lec 14 Flashcards
(15 cards)
- GENERAL ARRANGEMENT OF THE ABDOMINAL VISCERA
a. The what
is a large prominent organ, which occupies the upper part of the abdominal cavity.
b. The
what has a short segment in the abdomen that connects to the stomach.
c.The what
is a continuation of the alimentary canal from the stomach and consists of the duodenum,
jejunum, and ileum.
d.The what, a continuation of the small intestine, is divided into
the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and
anal canal.
e. Other organs located within the abdominal cavity include the what(5)
a. liver
b. esophagus
c. small intestine
d. large intestine
e. gall bladder, pancreas,
spleen, kidneys, and suprarenal (adrenal) glands.
The what is a thin, serous membrane, which lines the walls of the abdominal and pelvic
cavities, and either partially or completely covers viscera contained within it.
peritoneum
A.what—lines the walls of the abdominal and pelvic cavities
B. what—covers the organs directly
C. Secretes a small amount of fluid that lubdricates and facilitates movement of the organs; what are separated only by this thin layer of peritoneal fluid.
D. what—a potential space between the parietal and visceral layers. The cavity is
completely closed in the male, but in the female there is a communication with the exterior
of the body through the uterine tubes, the uterus, and the vagina.
E. what—an abnormal accumulation of serous fluid in the peritoneal cavity
a. Parietal peritoneum
b. Visceral peritoneum
c. the
parietal and visceral layers
d. Peritoneal cavity
e. Ascites
F. Divisions of the peritoneal cavity
1. what—the main compartment of the peritoneal cavity extending from the
diaphragm to the pelvis. A surgical incision through the anterior abdominal wall
enters the greater peritoneal sac.
2. wjhat (omental bursa)—a pouch situated behind the lesser omentum and
stomach, and in front of structures on the posterior abdominal wall. It allows for
free movement of the stomach. The right margin of the lesser sac opens into the
greater sac through the omental (epiploic) foramen. The sac projects upward to the
diaphragm; however, the downward projection, between the layers of the greater
omentum, fuses shortly after birth.
- Greater sac
2. Lesser sac
Xwhat—organs covered only in front by peritoneum, and not suspended by
a mesentery.
Retroperitoneal organs
Specialized areas of the peritoneum
1. what—a double layer of peritoneum that attaches part of the intestines to the
posterior abdominal wall. When an organ protrudes into the peritoneal sac, it takes
its vessels and nerves with it. They are located between the two layers of peritoneum
forming the mesentery.
2. what—a two-layered fold of peritoneum that attaches the stomach to another
viscus
a. greater omentum—2 layers of mesentery folded back on each other (i.e., a
4-layered structure); attached to the greater curvature of the stomach and the
inferior border of the transverse colon
b.what—from the lesser curvature of the stomach and the first part
of the duodenum to the liver; consists of the hepatogastric and
hepatoduodenal ligaments
- mesentery
- omentum
- lesser omentum
Nerve Supply
The parietal peritoneum is supplied by the same somatic nerves that innervate the
overlying muscle and skin. The diaphragmatic peritoneum is innervated by the what; peritoneum in the pelvis is innervated by the what. Parietal peritoneum
is sensitive to pain, temperature, touch, and pressure. Inflammation of parietal
peritoneum results in well localized pain that is often referred to areas of skin supplied
by the same nerves.
Visceral peritoneum is sensitive to stretch and is innervated by what
Overdistension of viscera will lead to a sensation of pain that is poorly localized.
phrenic nerve
obturator nerve
autonomic nerve fibers.
J. Functions
1. what—secreted by the peritoneum; ensures that mobile viscera can move
upon one another
2. The what(2) tend to fuse in the presence of
infections. Thus, intraperitoneal infectors remain localized.
3. Large amounts of fat are stored in the peritoneal ligaments and mesenteries, and
especially large amounts in the what.
