Abdomen & Superficial Structures Review

108 Questions

What is the average anteroposterior diameter of the adult abdominal aorta?

2 cm

Which organs receive blood supply from the splenic artery?

Spleen, pancreas, and stomach

What are the branches of the common hepatic artery?

Gastroduodenal artery and proper hepatic artery

What branches does the abdominal aorta give rise to?

Inferior phrenic arteries, superior mesenteric artery, median sacral artery

What are the landmarks of the ascending aorta?

From the sino-tubular junction to the takeoff of the innominate artery

Which arteries originate from the aortic arch?

Innominate artery, left common carotid artery, left subclavian artery

What is the term for the percentage by volume of red blood cells in the blood?

Hematocrit

Which breathing technique would move the spleen inferiorly away from the bony thorax alleviating rib shadows when scanning the spleen?

Inhaling

Which part of the spleen is not covered by the peritoneum?

Hilum

Which blood test is indicative of an infection?

CBC (Complete Blood Count)

What is the most common location of accessory spleens?

Near the splenic hilum or attached to the tail of the pancreas

What is the function of the spleen related to iron?

Stores iron

During fetal life, what does the spleen produce?

Red blood cells

What is an abnormal decrease in the number of circulating platelets termed?

Thrombocytopenia

What is the echogenicity of the spleen compared to neighboring liver parenchyma and cortex of left kidney?

Less echogenic than pancreas and more echogenic than cortex of kidney

What does the spleen act as during fetal life?

A site for removal of old RBCs, WBCs, and platelets

Which vessel carries blood from the gastrointestinal tract, spleen, pancreas, and gallbladder toward the liver?

Portal vein

What is the function of the hormone cholecystokinin (CCK)?

Aid in fat digestion

Which structure has echogenic walls?

Portal vein

Where does the portal vein bifurcate into right and left branches?

At the porta hepatis

Which part of the stomach is intraperitoneal?

Fundus

Where does most digestion occur?

Duodenum

Which vessel is posterior to the hepatic veins?

Inferior vena cava

Where does the abdominal aorta appear as an anechoic tubular structure with echogenic pulsating walls?

Aorta

Which part of the small intestine is retroperitoneal?

Ileum

What is the function of angiotensin II?

Increase blood pressure

What causes heartburn and acid taste known as GERD?

Incompetent cardiac sphincter

What is the function of the Ileocecal valve?

Connects small intestine to large intestine

What is the name of the localized bulge on the lateral surface of the kidney?

Dromedary hump

Which lab values are important to evaluate renal function?

Blood urea nitrogen and creatinine

What does the infant adrenal gland secrete?

Epinephrine and norepinephrine

What are the dimensions of adult kidneys approximately?

9-12 cm length, 4-6 cm diameter, 2.5-4 cm thickness

Which vessel delivers most of the blood flow to the liver?

Portal vein

From which vessel does the common hepatic artery originate?

Celiac trunk

Which region does the liver occupy?

Right hypochondriac region and epigastric region

What is responsible for the immune functions of the spleen?

White pulp

What is found within the falciform ligament on the inner surface of the anterior abdominal wall?

Ligamentum teres

What is described as hypoechoic compared to the liver?

Spleen

What does hemoglobin produce when broken down?

Hemosiderin

Which hormone is released from the small intestine by the presence of fat?

Cholecystokinin

What may cause difficulty in sonographic visualization of the bowel?

Bowel gas, fecal material, and obesity

Which layers of the bowel have characteristic sonographic appearance?

Lumen, mucosa, submucosa, muscularis propria, and serosa

What defines intussusception, a bowel abnormality?

Invagination of a proximal bowel segment into the lumen of a distal bowel segment

What is a characteristic feature of normal bowel loops?

Peristalsis and compressibility

What lines the walls of the abdominal and pelvic cavities?

Parietal peritoneum

What are the divisions of renal medulla called?

Renal columns of Bertin

What does the renal collecting system consist of?

Infundibulum, renal pelvis, and ureter

What causes release of renin from granular cells in the afferent arteriole?

Decrease in blood volume

What are nitrogenous wastes in the blood?

Urea, creatinine, uric acid, and ammonia

What is the function of granular cells in the afferent arteriole?

Secrete renin to increase salt and water reabsorption in the distal collecting tubules

What are the parts of the aorta?

Aortic root, ascending aorta, aortic arch, thoracic aorta, abdominal aorta

Which organs receive blood supply from the splenic artery?

Spleen, pancreas, and stomach

What are the branches of the common hepatic artery?

Hepatic artery proper and gastroduodenal artery

What is the average anteroposterior diameter of the adult abdominal aorta?

$2.5-3.0$ cm

What are the landmarks of the ascending aorta?

Valvular annulus to sino-tubular junction

What organs receive blood supply from the common iliac arteries?

Pelvis and lower extremities

What is the function of the spleen related to red blood cells?

Removes old RBCs

Which breathing technique would move the spleen inferiorly away from the bony thorax alleviating rib shadows when scanning the spleen?

