people |
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Term
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Definition
| may indicate increased pulse pressure or AAA, also seen in thin people |
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Term
| When is auscultation done in abdominal exam? |
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Definition
| after inspection but before percussion or palpation because these may alter frequency and intensity of bowel sounds |
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Term
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Definition
| stomach growling, loud prolonged gurgles |
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Term
| Causes of increased bowel sounds |
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Definition
| gastroenteritis, early intestinal obstruction, hunger |
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Term
| Causes of decreased bowel sounds |
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Definition
| peritonitis, paralytic ileus |
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Term
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Definition
| no sounds after 5 minutes of continuous listening, associated with abdominal pain and rigidity, surgical emergnecy |
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Term
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Definition
| heard over liver or spleen, rare, heard during inspiration, indicate inflammation of the peritoneal surface of the organ from a tumor, infection or infarct |
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Term
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Definition
| harsh, musical intermittent sound, reflects blood flow turbulence and indicates vascular disease |
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Term
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Definition
| soft low-pitched and continuous, occurs with increased collateral circulation between portal and systemic venous systems, heard around umbilicus |
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Term
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Definition
| heard over stomach and intestines due to air |
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Term
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Definition
| heard over organs and solid masses, also distended bladder |
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Term
| Liver span in midclavicular line |
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Definition
| proceed from tympany to dullness, normal is 6-12 cm, greater in males and tall people |
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Term
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Definition
| 2-3cm below costal margin |
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Term
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Definition
| 5th-7th intercostal space |
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Term
| Liver span in midaxillary line |
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Definition
| 5th-7th intercostal space dullness |
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Term
| Liver span in midsternal line |
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Definition
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Term
| Liver span with inspiration |
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Definition
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Term
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Definition
| dullness heard from 6th-10th rib |
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Term
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Definition
| 6th rib superiorly, midaxillary line paterally and left costal margin inferiorly, best place to hear splenic dullness to percussion |
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Term
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Definition
| percuss lowest intercostal space in anterior axillary line before and after inspiration- should remain tympanic, if the spleen is enlarged- will change to dullness with inspiration |
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Term
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Definition
| left lower anterior rib cage and left epigastric region, tympany here is lower in pitch than tympany of intestine |
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Term
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Definition
| tensing of abdominal musculature during palpation, may indicate inflamed viscera |
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Term
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Definition
| boardlike hardness of the abdominal wall overlying areas of peritoneal irritation |
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Term
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Definition
| C: congenital, Hirschsprung disease; O: obstructed; N: neoplasm; S: stricture; T: topical, painful hemorrhoids or fissure; I: impaction; P: rectal prolapse; A: anorexia and depression; T: temperature high, dehydration; E: endocrine, hypothyroidism; D: diet, diverticulitis, drugs |
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Term
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Definition
| use diaphragm of stethoscope, place over liver and scratch abdominal surface with other hand, moving toward liver; sound will intensify when over the liver |
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Term
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Definition
| shouldn't be palpable, if tender- cholecystitis, in nontender- common bile duct obstruction |
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Term
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Definition
| inflamed gallbladder comes in contact with fingers during inspiration, if inflamed- patient will feel pain and stop breathing, seen in cholecystitis |
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Term
| Is the spleen usually palpable? |
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Definition
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Term
| Is the left kidney usually palpable? |
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Definition
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Term
| Is the right kidney usually palpable? |
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Definition
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Term
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Definition
| if distended, it has a lower tone that air-filled intestines |
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Term
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Definition
| pathologic increase in fluid in peritoneal cavity, settles with gravity- dullness is heard in dependent portions of abdomen, fluid wave and shifting dullness are present |
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Term
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Definition
| border of dullness shifts to dependent side (approaching midline) as fluid settles with gravity if ascites is present, remains in same spot with no ascites |
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Term
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Definition
| the farther from the umbilicus the pain, the more likely it is organic in origin |
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Term
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Definition
| sudden dramatic change from mild pain to severe abdominal tenderness in the hypogastric area on involved side, rigidity and rebound may be seen |
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Term
| What is the most common cause of emergency abdominal surgery? |
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Definition
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Term
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Definition
| most common in second decade of life, signs- RLQ pain, initially periumbilical pain, pain before vomiting, positive psoas sign, rigidity, rebound tenderness |
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Term
| Alvarado score (AKA MANTRELS) |
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Definition
