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Questions and Answers
What borders the abdomen superiorly and then inferiorly?
What borders the abdomen superiorly and then inferiorly?
If a patient has had their parietal peritoneum removed, what would they be at increased risk for if they experience a perforation?
If a patient has had their parietal peritoneum removed, what would they be at increased risk for if they experience a perforation?
Which of the following is not an intraperitoneal organ?
Which of the following is not an intraperitoneal organ?
Which of the following is not an intraperitoneal organ?
Which of the following is not an intraperitoneal organ?
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Which of the following is not a retroperitoneal organ?
Which of the following is not a retroperitoneal organ?
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Which of the following is not a retroperitoneal organ?
Which of the following is not a retroperitoneal organ?
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What are two things that help protect the kidneys since they are retroperitoneal?
What are two things that help protect the kidneys since they are retroperitoneal?
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Which of the following is not intraperitoneal?
Which of the following is not intraperitoneal?
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During a laparoscopic surgery, what is inserted into the abdomen to blow the belly up with air (insufflation)?
During a laparoscopic surgery, what is inserted into the abdomen to blow the belly up with air (insufflation)?
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What is the double-layered fold of peritoneum mixed with fat that is the first thing you see when you cut into the stomach?
What is the double-layered fold of peritoneum mixed with fat that is the first thing you see when you cut into the stomach?
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What helps sequester infection and helps anchor the posterior liver to the lesser curvature of the stomach with ligaments?
What helps sequester infection and helps anchor the posterior liver to the lesser curvature of the stomach with ligaments?
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The liver is ____________ compared to the stomach.
The liver is ____________ compared to the stomach.
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The ____________ is the most common site of throat cancer due to repeated acid reflux.
The ____________ is the most common site of throat cancer due to repeated acid reflux.
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What is the purpose of the pyloric sphincter?
What is the purpose of the pyloric sphincter?
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What is the area where the greater omentum connects to the stomach?
What is the area where the greater omentum connects to the stomach?
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Why is the pancreas connected to the duodenum?
Why is the pancreas connected to the duodenum?
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What is chyme?
What is chyme?
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What is the difference in the jejunum compared to the ileum?
What is the difference in the jejunum compared to the ileum?
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What is the function of mesentery?
What is the function of mesentery?
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What takes up the most of the small intestines?
What takes up the most of the small intestines?
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What is the correct order of the digestive system?
What is the correct order of the digestive system?
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What would cause someone to have uncommon pain (back pain instead of stomach pain) when having appendicitis?
What would cause someone to have uncommon pain (back pain instead of stomach pain) when having appendicitis?
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Diverticulosis is commonly found where?
Diverticulosis is commonly found where?
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What is the correct order of the different parts of the large intestine?
What is the correct order of the different parts of the large intestine?
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What are some landmarks you look for on the large intestines?
What are some landmarks you look for on the large intestines?
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How does the taeniae coli create haustra of colon?
How does the taeniae coli create haustra of colon?
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What would Dr. Lang consider the 'accessory organs' of digestion?
What would Dr. Lang consider the 'accessory organs' of digestion?
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What is not one of the lobes of the liver?
What is not one of the lobes of the liver?
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In the removal of the gallbladder (cholecystectomy), what duct is supposed to be cut?
In the removal of the gallbladder (cholecystectomy), what duct is supposed to be cut?
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What organ does not have an impression on the posterior side of the liver?
What organ does not have an impression on the posterior side of the liver?
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What process is bile made from in the liver and what is its purpose?
What process is bile made from in the liver and what is its purpose?
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Bile salts can turn into stones which are usually formed in what structure resulting in a cholecystectomy?
Bile salts can turn into stones which are usually formed in what structure resulting in a cholecystectomy?
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Where do the liver, gallbladder, and pancreas release their products into the duodenum?
Where do the liver, gallbladder, and pancreas release their products into the duodenum?
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What is a common observance of a UTI seen in a CT once it hits the kidneys?
What is a common observance of a UTI seen in a CT once it hits the kidneys?
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What is the correct order of urine excretion through the kidney?
What is the correct order of urine excretion through the kidney?
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If one of your patients has an infection and is hence using more oxygen to create ATP to fight the infection, what would you expect their body to be producing?
If one of your patients has an infection and is hence using more oxygen to create ATP to fight the infection, what would you expect their body to be producing?
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What are some alternate forms of energy that the body can use if it does not have glucose or can't use it?
What are some alternate forms of energy that the body can use if it does not have glucose or can't use it?
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What is not a telltale sign of DKA?
What is not a telltale sign of DKA?
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Where is the first point of mechanical digestion and the first point of chemical digestion?
Where is the first point of mechanical digestion and the first point of chemical digestion?
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The stomach has the main goal of what?
The stomach has the main goal of what?
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What structure helps the small intestine have the biggest part in absorption?
What structure helps the small intestine have the biggest part in absorption?
