Lecture 11: Peritoneum and Abdominal Organs Flashcards Preview

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Flashcards in Lecture 11: Peritoneum and Abdominal Organs Deck (136):
1

Upper and lower boundaries of the abdominopelvic cavity

Cranially: Diaphragm
Caudally: Levator ani and coccygeus muscles

2

2 divisions of abdominal cavity

-Abdominal cavity proper
-Pelvic cavity

3

Contents of abdominal cavity

Blood vessels, viscera, nerves, and peritoneum

4

Where does the abdominal cavity extend and why?

Into the rib cage to protect abdominal organs (especially forget organs)

5

Purpose of the greater (or false) pelvis

Protect lower abdominal organs

6

What part of the abdominal wall contains criss-crossing muscles and what are their functions

Anterior and lateral abdominal walls. Provides protection to this region, which contains soft and vital viscera.

7

What are the names of the 2 horizontal planes of the abdomen and their locations

Subcostal plane- costal cartilage of 10th rib
Transtubecular plane- iliac tubercles of iliac crest

8

What are the names of the vertical planes of the abdomen and their location

Midclavicular planes- From mid clavicle to between the anterior superior iliac spine and pubic symphysis

9

What are the six different regions of the abdomen in order (right to left)

Right hypochondriac, epigastric, left hypochondriac, right lumbar, umbilical, left lumbar, right inguinal, hypogastric, and left inguinal

10

What's found in the right hypochondriac region?

Liver

11

What is found in the epigastric region?

Stomach

12

What is found in the left hypochondriac region?

Spleen

13

What is found in the right lumbar region

Right kidney

14

What is found in the umbilical region

Transverse colon

15

What is found in the Left lumbar region

Left kidney

16

What is found in the right inguinal region

appendix

17

What is found in the hypogastric region

Small intestine

18

What is found in the left inguinal region

Sigmoid colon

19

What are the 2 planes that divide the abdomen into four quadrants used by physicians

Median plane and transumbilical

20

What are the names of the 4 quadrants of the abdomen when divided by the median and transumbilical planes?

Upper left/right and Lower left/right quadrants

21

What was the embryonic precursor of the peritoneal cavity?

The intraembryonic coelomic cavity

22

What organs are contained within the peritoneal cavity

none

23

Are abdominal and peritoneal cavity synonymous?

No

24

Peritoneum

Serous membrane (thin layer of CT) covered by simple squamous epithelium (also called mesothelium)

25

What are the 2 peritoneum that delineated the peritoneal cavity

Parietal and visceral peritoneum

26

Which peritoneum is under extraperitoneal fat and transversals fascia that lies the abdominal wall?

Parietal peritoneum

27

Which peritoneum forms a shiny external covering over the abdominal organs

Visceral peritoneum

28

Mesentery definition

Double layer of peritoneum that encloses an organ and connects it to the body wall.

29

How do organs that are held within mesenteries receive blood?

Blood vessels travel through the mesentery to reach the organ

30

Peritoneal ligament definition

Double layer of peritoneum connecting an organ to the body wall or to another organ

31

Retroperitoneal definition

Organ that only slightly protrudes the peritoneal cavity

32

What doe retroperitoneal organs lack?

Mesenteries

33

Unique characteristics of retroperitoneal organs?

immobile and tough to access surgically

34

Primarily retroperitoneal

Never had a mesentery and never will (not gut organs)

35

Example of primarily retroperitoneal organ

Kidney

36

Secondarily retroperitoneal

They developed a mesentery but it was reabsorbed

37

Examples of secondary retroperitoneal organs

pancreas, duodenum, ascending and descending colon

38

How did the pancreas and duodenum loose their mesentery

Growth of the liver forces these two organs against the posterior back wall

39

How did the ascending and descending colons loose their mesentary

gut rotation cement rated the two structures against the posterior back wall

40

Location of subphrenic recess

Between the liver and thoracic wall

41

What boundaries from the hepatorenal recess

Bounded by the right kidney, liver, colon, and duodenum

42

What is the lowest point of the peritoneal cavity when the patient is laying down

The hepatorenal recess

43

In what recess does the vermiform appendix lie?

the retrocecal recess

44

What are the 2 divisions of the peritoneal cavity

The greater and lesser sac (or peritoneal cavity proper and omental bursa)

45

Location of the lesser sac

between the stomach and posterior body wall

46

What does the lesser sac allow for?

