What are the 2 subdivisions of the peritoneum?
Visceral
Parietal
Define peritoneal cavity
Potential space between visceral and parietal peritoneum
What are the two major divisions of the peritoneal cavity?
Greater sac
Lesser sac
Through which passage do these two sacs communicate?
Epiploic foramen
Define intraperitoneal
Organ completely surrounded by visceral peritoneum
Define retroperitoneal
Organ firmly attached to posterior abdominal wall and only covered by peritoneum on anterior surface
List all the retroperitoneal organs.
- Suprarenal glands
- Aorta
- Duodenum
- Pancreas
- Ureter
- Colon (ascending and descending)
- Kidneys
- Esophagus
- Rectum
List the intraperitoneal organs.
- Stomach
- Liver
- Final bit of duodenum
- Illeum
- Jejunum
- Transverse colon
- Sigmoid colon
- Caecum
- Spleen
What is present in the peritoneal cavity?
Peritoneal fluid
Which layer of peritoneum is more sensitive to pressure, pain, heat and cold?
Parietal
What are the attachments of the lesser omentum?
Lesser curvature of stomach
Liver
What are the attachments of the greater omentum?
Greater curvature of stomach
Transverse colon
Why is the greater omentum referred to as the abdominal policeman?
Adheres to site of infection, localising it and preventing further spread.
Name the 3 muscles of the posterior abdominal wall.
Quadratus lumborum
Psoas
Illiacus
State the vertebral levels of the 3 major openings in the diaphragm and state what passes through each.
T8 - IVC
T10 - oesophagus
T12 - aorta
What are the 3 main branches of the abdominal aorta which supplies blood to the gut tube?
Coeliac trunk
Superior mesenteric a
Inferior mesenteric a
What vertebral level does the abdominal sorta divide?
L4/L5
How is the IVC formed in the abdomen
2 common iliac veins
What level does the coeliac trunk branch off the aorta?
T12
What level does the superior mesenteric artery branch off the aorta?
L1
What level does the inferior mesenteric artery branch off the aorta?
L3
Coeliac trunk supplies what structures?
Foregut
Sup mesenteric supplies what structures?
Midgut
Inf mesenteric supplies what structures?
Hindgut
The hepatic portal vein is formed by the union of which 2 major veins?
Superior mesenteric vein
Splenic vein (which inferior mesenteric joins to)
List the 4 sites of portocaval anastomoses in the body.
- Oesophageal
- Rectum
- Liver - bare area
- Umbilicus
Clinical significance of these portocaval anastomoses?
Indicate portal hypertension.
In portal hypertension, the anastomoses become congested and form venous dilatations
What nerve is secretomotor to the stomach?
Vagus
What is the functional difference between the greater, lesser and least splanchic nerves and the pelvic splanchic nerves?
Pelvic splanchic nerves = parasympathetic
S2, S3, S4
Why does the right kidney lie lower than the left kidney?
Liver
Name 3 structures entering the hilum of the kidney.
Renal vein
Renal artery
Ureter
How are the kidneys peritonised?
Retroperitoneal
What is the anatomical location of the suprarenal glands?
Superior to kidney
What is the term used to describe the expanded upper part of the ureter?
Renal pelvis
Define ureter
Muscular duct carrying urine from kidneys to bladder
Ureters are constricted at 3 locations. Name them.
.Pelviureteric junction
Pelvic brim
Vesicoureteric junction
Name the 3 main branches of the coeliac trunk.
Common hepatic artery
Splenic artery
Left gastric artery
pain from the parietal peritoneum typically gives what clinical sign
rebound tenderness
what is the nerve supply to the parietal peritoneum
lower 6 thoracic nerves and 1st lumbar (T7-12 & L1)
4 sites of portocaval anastamoses
oesophagus
rectum
umbilicus
liver
what is the difference in the arrangement of the ganglia in the sympathetic and parasympathetic systems
sympathetic - para vertebral
parasympathetic - pre vertebral
at the renal hilum, which vessels is anterior most
renal vein
at the renal hilum, which vessel is posterior most
ureter