| used to diagnose appendicitis, migration of pain, anorexia, nausea/vomiting, tenderness in RLQ, rebound pain, elevation of temperature, leukocytosis, shift to the left |
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Term
| Pediatric appendicitis score |
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Definition
| pain with cough, hopping or rebound tenderness with percussion in RLQ |
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Term
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Definition
| use to identify risk of appendicitis, if low risk- observation, if moderate risk- diagnostic testing and imaging, for high risk- surgery |
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Term
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Definition
| sharp stabbing pain at site of peritoneal inflammation, same as rebound tenderness |
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Term
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Definition
| rebound tenderness over McBurney's point in RLQ suggesting appendicitis |
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Term
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Definition
| rigidity, tenderness and guarding, absent bowel sounds, positive obturator and psoas test, rebound tenderness, abdominal pain when walking, positive heel jar test, RLQ pain intensified during LLQ palpation |
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Term
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Definition
| pain or distress in area of heart or stomach on palpation of McBurney's point, seen in appendicitis |
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Term
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Definition
| fixed dullness to percussion in left flank, and dullness in right flank that disappears on change of position, seen in peritoneal irritation |
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Term
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Definition
| absence of bowel sounds in RLQ, seen in intussusception |
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Term
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Definition
| ecchymosis of flanks, seen in hemoperitoneum and pancreatitis |
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Term
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Definition
| abdominal pain radiating to left shoulder, seen in spleen rupture, renal calculi, ectopic pregnancy |
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Term
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Definition
| patient stands with straight knees, then raises up on toes, relaxes and allows heels to hit floor, causes abdominal pain if positive, seen in peritoneal irritation and appendicitis |
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Term
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Definition
| pain down the medial aspect of the thigh to the knees, seen in strangulated obturator hernia |
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Term
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Definition
| RLQ pain intensified by LLQ palpation, seen in peritoneal irritation and appendicitis |
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Term
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Definition
| used if you suspect appendicitis, patient raises right leg against resistance, pain indicates irritation |
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Term
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Definition
| used if you suspect ruptured appendix or pelvic abscess, flex right leg at hip and knee and rotate, pain indicates irritation |
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Term
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Definition
| palpation technique used to assess an organ or mass, place fingers and arm at 90 degrees and push in, if the mas is freely movable it will float upward |
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Term
| What shape is an infant's abdomen? |
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Definition
| rounded and dome shaped because abdominal musculature is not fully developed |
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Term
| What does a scaphoid abdomen in an infant indicate? |
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Definition
| abdominal contents are displaced into the thorax- diaphragmatic hernia |
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Term
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Definition
| intestines seen in umbilical cord or protruding into umbilical area and visible through a thick transparent membrane of infants |
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Term
| Umbilical hernia in infants |
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Definition
| common finding, measure diameter rather than amount of protruding contents, reach maximum size by 1 month, usually close spontaneously by 1-2 years |
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Term
| Diastasis rectus abdominis in infants |
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Definition
| 1-4cm separation in the midline between the xiphoid and umbilicus, usually no need to repair although herniation through the opening may be a problem |
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Term
| What causes visible peristaltic waves in infants? |
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Definition
| seen in thin malnourished infants, intestinal obstruction and pyloric stenosis |
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Term
| What does a thick umbilical cord indicate? |
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Definition
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|
Term
| When should bowel sounds appear after birth? |
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Definition
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Term
| What does a bruit of stenosis sound like? |
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Definition
| high frequency and soft, difficult to hear |
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Term
| What does a bruit of AV fistula sound like? |
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Definition
| continuous, difficult to hear |
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Term
| Spleen palpation in infants |
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Definition
| palpable 1-2 cm below left costal margin during first few weeks, enlarged spleen can indicate congenital hemolytic disease or sepsis |
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Term
| What might be seen in an infant with a poorly controlled diabetic mother? |
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Definition
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|
Term
| Liver palpation in infants |
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Definition
| palpable 1-3 cm below the right costal margin, slightly larger in females until age 2 |
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Term
| What are the most common causes of masses in newborns? |
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Definition
| hydronephrosis and multicystic dysplastic kidney |
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Term
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Definition
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Term
| Sausage shaped mass in LUQ or RUQ |
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Definition
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Term
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Definition
|
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Term
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Definition
|
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Term
| What are the most common abdominal tumors in infants? |
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Definition
| neuroblastoma, Wilms tumor, lymphoma |
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Term
| When do respirations stop being abdominal in children? |
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Definition
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Term
| Causes of obstruction in elderly |
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Definition
| hypokalemia, MI, pneumonia, sepsis, peritonitis, pancreatitis |
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