Inhaling

What is the term for the percentage by volume of red blood cells in the blood?

Hematocrit

Which test in the blood is indicative of an infection?

Complete Blood Count (CBC)

What does an abnormal decrease in the number of circulating platelets termed?

Thrombocytopenia

Is the spleen a retroperitoneal or intraperitoneal organ?

Intraperitoneal

How is the spleen related to the stomach in terms of location?

Lies posterolateral to the body and fundus of the stomach

What is the most common location of accessory spleens?

Near the splenic hilum

Where does the spleen produce RBCs during fetal life?

Red pulp

What marks the borders between liver segments?

Main portal vein

What is the medical term for the condition where the kidneys are fused together at the lower end or base?

Horseshoe kidney

Which lab values are important to evaluate renal function?

Blood urea nitrogen, creatinine, glomerular filtration rate, and specific gravity

What is the term for the plane between the gallbladder and the inferior vena cava that separates the right lobe from the left lobe of the liver?

Ligamentum venosum

Which vessel delivers most of the blood flow to the liver?

Portal vein

Which region does the liver occupy?

Right hypochondriac region and epigastric region

Which artery originates from the celiac trunk?

Common hepatic artery

Where is the spleen located?

Left hypochondriac region

What are the segments of the left lobe of the liver?

Caudate lobe, left lateral superior, left lateral inferior, left medial superior, and left medial inferior

Which vessel carries blood from the gastrointestinal tract, spleen, pancreas, and gallbladder toward the liver?

Portal vein

What are lab values important to evaluate renal function?

Blood urea nitrogen, creatinine, glomerular filtration rate, and specific gravity

Which hormone is released from the small intestine by the presence of fat?

Cholecystokinin (CCK)

What causes difficulty in sonographic visualization of the bowel?

Presence of air and fecal material

What is the most common location of accessory spleens?

Mediastinum

What are the dimensions of adult kidneys approximately?

$5 imes 3 imes 1$ cm

Which part of the stomach is intraperitoneal?

Fundus

Which breathing technique would move the spleen inferiorly away from the bony thorax alleviating rib shadows when scanning the spleen?

"Diaphragmatic breathing"

What defines intussusception, a bowel abnormality?

$Telescoping$ of one segment of bowel into another

What is responsible for the immune functions of the spleen?

"White pulp"

From which vessel does the common hepatic artery originate?

"Celiac artery"

Which part of the small intestine is retroperitoneal?

Duodenum

Which vessel appears as an anechoic tubular structure with echogenic pulsating walls in its longitudinal section?

Abdominal aorta

What is the most common indication for evaluating the portal venous system using ultrasound imaging?

Liver cirrhosis

Which structure carries blood from the gastrointestinal tract, spleen, pancreas, and gallbladder toward the liver?

Hepatic portal vein

Which part of the small intestine is retroperitoneal?

Ileum

What hormone is released from the small intestine by the presence of fat?

Cholecystokinin (CCK)

What marks the borders between the liver segments?

Interlobular septa

Which part of the stomach is intraperitoneal?

Fundus

Which valve connects the ileum of the small bowel to the cecum of the large bowel?

Ileocecal valve

What is responsible for carrying 75% of hepatic flow and 50% of oxygen to the liver?

Hepatic portal vein

What is the function of angiotensin II?

Vasoconstriction

Where do the biliary canaliculi originate from?

Hepatic lobules

What is the function of the valve of Heister?

Prevent the collapse or overextension of the GB neck

Which artery supplies the gallbladder?

Cystic artery

What is the location of Phrygian cap in the gallbladder?

Fundus

Which structure guards the entrance of the bile duct to the intestinal wall?

Sphincter of Oddi

What structures form the portal triad?

Portal vein, hepatic artery, hepatic duct

Where does the biliary tree drain to?

To the first segment of the duodenum

Which structure guards the entrance of the bile duct to the intestinal wall?

Sphincter of Oddi

What is the function of the valve of Heister?

Prevents reflux of bile into the liver

Which artery supplies the gallbladder?

Hepatic artery

Which part of the gallbladder projects below the inferior margin of the liver?

Fundus

What are the functions of the gallbladder?