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What organ can you not live without?
What organ can you not live without?
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Which of the digestive enzymes from the acinar cells of the pancreas are not matched with what they break down?
Which of the digestive enzymes from the acinar cells of the pancreas are not matched with what they break down?
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Someone you know has recently been diagnosed with Type I diabetes, what pancreatic cells are being destroyed due to autoimmune destruction?
Someone you know has recently been diagnosed with Type I diabetes, what pancreatic cells are being destroyed due to autoimmune destruction?
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What is the storage form of glucose in the liver and what is sent by the pancreas to allow its release?
What is the storage form of glucose in the liver and what is sent by the pancreas to allow its release?
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Pancreatic cancer used to be a death sentence until what procedure was invented?
Pancreatic cancer used to be a death sentence until what procedure was invented?
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The reason why the 'Keto' diet is so dangerous is because you are not eating carbs, making your body use fat for energy, which makes your body acidic because it produces what as a byproduct?
The reason why the 'Keto' diet is so dangerous is because you are not eating carbs, making your body use fat for energy, which makes your body acidic because it produces what as a byproduct?
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What is not a component of bile salts?
What is not a component of bile salts?
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What does the pancreas release to help the duodenum to regulate acidity?
What does the pancreas release to help the duodenum to regulate acidity?
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What hormone triggers the release of bile salts by stimulating gallbladder contraction and relaxation of sphincter of Oddi?
What hormone triggers the release of bile salts by stimulating gallbladder contraction and relaxation of sphincter of Oddi?
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In what part of the digestive system are 95% of bile salts reabsorbed to be used again?
In what part of the digestive system are 95% of bile salts reabsorbed to be used again?
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What organ does all of the blood in the abdomen go through (a malfunction of this can cause ascites)?
What organ does all of the blood in the abdomen go through (a malfunction of this can cause ascites)?
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Which of the following is not a function of the liver?
Which of the following is not a function of the liver?
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Which of the following is not a function of the liver?
Which of the following is not a function of the liver?
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What is the first-pass mechanism?
What is the first-pass mechanism?
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Acetaminophen is contraindicated in those with ____________. while ibuprofen (NSAIDs) is contraindicated in those with ____________.
Acetaminophen is contraindicated in those with ____________. while ibuprofen (NSAIDs) is contraindicated in those with ____________.
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Which of the following is not one of the ways the liver is involved in protein synthesis?
Which of the following is not one of the ways the liver is involved in protein synthesis?
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Which of the following is a way that the liver plays a role in metabolism?
Which of the following is a way that the liver plays a role in metabolism?
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Which of the cytochrome P450 enzymes make up 90% of the activity?
Which of the cytochrome P450 enzymes make up 90% of the activity?
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If a cytochrome P450 enzyme is inhibited, what would cause an increase in toxicity?
If a cytochrome P450 enzyme is inhibited, what would cause an increase in toxicity?
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You have a patient that states they haven't eaten since yesterday morning; what process would you expect to be happening?
You have a patient that states they haven't eaten since yesterday morning; what process would you expect to be happening?
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Insulin lowers blood sugar levels by doing what?
Insulin lowers blood sugar levels by doing what?
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How does glucagon increase blood glucose levels?
How does glucagon increase blood glucose levels?
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In diabetes type II, insulin receptors are being downregulated where?
In diabetes type II, insulin receptors are being downregulated where?
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Study Notes
Abdomen Borders
- The abdomen is bordered superiorly by the inferior thoracic aperture and inferiorly by the pelvic inlet.
Parietal Peritoneum
- The parietal peritoneum lines the abdominal cavity.
- If this is removed, there is an increased risk of peritonitis (infection) if a perforation occurs because the peritoneum acts as a barrier to infections.
Intraperitoneal Organs
- Intraperitoneal organs are organs that are completely surrounded by peritoneum.
- Examples include:
- Stomach
- Spleen
- Liver
- Jejunum
- Ileum
- Transverse Colon
- Second and third part of the duodenum
Retroperitoneal Organs
- Retroperitoneal organs are organs that lie behind the peritoneum.
- Examples include:
- Kidneys
- Pancreas
- Aorta
- Ascending and descending colon
- Ureters
- Adrenal glands
- First and fourth parts of the duodenum
- Kidneys are protected by the ribs and perirenal fat.
Peritoneal Structures
- The greater omentum is a double-layered fold of peritoneum mixed with fat that helps sequester infection and anchors the posterior liver to the lesser curvature of the stomach.
- The lesser omentum helps anchor the posterior liver to the lesser curvature of the stomach.
- Trocars are used in laparoscopic surgery to access the abdomen and inflate it with CO2 for insufflation.
Stomach and Esophagus
- The stomach is superior to the liver.
- The gastroesophageal junction (GE junction) is the most common site of throat cancer due to repeated acid reflux.
- The pyloric sphincter controls the release of stomach contents into the small intestine.
