1: Introduction to the GI System

Question 1

Where does the peritoneal cavity lie?

Answer 1

Between the parietal and visceral layers of peritoneum

Question 2

What does the peritoneal cavity contain? (2 things)

Answer 2

NO ORGANS Peritoneal Fluid

Question 3

What absorbs the peritoneal fluid

Answer 3

Lymphatic vessels on the interior surface of the diaphragm

Question 4

What’s the difference between the male and female peritoneal cavity?

Answer 4

Males: cavity completely closed Females: Cavity open to exterior of body through uterine tubes, cavity and vagina

Question 5

Why are females more prone to infection? (to do with peritoneal cavity)

Answer 5

Because peritoneal cavity open to exterior of the body

Question 6

What does the parietal peritoneum line?

Answer 6

Internal surface of abdominal wall

Question 7

What does the visceral peritoneum line? (2 things)

Answer 7

Stomach Intestines

Question 8

What do both layers of the peritoneum consist of?

Answer 8

Mesothelium - layer of simple squamous epithelial cells

Question 9

What is between the parietal peritoneum and the muscular layer of the abdominal wall?

Answer 9

Extraperitoneal tissue

Question 10

What allows for the considerable change in size of the bladder and rectum?

Answer 10

The extraperitoneal tissue only being attached to the parietal peritoneum LOOSELY

Question 11

Where is the extraperitoneal tissue most dense and most firmly adherent?

Answer 11

Behind the linea alba on inf surface of diaphragm (basically centrally right underneath diaphragm)

Question 12

Is the parietal peritoneum sensitive to pressure / pain / heat / cold and laceration? And why / why not?

Answer 12

Yes - pain well localised Because served by the SAME blood, lymphatic, and somatic nerve supply as region of wall it lines

Question 13

Why does the appendicitis pain shift from dull middle pain to sharp over the appendix?

Answer 13

The appendicitis has got worse and touched the parietal peritoneum inflaming it, localising the pain

Question 14

Is the visceral peritoneum sensitive to pressure / pain / heat / cold and laceration? And why / why not?

Answer 14

No - pain poorly localised Because served by the SAME blood, lymphatic, and somatic nerve supply as organs it covers

Question 15

Where is pain in the visceral peritoneum referred to?

Answer 15

Dermatomes of spinal ganglia

Question 16

What is a mesentry and why does it occur?

Answer 16

Double layer of peritoneum Occurs as a result of invagination of peritoneum by an organ

Question 17

What does a mesentry consist of?

Answer 17

Continuity of the visceral and parietal peritoneum

Question 18

What does a mesentry connect intraperitoneal organs to?

Answer 18

Body wall (usually posterior abdominal wall)

Question 19

What is the greater omentum and where is it?

Answer 19

4 layered peritoneal fold Hangs down like apron from greater curve of stomach Then folds back up to ant surface of transverse colon and its mesentry

Question 20

What does the lesser omentum connect the stomach to?

Answer 20

Portal triad (Part of a hepatic lobule containing: hepatic artery, hepatic portal vein, and bile ducts)

Question 21

What is the lesser omentum and what does it

Answer 21

2 layered peritoneal fold Connects lesser curve of stomach and proximal part of duodenum to –> liver

Question 22

What is a peritoneal ligament?

Answer 22

Double layer of peritoneum that connects an organ with another organ / abdominal wall

Question 23

What are the peritoneal ligaments of the liver and what do they connect it to? (3 ligaments)

Answer 23

1. Falciform - ant abdominal wall 2. Hepatogastric - stomach 3. Hepatoduodenal - duodenum

Question 24

What are the peritoneal ligaments of the stomach and what do they connect it to? (4 ligaments)

Answer 24

1. Hepatogastric - liver 2. Gastrophrenic - inf surface of diaphragm 3. Gastrosplenic - spleen 4. Gastrocolic - transverse colon

Question 25

What is the top right section of the abdomen called?

Answer 25

Right hypo-chondriac region

Question 26

What is the top middle section of the abdomen called?

Answer 26

Epigastric region

Question 27

What is the top left section of the abdomen called?

Answer 27

Left hypo-chondriac region

Question 28

What is the middle middle section of the abdomen called?

