Abdominal Cavity I Flashcards Preview

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Flashcards in Abdominal Cavity I Deck (66):
1

Where is the abdominal cavity located?

In between the thoracoabdominal diaphragm and the pelvic brim

2

What is the abdominal cavity sometimes referred to as?

Abdominopelvic cavity - the abdominal and pelvic cavities are continuous

3

List the abdominal wall layers going from superficial to deep

1. Skin

2. Superficial fascia

- Camper's fascia: outer fatty layer

- Scarpa's fascia: innermost membranous layer

3. Muscles

- External abdominal oblique

- Internal abdominal oblique

- Transversus abdominis

- Rectus abdominis

4. Endoabdominal fascia

5. Parietal peritoneum

4

What is the endoabdominal fascia made up of? And what is it deep to?

Transversalis fascia, extraperitoneal fat, psoas and iliacus fascia ("TEPI")

Deep to: muscle layers of abdomen

5

Parietal peritoneum

Serous membrane continuous w/ abdominal visceral peritoneum

6

Small intestine (bowel) segments

Duodenum

Jejunum (starts @ duodenojejunal junction)

Ileum (ends @ ileocecal junction)

7

Large intestine (bowel) segments

Cecum w/ ileocecal valve & vermiform appendix Ascending colon

Transverse colon

Descending colon

Sigmoid colon

Rectum

8

Abdominal digestive tract components

Distal end of esophagus

Stomach w/ greater and lesser curvatures & pyloric valve Small intestine

Large intestine

Liver and gall bladder

Pancreas

= DS'S LLP (Diss' large liver pan)

9

Abdominopelvic organs

Spleen, kidneys, adrenal glands, rectum, urinary bladder, uterus, uterine tubes and ovaries (SKAR UR OUUT)

10

Peritoneum "TELL"

TELL =

Thin, transparent serous membrane

Enclosed sac - organs develop against it

Lines abdominopelvic cavity, deep to transversalis fascia

Layers are formed - parietal and visceral

11

Parietal peritoneum ("parents LVs")

Lines abdominal wall

Very strong

Sensitive to somatic stimuli (cutting, burning, etc)

12

Visceral peritoneum - CNN

Covers viscera directly

Not as strong as parietal

Not sensitive to somatic stimuli

13

Peritoneal cavity

Potential space between visceral and parietal

Empty except for thin serous fluid

14

Define ascites - what does it result from?

Abnormal accumulation of serous fluid

Results from heart, kidney or liver failure

15

Peritonitis

(-itis = inflammation)

Inflammation of peritoneum

16

Subdivisions of peritoneal cavity

Greater peritoneal sac

Lesser peritoneal sac

Omental foramen (opening between greater and lesser sacs)

17

Intraperitoneal organs definition and examples

Organs protrude completely against the peritoneal sac and become completely covered by the peritoneum (They are NOT within the peritoneal cavity)

Examples: stomach, liver, jejunum

18

Mesentry

Double layer of peritoneum suspending the intraperitoneal organs from the posterior abdominal wall

Mesentry allows intraperitoneal organs to move freely in the abdominal cavity

19

What courses to the organ within the mesentry? (between two peritoneal layers)

Blood vessels, nerves, lymphatics

20

Omenta

Mesentries attached to the stomach

- Greater omentum

- Lesser omentum

21

Retroperitoneal (RPT) organs

Protrude only slightly against peritoneal sac

Are covered on one side by peritoneum -- e.g kidney

22

Retroperitoneal - location, mesentry

Organs grow up against posterior abdominal wall - posterior to the parietal peritoneum

RPT organs have no mesentry

23

Secondarily RPT

Start out as intraperitoneal but then develop against the posterior abdominal wall to become RPT

- Duodenum, pancreas, cecum, ascending colon, descending colon

24

Gastrocolic ligament of greater omentum (GGT)

Runs from greater curvature of stomach → transverse colon

25

Omental apron of greater omentum

Hangs down inferior to transverse colon

Shape and size varies

Helps seal off infections by sticking to a site of inflammation

26

Lesser omentum (LLL)

Runs from liver --> lesser curvature of stomach and duodenum

27

Portal triad

Part of the duodenum (free edge or hepatoduodenal ligament) that contains:

Bile duct

Hepatic artery proper

Portal vein

28

Where does the mesointestine (the mesentery) and root attach at? What courses within it?