- The greater curvature is the area where the greater omentum connects to the stomach.
Pancreas and Duodenum
- The pancreas is connected to the duodenum to deliver digestive enzymes.
- The duodenum is the first part of the small intestine.
Digestion
- Chyme is a semi-fluid mass of partially digested food.
- The jejunum and ileum are the two main sections of the small intestine.
- The jejunum has more plicae circulares than the ileum, which helps increase surface area for absorption.
- The mesentery supports and stabilizes the intestines.
- The small intestines, particularly the jejunum, are the site of most nutrient absorption.
- The large intestine consists of the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum.
Large intestine Landmarks
- Haustra are pouches in the large intestine created by the taeniae coli, which are bands of smooth muscle that run along the length of the colon.
Accessory Organs
- Accessory organs of digestion include the pancreas, liver, and gallbladder. These organs play a role in producing enzymes, bile, and regulating blood sugar.
Liver Structures
- The liver has five lobes: right, left, caudate, quadrate, and a "Coudé" lobe.
- The gallbladder fossa (impression on the posterior side) of the liver is where the gallbladder is located.
- The renal impression on the posterior side of the liver is from the right kidney.
- Bile is produced in the liver from the breakdown of RBCs and is used to emulsify fats.
- Bile is stored in the gallbladder, and the cystic duct connects the gallbladder to the common bile duct.
- The sphincter of Oddi is located at the point where the common bile duct enters the duodenum.
- The liver plays a crucial role in blood sugar balance, protein synthesis, cholesterol production, storage of micronutrients, and detoxification of harmful substances.
Pancreas and Diabetes
- The pancreas produces digestive enzymes from acinar cells and hormones from islet cells.
- The pancreas releases bicarbonate to help neutralize the acidity of chyme in the duodenum.
- Type I diabetes is an autoimmune disease where the beta cells of the pancreas are destroyed, leading to a deficiency in insulin production.
- Type II diabetes is characterized by downregulation of insulin receptors in the liver and tissues.
- Glucagon is a hormone released by the pancreas that increases blood glucose levels by stimulating glycogenolysis in the liver.
- Glycogen is the storage form of glucose in the liver.
Kidney Function
- The kidneys are responsible for filtering blood and producing urine.
- Urine flows through the following structures in order: nephron, collecting duct, renal pelvis, ureter, bladder, and urethra.
- Perinephric fat stranding (inflammation) is a common observable finding in a CT scan in the kidneys during a UTI.
Metabolism
- Gluconeogenesis is the process of creating glucose from non-carbohydrate sources such as amino acids and glycerol.
- Ketogenesis is the process of producing ketones from fatty acids.
- Ketones are acidic byproducts that are produced when the body breaks down fats for energy.
Liver Function
- The liver plays a role in protein synthesis, including
- Blood clotting (prothrombin)
- Copper bioavailability (ceruloplasmin)
- Cholesterol transport (lipoproteins)
- Immune Function (globulin)
- The liver also plays a role in metabolism, such as
- Conversion of T4-T3 (thyroid hormones)
- Conversion of excess fatty acids to urea
- Conversion of amino acids to ketone bodies
- The liver metabolizes drugs through cytochrome P450 enzymes. The CYP3A4 and CYP2D6 enzymes make up 90% of the enzyme activity.
- Inhibiting cytochrome P450 enzymes can lead to decreased drug metabolism and increased drug toxicity.
- The liver also plays a role in regulating blood glucose levels.
- Insulin lowers blood sugar levels by facilitating glucose uptake by cells.
- Glucagon increases blood sugar levels by stimulating glycogenolysis in the liver and inhibiting glycogen synthesis.
- The liver is also the major site of blood filtration and detoxification.
First Pass Mechanism
- The first-pass mechanism refers to the metabolism of drugs in the liver before they enter the systemic circulation.
- Acetaminophen is contraindicated in those with liver disease.
- Ibuprofen (NSAID) is contraindicated in those with renal disease.
Other Key Points
- The spleen is the largest lymphatic organ in the body and is involved in the immune system, but is not essential for life.
- Ascites is a condition where fluid builds up in the abdominal cavity, often due to malfunction of the liver.
- The ileum is the longest part of the small intestine and is the site of most bile salt reabsorption.
- Cholecystokinin (CCK) is a hormone that stimulates gallbladder contraction and relaxation of the sphincter of Oddi, which triggers the release of bile salts.
- DKA (diabetic ketoacidosis) is a dangerous condition that can occur in type I diabetics, and is characterized by hyperglycemia, ketosis, metabolic acidosis, and dehydration.
- Polyuria (increased urination) and polydipsia (increased thirst) are common symptoms of DKA.
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Description
Test your knowledge on the anatomy of the abdomen and the peritoneum. This quiz covers key concepts such as intraperitoneal and retroperitoneal organs, as well as the implications of peritoneum removal on infection risks. Challenge yourself to identify these important structures and their functions!
