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LSS 2 - Abdomen, Alimentary and Urinary systems > Lecture 2 - Anatomy of the abdomen > Flashcards

Lecture 2 - Anatomy of the abdomen Flashcards

1
Q

What is the peritoneum?

A

Continuous membrane lining the abdominal cavity consisting of mesothelial layer supported by a layer of connective tissue

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2
Q

What is the abdominal wall?

A

Muscle and connective tissue deep into which lies the abdominal cavity

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3
Q

What is the peritoneum made of?

A

Single continuous membrane of simple SQUAMOUS epithelium (mesothelium)

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4
Q

What is the peritoneal cavity?

A

Potential space within the layer of peritoneum

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5
Q

What is present in the abdomino-pelvic cavity?

A

Abdomen: Small intestine, asc/desc colon, cecum and appendix Pelvic: Sigmoid colon, rectum Thoracic cage: liver, gall bladder, transverse colon, stomach, spleen

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6
Q

Where does the gut tube originate from?

A

Endoderm and splanchnic mesoderm - 4 weeks IUL

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7
Q

From where is the gut tube suspended?

A

From the posterior abdominal wall by the dorsal mesentery

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8
Q

What are mesenteries?

A

Peritoneal folds attaching viscera to abdominal wall

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9
Q

What are the functions of mesenteries?

A

Conduit for VESSELS, NERVES and LYMPHATICS supplying viscera.

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10
Q

What is the difference between visceral and parietal peritoneum?

A

Visceral peritoneum surrounding the viscera Parietal peritoneum lines the abdominal cavity.

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11
Q

What is the difference between intra and retroperitoneal?

A

INTRAperitoneal – structures, like most of small intestine, suspended from the abdominal wall by mesenteries. RETROperitoneal – structures, like kidneys and great vessels that lie between parietal peritoneum and abdominal wall.

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12
Q

What are some retroperitoneal organs on posterior abdominal wall?

A

Kidneys & ureters Suprarenal glands Aorta/Inferior vena cava Nerves: lumbar plexus, sympathetic trunk Oesophagus Rectum

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13
Q

What are some secondarily retroperitoneal organs and what does this mean?

A

They had a mesentery but it fused with the abdominal wall: Duodenum (except the first part) Pancreas (tail is INTRAperitoneal) Colon (ascending and descending only)

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14
Q

What are the 3 divisions of the GIT?

A

FOREGUT – Distal 3rd of oesophagus to the 2nd part of the duodenum at the entrance of the bile duct (Major duodenal papilla). MIDGUT – 2nd part of the duodenum to two-thirds along transverse colon. HINDGUT – Distal third of transverse colon to the rectum.

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15
Q

Why is it important to divide the GIT into 3 parts?

A

Each part of GIT has its own arterial supply, coeliac trunk, superior mesenteric artery

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16
Q

What does the dorsal mesentery do?

A

Suspend the entire gut

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17
Q

What is special about the foregut?

A

It is suspended by both dorsal and ventral mesentery

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18
Q

What is in the ventral mesentery?

A

Foregut, liver - split into falciform ligament and lesser omentum

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19
Q

How is the omental bursa (lesser sac) of the peritoneal cavity formed?

A

As the liver grows, it moves to the right, while the dorsal mesentery and spleen move to the left, so original right side of upper peritoneal cavity is now posterior

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20
Q

What does the omental bursa look like?

A
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21
Q

How are the greater and lesser omentum formed?

A

Lower part of dorsal foregut mesentery extends down as a double fold called greater omentum (apron) anterior to intestine Lesser omentum is part of ventral foregut mesentery

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22
Q

What is the epiploic foramen?

A

Entrance to lesser sac

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23
Q

What do the greater and lesser omentum look like?

A
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24
Q

Where do the portal vein, hepatic artery and bile duct run through?

A

Between the posterior abdominal wall and liver within lesser omentum near its free edge

25
Q

Why is there a free edge present in the lesser omentum?

A

Due to ventral mesentery ending at start of midgut

26
Q

What do the greater and lesser sacs look in sagittal view?

A
27
Q

What are the names of the peritoneal compartments?

A

Supracolic compartment, mesentery of transverse colon, infracolic compartment (R/L), R/L paracolic gutter, mesentery of small intestine

28
Q

Fill in the peritoneal compartments in this picture:

A
29
Q

How does the peritoneal fluid flow in peritoneal cavity?

A
30
Q

How does the inflammatory exudate flow in the peritoneal cavity?

