Pathological, surgical, or traumatic formation of an opening between two normally separate organs
A secretion of the liver that breaks down fats, preparing them for digestion & absorption in the small intestine
A white liquid that consists of products of digestion, chiefly emulsifies fats, that passes through the small intestine into the lymphatic system
1) Refers to the outer portion of a cavity or organ.
2) Pertaining to the parietal bone of the cranium.
3) Pertaining to the parietal lobe of the cerebrum
Rythmic contractions of smooth muscle layers that force food through the GI tract urine through the ureters, and bile through the common bile ducts
Portal venous system
Venous system that carries blood to a second capillary bed prior to returning blood to the general circulation
A crater-like lesion that is usually circular in shape & penetrates the skin; may be very deep, resulting from infection
Linea alba literally means_____ ____ and will be found in the ______ abdominal wall.
white line; rectus
What is the primary function of the peritoneum
Provide a slippery surface of which the viscera can glide
Identify the three regions of the retroperitoneal space and the organs that are located in each
Anterior pararenal; Pancreas and parts of the duodenum and colon.
Parirenal; Holds structures of the ruologic & vascular concern
Posterior pararenal; Contains NO organs
Trace the alimentary pathway
Mouth; Uvula; Pharynx; Epiglottis; Esophagus; Cardiac sphincter; Fundus of stomach; Cardia of stomach; Body of stomach; Pylorus of stomach; Pyloric sphincter; Duodenum; Jejunum; Ileum; Ileocecal valve; Cecum; Ascending colon; Hepatic flexure; Transverse colon; Splenic flexure; Descending colon; Sigmoid colon; Rectum; Anus.
Lower GI tract
Ileocecal valve; Cecum; Ascending Colon; Hepatic flexure; Transverse colon; Splenic flexure; Descending colon; Sigmoid colon; Rectum; Anus
Identify the five major segments of the stomach and the purpose of each section
Cardia; secretes mucous to ease passage of food. Fundus; produces hydrochloric acid. Corpus; produces acid & secretes pepsinogen & mucous. Antrum; non-acid producing secretes mucous & gastrin. Pylorus; food storage area before is passes in the duodenum.
Parasympathetic innervation to the stomach is provided by the ______ nerve. This nerve and the main left and right gastric arteries run primarily along ________ of the stomach. The left gastroepiploic artery is located primarily along the _____ of the stomach.
The four layers of the wall of the digestive tract are
Mucousa; Submucousa; Muscularis External; Serosa
The breaking down of large fat globules into the intestines into smaller, uniformly distributed particles
The movement of food through the intestines by the muscles of the alimentary canal is called______
What is the purpose of the mesentary?
Contain blood vessels, nerves, and lymph vessels that serve the adjoining organs.
The three segments of the gallbladder manipulated during removal include:
Fundus, body, Hartman's Pouch
The biliary tree outlined during an intraoperative cholangiogram my include:
R & L Hepatic ducts, Common hepatic duct, Cystic duct, Common bile duct.
Identify the duct(s) that transport enzymes from the pancreas to duodenum.
Duct of Santorini, Duct Wirsung
Where are the islets of Langerhans located and what is their function?
In the pancreas for the production of insulin.
What is the largest parenchymal organ in the normal abdominal cavity. Identify the blood supply of this organ.
Liver; Hepatic portal vein
List the functions that are performed by the cells of the liver.
Produce bile; Metabolize carbs, fats, & proteins; Store sugar as glycogen; Store fat soluble vitamins, A,D,E & K, plus iron & copper; Detoxify harmful substances via phagocytosis.
List the significant tissues and landmarks of the groin area.
Skin & subcutaneous tissues, Scarpa's fascia, interparietal fascia, internal oblique muscle, transverse abdominus muscle, transversalis fascia, Cooper's ligament, rectus abdominus muscle and peritoneum.
Inguinal hernias occur_____the abdominocrural crease; femoral hernias occur_____the abdominocrural crease
Where can varicose veins occur?
Lower extremity, but can also be; lower esophagus, spermatic cord, and in anorectal region.
What is the major function of the thyroid gland?
Makes, stores and releases the hormones, T4 & T3.
Describe the parathyroid glands
Number from 2-6 and are small, flat, oval structures lying on the dorsal side of the thyroid gland.
Defect in abdominal wall affecting structures of spermatic cord, Scarpa's fascia, cremaster muscle
What are the two types of choleliths, and what is the composition of each?
Cholesterol stones; by-product of liver bile.
Pigment stones; composed of calcium biliruinate, bilirubin polymers, bile acids, irons & phosphors
Peptic ulcers are most frequently found in which location?
Inside the lining of the esophagus, stomach and the upper portion of small intestines.
Define gynecomastia, and describe the surgical treatment.
Development of breast tissue on a male; can be function and develop cancer.
Is the Maloney dilator inserted under sterile conditions? Why?
No. It is used by the anesthesiologist who is not sterile.
Explain what is meant by the phrase "mobilize the bowel."
Detach it from its support structures in prep for resection or anastomosis
List the three basic configurations for intestinal anastomosis
End to End
End to Side
Side to Side
What ligament is sued as an anatomical landmark to identify the end of the duodenum and the beginning of the jejunum
Ligament of Treitz
Describe the technique used to care for instrumentation and supplies that have been exposed to the inside of the intestinal tract.
Bowel technique; All instruments exposed are contained within the immediate field & when removed placed in a separate, but visible basin for subsequent counting.
What is a stoma?
A communication of a section of bowel with the outside of the abdominal cavity that is created to divert the fecal stream
Describe the difference between and end colostomy and a loop colostomy.
"End" is created from the descending colon. "Leep" utilizes the transverse colon.