Answer 28

Umbilical region

Question 29

What is the middle right section of the abdomen called?

Answer 29

Right lumbar region

Question 30

What is the middle left section of the abdomen called?

Answer 30

Left lumbar region

Question 31

What is the bottom right section of the abdomen called?

Answer 31

Right iliac region

Question 32

What is the bottom middle section of the abdomen called?

Answer 32

Hypogastric region

Question 33

What is the bottom left section of the abdomen called?

Answer 33

Left iliac region

Question 34

What is the transverse mesocolon?

Answer 34

Mesentry of the transverse colon

Question 35

What does the transverse mesocolon divide?

Answer 35

The abdominal cavity into: 1. Supracolic Compartment (above it) 2. Infracolic Compartment (below it)

Question 36

What does the supracolic compartment contain? (3 things)

Answer 36

Stomach Liver Spleen

Question 37

What does the infracolic compartment contain? (3 things)

Answer 37

Small intestine Ascending colon Descending colon

Question 38

Where is anterior to the infracolic compartment?

Answer 38

Greater omentum

Question 39

What divides the infracolic compartment into left and right infracolic spaces?

Answer 39

Mesentry of small intestine

Question 40

What are on the lateral sides of the ascending and descending colons?

Answer 40

Paracolic Gutters

Question 41

What do the paracolic gutters allow?

Answer 41

Free communication between surpracolic and infracolic compartments

Question 42

What is the greater sac made up of?

Answer 42

Supracolic and infracolic compartments

Question 43

Where is the lesser sac?

Answer 43

Post to stomach and lesser omentum

Question 44

What is the superior recess of the lesser sac?

Answer 44

Where it cuts off at the top, at the diaphragm and coronary ligament of liver

Question 45

What is the inferior recess of the lesser sac?

Answer 45

Where it cuts off at the bottom, at the sup parts of the layers of the greater omentum

Question 46

How do the greater and lesser sac communicate?

Answer 46

Through omental foramen

Question 47

What is the right subphrenic space?

Answer 47

Space between diaphragm of right lobe of liver Common site of fluid collection after right sided abd inflamm.

Question 48

What is the right subphrenic space bounded by?

Answer 48

Bounded on left by falciform ligament Bounded post by upper layer of coronary ligament

Question 49

What is the left subphrenic space?

Answer 49

Space between the diaphragm and left lobe of liver Bigger than right bc liver is on right Even bigger if spleen removed

Question 50

What is the left subphrenic space bounded by?

Answer 50

Bounded to right by falciform ligament Bounded post by ant layer of left triangular ligament

Question 51

What is the recto-uterine pouch? (Pouch of Douglas)

Answer 51

Where peritoneum passes from rectum down to post vaginal fornix, then back up to uterine cervix and body

Question 52

What is the vesico-uterine pouch?

Answer 52

Where the peritoneum passes down from the uterine fundus and then up towards the bladder

Question 53

What is the recto-vesical pouch?

Answer 53

In males, where the peritoneum passes from rectum down to the seminal vesicles then up to the bladder

Question 54

What is the mesentry of the small intestine?

Answer 54

Fan shaped fold connecting jejunum and ileum to post abdominal wall

Question 55

What is the root of the mesentry and where is it?

Answer 55

The parietal border of the mesentry attached to the small intestine 15cm from duedojejunal flexture on left side of L2, diagonally to ileocaecal junction (small and large intestine junction)

Question 56

What does the root of the mesentry cross? (6 things)

Answer 56

2nd and 3rd parts of duodenum Abd aorta IVC R ureter R psoas major muscle R gonadal artery

Question 57

What is the sigmoid mesocolon?

Answer 57

Peritoneal fold attaching sigmoid colon to pelvic wall

Question 58

What shape is the sigmoid colon?

Answer 58

Inverted V, with apex at division of L common iliac artery

Question 59

Where do the limbs of the sigmoid colon pass?

Answer 59

L limb descends medial to L psoas major muscle R limb passes into pelvis to end in midline at level of S3

Question 60

What vessels run in between the layers of the sigmoid mesocolon?

Answer 60

Sigmoid and sup rectal vessels L ureter descends into pelvis behind SM apex