Dissension of the stomach

47

How does the lesser sac communicate with the greater sac?

Through the epiploic foramen of Winslow

48

What is another name for the epiploic foramen of Winslow?

Omental foramen

49

What are the lateral boundaries of the mental bursa

Glastrosplenic ligament and lienorenal ligament

50

What are the structures that are anterior and posterior to the omental bursa

Anterior: Stomach
Posterior: Pancreas

51

What are the 3 parts of the omental bursa

-Superior recess- between the liver and diaphragm
-Main portion behind the stomach
-Inferior recess- Between the double layers of the gastrocolic ligament

52

What recess is obliterated in the omental bursa during adulthood

the inferior recess

53

What forms the median umbilical fold

Formed by urachus

54

What is the urachus an embryonic remanent of

allantois

55

Function of the allantois

Connect the urinary bladder to anterior body wall

56

What is the medial umbilical fold a remanent of?

Umbilical arteries

57

What artery travels through the lateral umbilical fold?

The inferior epigastric artery

58

Where does the falciform ligament extend

From the umbilicus to liver

59

What does the falciform ligament contain

The ligamentum teres hepatic

60

What is the ligamentum teres hepatis a remanent of?

Umbilical v.

61

Which mesentery is the derivative of the falciform ligament

Ventral mesentery

62

What are the functions of the mesenteries that attach structures to the posterior body wall?

transport vessels, nerves, and lymphatics, and allow for mobility of intestines

63

What are the 3 mesenteries that suspend the intestines to the back wall

-Mesentery proper (suspends the jejunum and ileum)
-Transverse mesocolon (transverse colon)
-Sigmoid mesocolon (sigmoid colon)

64

Function of Greater Omentum

Attach the stomach and proximal duodenum to body wall

65

What did omentum derive from

primitive mesentery

66

Greater omentum location and description

Fat-filled apron suspended from the greater curvature of the stomach over intestines

67

Structural derivative of the greater omentum

Dorsal mesentery

68

How many layers was the greater omentum in the embryo

4 layers

69

How many layers is the greater omentum in the adult

2 layers

70

Why is the greater omentum the "policeman of the GI tract"

Localizes infection

71

What ligaments make up the major and minor portions of the greater omentum

Major- Gastrocolic ligament
Minor- Gastrosplenic and gastrophrenic ligaments

72

Role of the lesser omentum

Suspends the stomach (from lesser curvature) from the liver

73

What is the structural derivative of the lesser omentum

The ventral mesentery

74

What ligament from the liver attaches to the stomach in the lesser momentum

Hepatogastric ligament

75

What are the two ligaments that make up the lesser omentum

hepatogastric and hepatoduodenum ligaments

76

What are the four depressions (or pathways) for the conduction of fluid and infections formed by the attachments of mesenteries of the small intestine, ascending and descending colon

-Right paracolic gutter
-Gutter to the right of the mesentery
-Gutter to the left of the mesentery
-Left paracolic gutter

77

How is the right paracolic gutter formed

Formed from the fact that ascending colon is secondary retroparitoneal pushed against back wall and there is parietal paritoneum on the outside making an unimpeded path for fluid to travel when you are upright.

78

What is the role of the right paracolic gutter

Communication between hepatorenal recess and pelvis

79

What is the direction of fluid movement from the hepatorenal recess when you sit up

Fluid from the hepatorenal recess drains into the peritoneal gutter via the right parabolic gutter down to the retrocecal recess.