A
31
Q

What is the layout of the GI tract from outermost to innermost tissue layer?

A

Mesentery Serosa (alveolar connective tissue and epithelium) Muscularis (longitudinal/circular muscle) Submucosa Mucosa (epithelium, lamina propia, muscularis mucosae)

32
Q

Where does the oesophagus cross into the abdomen?

A

T10 - pierces through the diaphragm, contributing to lower oesophageal sphincter

33
Q

What are the 4 main parts of the stomach?

A

Cardia surrounding the opening Fundus Body Pyloric region consisting of pyloric atrium and pyloric canal (with pyloric sphincter preventing food from entering duodenum)

34
Q

What are the 4 parts of the duodenum?

A

Superior – duodenal cap, common place for peptic ulcers. Passes anteriorly to bile duct, gastroduodenal artery, portal vein and IVC. Descending – contains minor/major duodenal papillae where accessory pancreatic duct and bile duct enter respectively. Inferior – crosses IVC and has SMA anterior to it. Ascending – terminates at duodenojejunal flexure

35
Q

What are the differences between jejunum and ileum?

A

Jejunum: proximal 2/5ths, larger in diameter, ULQ of abdomen, less prominent arterial arcades, longer vasa recta Ileum: distal 3/5ths, smaller diameter, LRQ of abdomen, prominent arterial arcades, shorter vasa recta

36
Q

What are the distinguishing features of the large intestine from the small intestine?

A

Large: appendices epiploicae, taeniae coli, segmented/pocketed walls

37
Q

What are the 3 unpaired arteries arising from anterior of aorta and what do they supply?

A

Coeliac trunk - foregut, liver, pancreas, spleen Superior mesenteric artery - midgut Inferior mesenteric artery - hindgut

38
Q

What does the coeliac trunk do?

A

Supplies entire foregut and derivatives - spleen shares a blood supply

39
Q

Where is the coeliac trunk located?

A
40
Q

What does the posterior relations of liver and stomach look like?

A

All part of retroperitoneum:

41
Q

What are the branches of the superior mesenteric artery?

A

Middle/Right colic artery, ileocolic artery, jejunal arteries and ileal arteries

42
Q

What are the branches of the inferior mesenteric artery?

A

Left colic artery, superior rectal artery and sigmoid arteries

43
Q

To what is the junction of mid and hindgut close to?

A

Left flexure of colon - change from SMA to IMA supply at this level with anastamoses between them

44
Q

How does venous drainage work in the peritoneal cavity?

A

Portal vein arises from SMV and splenic veins posterior to 1st part of duodenum/pylorus of stomach - portal vein then runs in the free edge of lesser omentum to the liver, draining blood from all abdominal viscera and liver

45
Q

What are the major venous drainage veins in peritoneal cavity?

A

Portal vein, superior mesenteric vein, inferior mesenteric vein and splenic vein

46
Q

What are portosystemic anastamoses?

A

Where veins draining into portal vein and IVC communicate

47
Q

What happens if liver or portal obstruction occurs in the portosystemic anastamoses?

A

Veins dilate widely, possibly leading to severe venous haemorrhage from oesophagus/rectum

48
Q

Which blood supply does the lymphatic drainage of the bowel follow?

A

Arterial supply

49
Q

Where does all lymph drain into?

A

Cisterna chyli

50
Q

What is the cisterna chyli?

A

An elongated lymphatic sac loncated in front of L1 and L2 bodies

51
Q

Where does the thoracic duct begin?

A

From the cisterna chyli

52
Q

Fill in the blanks of the lymphatic system in the abdomen

A
53
Q

How is the abdominal viscera innervated?

A

Autonomic nervous system - sensory fibres are the most important

54
Q

Which are the parasympathetic sensory nerves in the gut and what do they do?

A

Vagus nerve and pelvic splanchnic nerves (S2-4) They regulate reflex gut action

55
Q

Which are the sympathetic sensory nerves in the gut and what do they do?

A

Thoracic splanchnic (T5-T12) and lumbar splanchnic (L1/2) Mediate pain

56
Q

Fill in the blanks of the innervation of the gut

A
57
Q

Which nerves mediate pain in viscera of gut?

A

Sensory fibres running with sympathetic (T1-L2)

58
Q

Which nerves are involved in reflex regulation of gut function?

A

Sensory fibres with the parasympathetic (vagus/sacral)

LSS 2 - Abdomen, Alimentary and Urinary systems (29 decks)

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