Peritoneal fluid
greater omentum and peritoneal coverings
greater omentum
A. Esophagus
The abdominal part of the esophagus enters the abdomen through an opening in the
diaphragm at the level of what, and enters the stomach at its cardiac orifice.
- The what constitutes a barrier (physiologic sphincter) to the
reflux of contents from the stomach to the esophagus.
This lower esophageal
sphincter has three components: what(3)
what—a painful stimulation of the lower esophagus that occurs when acidic
gastric contents reflux past the sphincter.
- Innervation—supplied by the what and what via
the greater splanchnic nerve.
T10 vertebra
gastroesophageal junction
a. esophageal muscle
b. diaphragmatic sling
c. angle of entrance of the esophagus into the stomach
Heartburn
vagus nerves and the thoracic sympathetic trunks
B. Stomach 1. Parts a. what—between abdominal end of esophagus and stomach b. what-above entrance of the esophagus c.what—between the fundus and pylorus d. hwat—opens into duodenum e. what—controls the rate of discharge of stomach contents into the duodenum f. Lesser and greater curvatures
Cardiac part
Fundus
Body
Pyloric part
Pyloric part
The what is the most fixed part. The fundus fits into the curve of the
left dome of the diaphragm and moves with it. The stomach is fixed at both ends
but in between is very mobile.
The entire anterior surface is covered by
what.
The posterior surface is covered by peritoneum except where the
what is attached.
Anterior to the stomach is the anterior
abdominal wall. Posterior to the stomach is the lesser sac and the pancreas.
The
shape and position of the stomach vary in different persons, and in the same individual as a result of movements of the diaphragm during respiration.
- cardiac orifice
- peritoneum
- hepatogastric ligament
4.
The stomach has three main functions: (1) storage of food, (2) mixing stored
food with gastric secretions, and (3) controlling the rate of delivery into the
duodenum. The stomach stores ingested food and prepares it for eventual
treatment by the small intestine. The stomach synthesizes:
what(5)
As the pyloric sphincter relaxes, churned food is squirted into the duodenum.
Digestion occurs mechanically and enzymatically.
Waves of contraction
(peristalsis) create an agitator action similar to that in a washing machine. Very
little absorption of foodstuffs goes on at the stomach level except readily
dissolvable, relatively short-chain compounds.
a. HCl
b. Pepsinogen (converted to pepsin by HCl)
c. Intrinsic factor (aids vitamin B12 absorption)
d. Mucus
e. Gastrin (increases acid secretion, pepsinogen sectretion, and overall
motility)
. Blood Supply
a. All arteries are derived directly or indirectly from the what.
b. Celiac trunk (artery)
i. what—supplies esophagus and upper part of stomach
ii. splenic artery—gives off pancreatic branches, left gastroomental
(gastroepiploic), and short gastric arteries
iii. what—branches into proper hepatic artery and
gastroduodenal artery. The proper hepatic artery gives off the right
gastric artery, then branches into right and left hepatic arteries.
The venous drainage is directly or indirectly into the portal vein: 1) right
and left gastric, along the lesser curvature 2) right and left gastroomental
(gastroepiploic) and short gastric, along the greater curvature.
a. celiac trunk
b.left gastric artery
c. common hepatic artery
d.
Nerve supply—derived from the celiac sympathetic plexus through the plexuses
around the gastric and gastroomental (gastroepiploic) arteries. The parasympathetic
nerve supply is derived from the what
vagus nerve
- Clinical Conditions
a. what—This is due to an imbalance between acid secretion and
mucosal defenses, as well as infection with a bacterium known as H. pylori.
It can result in epigastric pain and GI bleeding. It can also perforate, leading
to peritonitis.
b. what—A portion of the fundus of the stomach herniates through the
esophageal hiatus into the thorax.
c. what—An overdevelopment of the pyloric sphincter muscle leads
to gastric outlet obstruction.
a. Gastric ulcer
b. Hiatal hernia
c. Pyloric stenosis
