What are the two layers of the abdominal cavity
What is there innervation
Parital- lines the body wall and covers the retroperitoneal organs
Visceral- encloses the surface of the intraperitoneal
Innervated by the lower intercostal nerves and the ilioinguinal and the iliohypogastric nerves of the lumbar plexus
Describe the mesenterary and its function
DOuble layered peritoneal membrance that suspends part of the GI tract from the body walll and allows for movement of the GI as needed. Also allows vessels, nerves and lymphatics to reach the GI tract
What are the four important remnants of the mesentery in the abdomen
The less omentum--attach the liver to the lesser curvature of the stomach and the duodenum.
The greater omentum--attach to the greater curvature of the stomach.
The Mesocolon---attach the body wall to the transverse and sigmoid colon.
Ligaments---reflections of mesenteries between organs or the body wall that are named according to their attachments.
What are the layers of fascia of the peritoneum and their function and what defines them?
The fascia create space, cover organs and allow limited movement.
1. Transversalis fascia-- deep to the muscles of the abdominal
2. Extraperitoneal fascia- deep to the transversalis fascia (lines the abdominal
3. Peritoneal membrane-defines the peritoneal cavity. has two layers
A. parietal peritoneum (paries = wall) lines the wall of the abdomen. Parietal peritoneum is
very sensitive to somatic pain* and is innervated by the lower intercostal nerves and
nerves of the lumbar plexus. e.g. Inflammation of the parietal peritoneum (peritonitis)
results in sharp pain that is localized over the area. ---- reason for severe pain during peritonisis
B. visceral peritoneum-(viscus = organ) encloses the surfaces of the intraperitoneal and is not senstitive to somatic pain
intraabodomen fascia identify
what does the mesentery form from
Remember that mesenteries form from the ventral and dorsal mesogastrium
Major organs- identify
The ________plus__________ equals Lesser omentum
The epiploic foramen of Winslow connects the_______
to the _______
The lesser omentum connects the __________ to the ___________.
The _Heptagastric ligament____plus_heptaduodenal ligament____ equals Lesser omentum
The epiploic foramen of Winslow connects the_lesser sac__ to the greater sac_______
The lesser omentum connects the liver__________ to the _lesser curvature of the stomach and the first part of the duodenu,__________.
Explain the different regions in the abdominal cavity
1. The abdominal viscera are line by the peritoneum
2. Some organs (e.g. ascending and descending colon) never grow into the cavity and are pressed against the body wall in their retroperitonealposition.
3. Other organs like the pancreas become
How is the peritoneal sac cavity divided during developement?
What borders the lesser sac?
How do they communicate?
1. During development the peritoneal cavity is subdivided into the greater and lesser sacs.
2. The lesser sac is bordered by the posterior abdominal wall (posteriorly) and the gastrocolic ligament, stomach and lesser omentum (anteriorly).
3. The two sacs communicate through the epiploic foramen of Winslow
IMportant relationships within the foramen of winslow
Anterior-- Hepatoduodenal ligament and the hepatic portal vein
Posterior---Inferior vena cava
Superior---Caudate lobe of the liver
Inferior---First part of the duodenum
What organs are intraperitoneal
Tail of the pancreas
1st part of the duodenum
What organs are retroperitoneal?
What does that mean?
They never had a mesentary-- even during development
Head, neck and body of the pancreas
Ascending and descening colon
2nd and 3rd part of the duodenum
What organs are secondarily retroperitoneal?
What does that mean?
They had a mesentary but lost it during development (A.I.L. plus kidney stuff)
Inferior vena cava
The stomach has a ___________curvature, which is connected to the_________
of the liver by
the ___________ (_____________), and a left
______________ from which the ____________ is suspended.
The stomach has a right lesser curvature, which is connected to the porta hepatis of the liver by the lesser omentum (hepatogastric ligament), and a left greater curvature from which the greater
omentum is suspended.
Explain what main thing happens at each part of the stomach
What two organs does the stomach attach to by the lesser omentum
The cardiac region- receives the esophagus
Fundus- dome- shaped upper portion of the stomach, which is normally filled with air. Rest on left dome of diaphragm
Body- The main central part of thestomach .
The pyloric portion- (under the body) of the stomach has a thick muscular wall and narrow lumen that empties into the duodenum approximately in the transpyloric plane (L1 vertebra)
Liver and gallbladder by lesser omentum
When does a sliding hiatal occur?
What can be damaged?
Sliding hiatus occurs when the cardia of the stomach herniates through the esophageal hiatus of the diaphragm. This can damage the vagal trunks as they pass through the hiatus
Parts of the stomach
What are the livers two surfaces?
What surronds it?
