Exam 3- Abdomen

What is the shape of the Diaphragm?

Umbrella-shaped muscle

Should the psoas muscle be visible on an X-ray?

Yes

What are the 3 parts of the small intestine?

duodenum, jejunum, ileum

What sits in the C loop of the duodenum?

The pancreas

Duodenum length

10 inches, which is the shortest and widest

What drains into the duodenum?

Ducts drain

About the Jejunum (small intestine)

2/5 of the small intestine, feather like

About the ileum (small intestine)

3/5 of the small intestine, area of the ileocecal valve

What does enter/o mean?

small intestine

Where is the appendix hanging off of?

The cecum

What side is the hepatic flexure on?

right

What side is the splenic flexure on?

left

What does splen/o mean

spleen

What system is the spleen apart of?

lymphatic system

What are the accessory organs of the digestive system?

liver, gallbladder, pancreas

What does Pancreat/o mean?

pancreas

What does Hepat/o mean?

liver

What is the largest solid organ of the body?

Liver

What does the liver produce?

Produces bile and breaks down fat

What does the pancreas do?

produces enzymes for digestion

What does the spleen do?

Filters bacteria out of the blood

What does cholecyst/o mean?

gallbladder

Where is bile made?

liver

What does the gallbladder do?

stores and concentrates bile

What does ren/o and nephr/o mean?

Kidneys

How many kidneys are there?

two

Are the kidneys peritoneal or retroperitoneal?

retroperitoneal very posterior

What kidney is lower and why?

Right kidney due to the large right lobe of the liver

How many ureters are there?

2 (one for each kidney)

Where do the ureters enter the bladder?

posterior wall

What does ureter/o mean?

Ureters

What does cyst/o mean?

bladder

What does urethr/o mean?

Urethra

Does a male or a female have a longer urethra?

male, has to go through penis

What are the 2 suprarenal (adrenal glands) apart of?

The endocrine system

What 4 terms are part of the abdominal cavity?

Peritonitis, mesentery, omentum, mesocolon

What are the 2 types of the peritoneum?

parietal and visceral

What is Ascites?

accumulation of serous fluid in the peritoneal cavity

What does the mesentery do for the abdominal cavity?

Double fold peritoneum to stabilize and support the small intestine

Greater and Lesser what?

Omentum

What does the greater omentum connect?

connects the transverse colon to the greater curvature of the stomach inferiorly

The organs on the test:

Kidney, pancreas, spleen, stomach

retroperitoneal organs

Pancreas and kidney

intraperitoneal organs

Spleen and stomach

How many quadrants are there?

4

What is located in the RUQ?

Liver, gallbladder, hepatic flexure, duodenum, head of pancreas, right kidney, and right suprarenal glands

What is located in the RLQ?

Ascending colon, appendix, cecum, and 2/3rd of ileocecal valve

What is located in the LUQ?

spleen, stomach, splenic flexure, tail of pancreas, left kidney, and left suprarenal gland

What is located in the LLQ?

Xiohoid process of sternum

T9-T10

Inferior costal margin location

L2-L3

Iliac crest location

L4-L5

Landmark ASIS:

Anterior superior iliac spine, on the iliac crest.

Landmark Greater trochanter:

Use for inferior margin of KUB

Landmark symphysis pubis:

Inferior margin of abdomen

Landmark ischial tuberosity:

symphysis pubis used for prone positioning

Breathing considerations for abdomen:

1: prevent voluntary motion (breathing)

2: prevent involuntary motion (heart beat)

3: use shortest exposure time to control involuntary motion

4: expose on expiration

For shortest exposure time do you use high or low mA?

Highest mA that you can

What is the kVp for an abdomen?

70-85 kVp

The parietal peritoneum adheres to what?

the abdominal cavity wall

The visceral peritoneum covers what?

covers an organ

Peritoneum:

a large serous, double-walled, saclike membrane that covers the abdominal cavity and contains most of the abdominal structures and organs.

What is cholelithiasis?

presence of gallstones in the gallbladder

Retroperitoneal means?

retro= behind

Infraperitoneal means?

infra=below

What organs are located infraperitoneal?

located in the true pelvis: lower rectum, urinary bladder, and reproductive organs

Intraperitoneal means?

intra=within

What organs are located intraperitoneal?

Liver, gallbladder, spleen, stomach, jejunum, ileum, cecum, and transverse and sigmoid colon: organs within the abdominal cavity that are covered by some type of visceral peritoneum

How many abdominal regions are there?

9

What are the 9 abdominal regions?

1. right hypochondriac

2. epigastric

3. left hypochondriac

4. right lumbar

5. umbilical

6. left lumbar

7. right iliac

8. hypogastric

9. left iliac

How many landmarks are used for the abdomen?

7

Anterior superior iliac spine (ASIS) location:

anterior aspect of the ilium- it is a prominent bump

Greater trochanter location:

rotate leg to feel it- at the same level of the pubis symphysis

Symphysis Pubis location:

the most superior anterior portion of the pubis

Ischial tuberosity location:

determines the lower margin on a PA abdomen or pelvis

What is easier to palpate on a bariatric (obese) patient?

ASIS; take two exposures both landscape

What needs to be performed if a patient has ascites?

An acute abdominal series- increase exposure factors

Pneomoperitoneum:

free air or gas in the peritoneal cavity.

best demonstrated in a horizontal beam decub, erect ab, or erect chest to see air rise

What should be performed for a pneumoperitoneum?

an acute abdominal series (erect); there will be a thin, crest-shaped radiolucency under the dome of the right hemidiaphragm on the erect images

Dynamic or mechanical bowel obstruction:

complete or nearly complete blockage of the flow of intestinal contents

What are the 4 types of dynamic blockage?

1. fibrous adhesions

2. Crohn's disease

3. Intussusception

4. Volvulus

Fibrous adhesions:

the most common cause of mechanically based obstruction, in which a fibrous band of tissue interrelates with the intestine, creating a blockage

Crohn's Disease:

chronic inflammation of the intestinal wall that results in bowel obstruction in at least half of affected patients

Intussusception:

telescoping of a section of bowel into another section or loop, creating an obstruction

Ileus (nonmechanical bowel obstruction):

Adynamic ileus and most frequently caused by peritonitis or paralytic ileus which is caused by lack of intestinal motility.

What does ileus mean?

intestinal obstruction

When does a nonmechanical bowel obstruction occur?

most in postoperative patients usually 24-72 hours after abdominal surgery.

Where does the large intestine begin?

begins in the RLQ at the junction of the small intestine and the ileocecal valve

Cecum: RLQ

is attached to the posteromedial aspect of the cecum

Ascending colon joins....

joins the transverse colon at the hepatic flexure (right)

Transverse colon joins...

descending colon at the splenic flexure (left).

What does colic mean?

pertaining to the colon

What is the transverse colon found between?

the hepatic and the splenic flexure

Descending colon continues as...

the S- shaped sigmoid colon in the lower abdomen

How long is the rectum?

final 6 inches

Where does the rectum end?

anus; sphincter muscle at the terminal opening of the large intestine

Is the transverse colon high or low in wide hypersthenic body types?

high in the abdomen

Is the transverse colon high or low in slender hyposthenic and asthenic body types?

low in the abdomen