Why is it important to expel all air from the cholangiogram system prior to an intraoperative cholangiogram?
The air bubble can be mistaken for a gallstone.
What is the reason for providing a second setup to perform a breast reconstruction following a modified radical mastectomy due to a malignancy?
To keep any cancerous cells away from instruments that are going to be used for reconstruction.
Why is it important for STSR to maintain the sterile field until the patient is extubated and breathing freely following a thyroidectomy?
In case they start to bleed and need to come back to the OR.
removal of a breast and the underlying muscles (pectoralis major and pectoralis minor) and lymph nodes in the adjacent armpit
Modified radical mastectomy
removal of a breast and the pectoralis minor and some lymph nodes in the adjacent armpit
surgical removal of a tumor without removing much of the surrounding tissue or lymph nodes
Inferior epigastric artery, Lateral border of the rectus abdominus, and Inguinal ligament
Muscle that pulls the scrotum closer to the body in cold temperatures and relaxes to let the testicles be farther away from the body in warmer weather
Motor fibers that cause the cremaster muscle to contract, elevating the testis
inflation of the peritoneal cavity with carbon dioxide gas to prevent injury to abdominal structures during laparoscopic surgery
cannot be felt on clinical examination; this type of breast mass is one that is usually identified on screening mammogram and is too small to be felt as a breast lump on BSE or CBE.
Begins at pyloric sphincter; duodenum (superior, descending transverse, ascending) terminates at the ligament of Treitz; jejunum (thicker walls, wider lumen, absorption); ileum; mesenteric small intestine. Terminates at the ileocecal valve
Hollow tube; connects the pharynx above (pharyngoesophageal sphincter); connects the stomach below (cardiac sphincter)
*Fundus; Hydrochloric acid
*Cardia; Muscus secretions
*Corpus; acid, pepsinogen, mucus
*Antrum; mucus, gastrin
*Pylorus; storage area
*Rugae; gastric pits
Cecum (pouch, appendix), Ascending, Transverse, Descending, Sigmoid, Rectum, Anus, Compaction of fecal waste, Production of vitamin K, Absorption of water/Electrolytes, Left colon is for storage
Lesser omentum - Continous with peritoneum
Greater omentum - Four layers, Stores fat, Limits peritoneal infection
Both Endocrine & Exocrine
Endocrine - Islets of Langerhans (Alpha cells, Glucagon; Beta cells, Insulin)
Exocrine - Duct of Wirsung (Breaks down: fats, rotein, carbs, nucleic acids
Lymphatic tissue, Left Upper Quadrant, Filtration, White pulp; Lymphocytes, Red pulp; Erythrocyte storage
Larges organ; Produces bile; Metabolizes, carbs, fats, proteins; Detoxifies; Stores suger as glycogen; Synthesizes, prothrombin, Fibrinogen; stores vitamins, A, D, E, K, Iron & Copper
Communicates between the liver and the duodenum; Gallbladder; Cystic duct; Common hepatic duct; Common bile duct; Sphincter of Oddi
removal of the colon and rectum through both abdominal and perineal approaches; performed to treat colorectal cancer and inflammatory diseases of the lower large intestine
laparotomy performed with a laparoscope that makes a small incision to examine the abdominal cavity (especially the ovaries and Fallopian tubes)
procedure whereby a section of the large intestine is removed and its continuity is restored
closed sac located in the sacrococcygeal area of the back; sometimes noted at birth as a dimple
Extensive surgical technique whereby the head of the pancreas, duodenum, part of the jejunum and part of the stomach are removed. Usually done in cases of early pancreatic cancer.
Randall stone forceps, Scoops, Potts scissors, Bakes dilators, Gallbladder trocar
Trocars, Veress needle, Laparoscope, Grasping forceps, Laparoscopic Babock, Laparoscopic scissors, Electrocauter
Muscle; External/External oblique Transversus abdominus
removal of the gall bladder through small punctures in the abdomen to permit the insertion of a laparoscope and surgical instruments
The surgical dissection of branches of the vagus nerve to reduce acid secretion in the stomach
Anatomy of the Groin
External oblique muscle
Internal oblique muscle
Transverse abdomonius muscle
Rectus abdominus muscle
postoperative hernia caused by a weakness in the abdominal wall from the incision or postoperative complications
hernia resulting from the protrusion of part of the stomach through the diaphragm
is a hernia in which the contents of the hernial sac can be returned to their normal position. (Inguinal Hernia)
is an irreducible hernia in which the contents of the hernial sac are entrapped or stuck in the groin
occurs when a portion of the intestine is constricted inside the hernia and its blood supply is cut off.
A hernia in which the stomach and a section of esophagus which joins the stomach slide up into the chest through what is called the hiatus
hernia in which a loop of intestine enters the inguinal canal; most common type in males
Superior thyroid artery
Inferior thyroid artery
Recurrent laryngeal nerve
Four parathyroid glands
Produce, store, and release thyroxine and tri-iodothyronine hormone
Regulations of metabolism
Maintain calcium homeostasis
Dorsal side of the thyroid
Maintains blood calcium levels
along the posterior side of the body made of the cranial cavity and the spinal cavity
Diaphragmatic Cavity/Thoracic Cavity; heart, lungs, blood vessels/Pericardium Cavity; heart
the part of the thoracic cavity between the lungs that contains the heart and aorta and esophagus and trachea and thymus
Contains: Abdominal; most of the intestines, liver, gallbladder, spleep, pancreas, stomach, kidneys. Pelvic cavities; Urinary bladder, rectum, reproductive system.
Numerous arteries that go into the remainder of the small and all of the large intestines; come off the dorsal aorta.