Attaches to jejenum and ileum

Superior mesenteric vessel and autonomic nerves course within it

29

Mesoappendix -- attachment

Attaches the appendix to the posterior abdominal wall

30

Transverse mesocolon -- attachment

Attaches to inferior margin of transverse colon - has root along pancreas

31

Sigmoid mesocolon -- attachment

Root attaches sigmoid colon to posterior abdominal wall

32

Falciform ligament

Has round ligament of liver (ligamentum teres hepatis) in its free border

Round ligament is remnant of the fetal umbilical vein

33

Distal esophagus: entry into abdomen

Enters abdomen via opening in diaphragm = esophageal hiatus

EH opens into stomach at the cardiac orifice

34

Lower esophageal sphincter

Prevents reflex of food into esophagus via:

- Contraction of voluntary muscles of the diaphragm and smooth muscles

Note: this is a physiological sphincter, not an anatomical one -- no thickening of smooth muscle

35

What are the stomach's 4 parts it can be divided into?

Cardiac region

Fundus

Body

Pyloric region

 

36

Fundus

Dilation/bulge that's superior to a horizontal line drawn to the left from region of cardiac notch

Rests against left dome of thoracic diaphragm

Filled with gas (radiolucent [dark] on an x-ray)

37

Body

Largest part of stomach

- Below cardiac region and fundus to a vertical line dropped from angular incisure

38

Pyloric Region

Drop a line from the angular incisure to find this region

Has 2 parts:

  1. Pyloric Antrum - wider area, adjacent to body
  2. Pyloric canal - narrower region, leading to pyloric sphincter

39

Pyloric sphincter (valve)

- Location

- What type of sphincter is it

- Function

 

L: Junction between stomach and duodenum

S: True anatomical sphincter - actual thickening of muscle

F: Controls rate that stomach empties at

  • In a state of tonic contraction
  • Closed unless emitting stomach content

40

Rugae

Stomach is lined by gross folds of mucosa called rugae

(Think that rugs line the floor, so rugae lines the stomach)

41

Functions of stomach/pathway of food -  DB-CPS

 

  • Distensible - acts as blender and reservoir of food
  • Food enters stomach as lump = bolus
  • Mixes with enzymes to make watery mixture = chyme
  • Peristaltic actions move chyme from stomach --> intestine
  • Stomach empties 2-3 hours after eating

42

Hiatal Hernia

 

Part of stomach bulges through esophageal hiatus into thoracic cavity

43

Small intestine:

- Attachment

- Pilcae circulares

- 3 parts

Attachment: proximally to stomach, distally to cecum of large int.

Pilcae: Muscosal folds that cover the inner surface

3 parts: duodenum, jejunum, ileum

44

Duodenum

- shape

- location

- parts

Secondarily retroperitoneal - except 1st part that is intraperitoneal

Shape: C-shaped, cradles head of pancrease

Location: starts to the right of the midline --> ends to left of midline at the duodenojejunal junction

4 Parts: superior, descending, horizontal, ascending

45

What empties at the 2nd part of duodenum?

What is that specific area called?

Common bile duct and main pancreatic duct empty into LT side of 2nd (descending) part of duodenum at the major duodenal papilla

Accessory pancreatic duct also opens into 2nd

46

Jejunum

 

Intraperitoneal

Continuous w/ duodenum - proximally

Continuous w/ ileum - distally

  • No clear demarcation from ileum

47

Jejunum characteristics as compared to ileum

"OW-RPB"

 

  • Often empty
  • Wider diameter w/ thicker walls
  • Redder in living state - greater vascular supply
  • Prominnet pliae circulares slow passage of food and aid in bsorption
  • Blood vessels in mesentery
    • 1-2 layers of arcades
    • long vasa recta (straight arteries)

48

Ileum

 

Intraperitoneal

Continuous w/ jejunum proximally, cecum distally

Most prominent characteristics are at distal end

49

Ileum characterisitics relative to jejunum

 

NP Sib, B Pays Meck.