Stores and concentrates bile

Study Notes

Cholecystokinin is a hormone released from the small intestine by the presence of fat.
Difficulty in sonographic visualization of the bowel can be caused by bowel gas, fecal material, and obesity.
Bowel layers have characteristic sonographic appearance, including lumen, mucosa, submucosa, muscularis propria, and serosa. First, third, and fifth layers are echogenic, while second and fourth layers are hypoechoic.
Intussusception is a bowel abnormality where a proximal bowel segment invaginates into the lumen of a distal bowel segment.
Normal bowel loops demonstrate peristalsis and are compressible.
Parietal peritoneum lines the walls of the abdominal and pelvic cavities, and visceral peritoneum covers the organs.
Kidneys are located in the retroperitoneal region of the abdomen, with the hilum as the concave border and the cortex as the convex border.
The order of tissue layers surrounding the kidney includes the renal capsule, perirenal fat, Gerota's fascia, and pararenal fat.
Kidney parenchyma consists of the cortex and medulla, and the divisions of renal medulla are called renal columns of Bertin.
The renal collecting system consists of the infundibulum, renal pelvis, and ureter. The renal pelvis is the upper expanded end of the ureter, and the renal hilum is the medial portion of the renal sinus where the renal artery enters and the renal vein and ureter exit.
The left renal vein is longer and the right renal artery is longer due to the positions of the IVC and aorta in the body.
From the most anterior to the most posterior, the structures in a female are the pubic bone, bladder, uterus, vagina, and rectum.
The ureters enter the urinary bladder posteriorly at the trigone area.
Granular cells in the afferent arteriole detect a decrease in blood volume and release renin, which acts on angiotensinogen to increase systemic pressure. Macula densa cells in the distal convoluted tubule can inhibit renin secretion when blood volume returns to normal.
Nitrogenous wastes in the blood include urea, creatinine, uric acid, and ammonia.
Granular cells in the afferent arteriole secrete renin, which increases salt and water reabsorption in the distal collecting tubules.
The kidney functions include urine production, detoxification of blood, maintaining acid base balance, maintaining normal iron levels, blood pressure regulation, and stimulating red blood cell production.
Adult kidneys have a highly reflective (hyperechoic) appearance in the renal sinus and true capsule, while the renal medulla is anechoic when filled with urine. Normal kidneys in children are hypoechoic to the liver with a relative increase in brightness in the cortex.
A localized bulge of the lateral surface of the kidney is called a renal sinus horn or a renal sinus angle.
The superior abdominal aorta is about 2 cm in diameter at its start and 1 cm at the bifurcation.
Angiotensin II is a vasoconstrictor.
The abdominal aorta in its longitudinal section appears as an anechoic tubular structure with echogenic pulsating walls.
Low-resistance waveforms should be present in the internal carotid artery, vertebral arteries, renal arteries, branches of the celiac trunk, and postprandial SMA.
The aorta is posterior to the body of the pancreas, left lobe of the liver, left renal vein, and medial to the left kidney.
The inferior phrenic veins are the most superior tributaries that empty into the IVC.
The normal adult IVC at the junction with the right atrium has a diameter up to 2.5 cm on expiration.
Venous valves, ventricular contraction with the pressure gradient, and respiratory movements help the blood to move forward in the veins.
The IVC is to the right side of the aorta and posterior to the hepatic veins.
The IVC forms at the level of the fifth lumbar vertebra.
The portal vein forms posterior to the pancreas neck.
The main portal vein courses superiorly for about 5 cm, reaching the porta hepatis where it bifurcates into right and left branches.
The normal main portal vein is 5 cm long with a diameter up to 1.3 cm in adults.
The right portal vein gives rise to anterior and posterior branches, and the left portal vein gives rise to medial and lateral branches.
The portal vein carries blood from the GIT, spleen, pancreas, and gallbladder toward the liver for detoxification and metabolism.
The portal triad is composed of branches of the portal vein, hepatic artery, and hepatic bile duct, located at the porta hepatis and the corners of the hepatic lobules.
Portal veins have echogenic walls.
Ultrasound imaging, including gray-scale images, color Doppler, and duplex imaging, is the best tool to evaluate the portal venous system with the most common indication being portal hypertension.
The best plane to visualize the union of the superior mesenteric vein and splenic vein is in a transverse section.
Portal vein provides 75% of hepatic flow and 50% of oxygen to the liver.
Most digestion occurs in the duodenum, and nutrients are absorbed in the small bowel.
The cardiac sphincter at the junction of the esophagus with the stomach is incompetent causing heartburn and acid taste known as GERD.
The bulb of the duodenum is posterior to the common bile duct and common hepatic artery.
The descending duodenum (2nd segment) receives the common bile duct.
The fundus, body, and pylorus are parts of the stomach, intraperitoneal.
The duodenum, jejunum, ileum are parts of the small intestine, the first segment of the duodenum is intraperitoneal, the second, third, and fourth segments of the duodenum, jejunum, and ileum are retroperitoneal.
The large intestine is composed of the vermiform appendix; cecum; ascending, transverse, descending, and sigmoid colons; rectum; and anus. The ascending colon, descending colon, rectum, and anal canal are retroperitoneal structures; the cecum and transverse colon are intraperitoneal.
The ileocecal valve connects the ileum of the small bowel to the cecum of the large bowel.
The cecum does not have a mesentery and so has a variable attachment to the posterior abdominal wall.
The appendix arises approximately 2.5 cm inferior to the cecum and posteromedial to the ileocecal valve.
The bend of the ascending colon is called the hepatic (right colic) flexure, and the bend of the transverse colon that courses down is called the splenic (left colic) flexure.
The hormone released from the small intestine by the presence of fat is cholecystokinin (CCK).

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