Where is it place and what protects it?
Superior diagphgramtic surface and inferior visceral surface
Surronded by visceral peritoneum
Protected by the rib cage and in the right abdominal cavity
What are the reflections of visceral of the liver?
falciform ligament-- between the diaphragmatic surface of the liver and the diaphragm. attaches to the anterior abdominal wall
•coronary ligament-- the reflection point from the liver and has right and left
• The lesser omentum--extends between the visceral surface of the liver (hepatogastric ligament) and the first part of the duodenum (hepatoduodenal ligament.
Explain the two lobes in terms of size and relation to the other two lobes
Right larger than left
Quadrate and cuadate lobes are anatomically with right lobe but functionally with the smaller left lobe
Identify Superior Surface of LIver
What are the structures seen on the inferior portion of the liver?
ligamentum teres and the ligamentum venosum
•fossa for the gallbladder
•quadrate lobe, and the caudate lobe
The portal triad is located in the hepatoduodenal ligament at the right free border of thelesser omentum and contains
Arterial supply from the hepatic artery.
•Porta hepatis, which receives venous blood from the portal vein.
•Common bile duct which collects bile produced by the liver.
How does the hepatic vein work
Collects blood from the livers sinosoids and drains them into the inferior vena cava
explain the bare area in the liver
The liver and diaphragm have a common embrologivcal origin and maintain part of the connect in adult where the bare area of the liver is directly attached to the diaphragm
What are the peritoneal reflectiosn associated with the liver
falicform ligament- attached to the anterior abdominal wall by the
heptaogastric ligament- connect the liver to the stomach
heptaduodenal ligament --- connect the liver to the duodenum
Coronary ligament (at bare region) and triangular (where coronary come together) ligaments- connect the diaphragm to the liver
Explain what happens at the bare region
The bare area of the liver has a boundary where the parietal peritoneum reflects onto the liver thus becoming visceral peritoneum.
This reflection is called the coronary ligament. The extreme margins of the coronary are the right and left triangular ligaments
What area of the abdominal cavitiy is the spleen in?
Deep to what ribs on what side?
What does the visceral of the spleen come in contact with
How does the spelnic artery and vein reach the spleen
Intraoperitoneal organ (suspended by mesentary)
In the upper left quadrant protected by ribs 9,10, and 11 (hence the spleen can be lacerated by fracture of these ribs)
comes in contact with colic flexure, stomach and left kidney
Reach spleen hilum by tranversing the splenorenal ligament
Location and parts of the pancrease
Deep to the stomach at the transpyloric place
•Head-- within the C-shaped area of the duodenum; traversed by the common bile duct. Has an uncinate process.
•Neck--posterior to the neck is the hepatic portal vein and superior mesenteric vessels..
•Body--anterior to the aorta and the left kidney. The splenic artery and vein pass posterior/superior
border of the body of the pancreas.
•Tail--enters the splenorenal ligament to reach the hilum of the spleen.
Route of main pancreatic duct
Courses through the pancreas to the head where it joins the common bile duct to form the heptapancreatic ampulla
Blood supply to the pancreas
Neck, body, and tail- splenic artery
Head- superior and inferior pancreaticduodenal branches of the gastroduodenal and superior mesenteric arteries
Parts of the duodenum/relation to other organs
1st part- intrapreitoneal- anterior to the gastroduodenal artery and common bile duct
2nd part- intraperitoneal- recieve the common bile duct and the main pancreatic duct at the hepatopancreaatic ampulla. Smooth muscle in the wall is known as the sphincter of Oddi
3rd part- horiztonal, retroperitoneal, anterior to the aorta, deep tp tje superior mesenteric artery and vein
4th part- ascending connects to jejunum at the suspernsory ligament of Trietz (has msucle fibers from the right crus of the diaphragm)
Duodenum parts-- pay attention to what lies anterior and posterior to each part of the duodenum
3 trunks of celiac and what do they supply
Where is the left gastric?
What does it give off?
And what does it connect with?
•lesser curvature of stomach
•short esophageal branches
•connects with right gastric
Where does the splenic travel and waht does it give off
Posterior to the stomach
Gives of the left gastro-omental branchs and pancreatic branches
What arteries arise from the common hepatic artery
Gastroduodenal-- right hastro-omental
Important Anastomoses Review this card's materias
Right Gastric (off common hepatic) anastomosis with Left Gastric (off celiac) .
Gastrodudoneal Branch (offf common hepatic) -- duodenal branches
and superior pancreaticoduodenal branches
(anterior and posterior;
i.e. the pancreas is an endocrine/digestive organ and needs a lot of blood.)
Proper Hepatic Branch (off common hepatic) with cystic artery