  • Narrower diameter w/ thinner walls
  • Paler and less vascularized
  • Small or absent plicae circulares
  • Increased intermesenteric fat
  • Blood vessels in mesentry
  • Payer's patches
  • Meckel's diverticulum

50

Ileum blood vessels characteristics

4-5 layers of arcades

Short vasa recta

51

Peyer's patches

Meckel's diverticulum

  1. Peyer: submucosal aggregates of lymphatic tissue on antimesenteric border
  2. Meckel: common developmental malformation
  • Fingerlike bind pouch - remnant of embryonic vitelline duct
  • 2 ft from ileocecal junction
  • If inflammed, may mimic the symptoms of appendicitis

52

Jejunum and ileum attachment

Attached to posterior abdominal wall by mesentry

  • Mesentry is fan shaped
    • Root = short, runs obliquely
    • Long border = 6-7 m, point of attachment of jejunum and ileum

53

Large intestine's 3 distinct surface characteristics
"THO"

  1. Tenia coli
  2. Haustra
  3. Omental (epiploic appendices)

54

Large intestine - tenia coli

 

3 equally spaced bands formed bc:

Outer longitudinal muscle layer is incomplete

 

 

55

Large Intestine - Haustra (sacculations)

Gut walls that bulge out between tenia coli

(bc tenia coli are 1/6 shorter than rest of colon)

56

Large intestine - omental (epiploic) appendices

Fat filled appendices

57

Semilunar fold

 

  • Inner surface of large intestine's mucosal folds
  • Runs between tenia coli

58

LI - Cecum region is "bossy = basi"

 

  • Blind pouch
  • Appendicular orifice here

  • Secondarily retroperitoneal

  • Ileum enters cecum @ ileocecal orifice
    • Ileocecal valve guards orifice
    • Most reflux is prevented by contraction of the terminal ileum

59

LI - Vermiform appendix region

 

  • Intraperitoneal
  • Fixed point = root
    • Located 2/3 from umbilicus to ant superior iliac spine - where appendectomy incisions are made (McBurney's Point)
  • Mesentry = mesoappendix
  • Frequently inflamed = appendicitis

60

Ascending colon of LI

 

  • Secondarily retroperitoneal
  • From proximal cecum --> distal right colic (hepatic) flexure
  • Narrower than cecum

61

Transverse colon - LI

 

  • Intraperitoneal
  • Largest & most mobile portion of LI
  • From RT colic flexure --> LT colic flexure
    • LT = more superior
  • 2 mesenteric attachments:
    • Transverse mesocolon
    • Gastrocolic ligament

62

Transverse mesocolon - LI

 

  • Transverse colon is posteriorly attached to trans. mesocolon
  • Courses acrocc post abdominal wall
    • Across duodenum and pancreas

 

63

Gastrocolic ligament and transverse colon - LI

  • Trans colon is anteriorly attached to GC ligament
    • Follows curvature of stomach
    • Can actually hang into pelvis

64

Descending colon - LI

Secondarily retroperitoneal

From LT colic --> sigmoid colon

Narrowest portion of colon

65

Sigmoid colon - LI

 

Intraperitoneal

S-shaped loop  - from descending colon --> rectum

Attached to: sigmoid mesocolon - v-shaped mesentry

66

Rectum and anal canal

 

Retroperitoneal

W/in true pelvis

Continuous w/ sigmoid colon (@ S3 vertebrae)

 

Anal canal - inferior 1.5 in of GI

  • Continuous w/ rectum @ anorectal junction