80

What gutter is the pathway for infection from the hepatorenal pouch into the pelvis?

The right paracolic gutter

81

Gastrosplenic ligament

Stomach to spleen

82

Gastrophrenic ligament

Stomach to diaphragm

83

At what vertebral level does the esophagus pierce the diaphragm

T10

84

What is the name of the hole the esophagus enters through the diaphragm

Esophageal hiatus

85

What does the abdominal portion of the esophagus "groove" before

The left lobe of the liver

86

What region of the stomach does the esophagus enter?

Cardiac oriface

87

Where along the esophagus is the structure covered in peritoneum

Lateral and anterior borders

88

What nerve plexus surrounds the esophagus

Esophageal plexus

89

What arteries supply the esophagus

Esophageal artery from left gastric artery of celiac trunk and inferior phrenic a.

90

What partially covers the stomach

ribs

91

Greater curvature of the stomach

Left boarder of the stomach notched where the esophagus enters (cardiac notch). Greater momentum attaches here

92

Lesser curvature of the stomach

Right border at the pyloric end contains the angular notch

93

What are the 4 different regions of the stomach

Cardiac antrum, fundus, body, and pylorus

94

Cardiac antrum

region joining esophagus

95

Fundus

Region superior and left of cardiac antrum demarcated by a horizontal plane through the cardiac oriface

96

Body

Major portion of the stomach

97

Pylorus

separate from the body by the angular notch of the stomach Divided into the pyloric antrum (wider) and pyloric canal which ends with a very thick band of smooth muscle the pyloric sphincter

98

Duodenum shape

C shaped loop

99

4 parts of duodenum

-Superior
-Descending
-Horizontal
-Ascending

100

What parts of the duodenum are secondarily retroperitoneal?

The superior and descending

101

What are the vertebral levels for each region of the duodenum

-Superior L1
-Descending L3
-Horizontal L3
-Ascending L2

102

What regions of the duodenum are forgut derivatives? What are the remaining regions a part of?

-Superior and descending are forget derivatives the remainder are midgut

103

What is the blood supply to the superior and descending portion of the duodenum?

Celiac trunk

104

What are the horizontal and ascending regions of the duodenum supplied by?

Superior mesenteric artery

105

What is another name for the superior region of the duodenum?

The duodenal bulb

106

Ampulla of Vater location

Descending suodenum

107

Ampula of Vater: What is it?

Region where the common bile duct and main pancreatic duct enter the descending duodenum

108

Major duodenual papilla

Marks the opening of the common bile and main pancreatic duct inside the duodenum

109

Where do duodenal ulcers typically occur

Superior and descending region above the major duodenal papilla

110

What mesentery suspends the jejunum and ileum

Mesentery proper

111

Location of the mesentery proper

Obliquely, inferior, and to the right of the duodenaljejunal fleecer to the left side of L2 vertebrae and to the right sacroiliac joint (next to midbody of L5)

112

What covers the jejunum and ilium anteriorly?

Greater omentum

113

What region of the abdomen contains the jejunum

Unbilical region

114

What region of the abdomen contains the ileum

Hypogastric and inguinal regions

115

Which is more muscular the jejunum or ileum?

Jejunum

116

What do the intestinal arteries from the superior mesenteric artery form

Arterial arcades and vasa recta

117

Differences in arterial arcades and vasa recta between the jejunum and ileum

The ileum has more complicated arterial arcades and shorter vasa recta

118

Pilcae circulares

Spiral folds of mucous membrane

119

Which has more pronounced plicate circulates the jejunum or ileum?

Jejunum

120

What are the different regions of the large intestine

Cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum.

121

What parts of the large intestine have a mesentery

The transverse and sigmoid colon

122

Where does the large intestine begin

At the ileoceccal junction

123

At what point does the descending colon become the sigmoid colon

When it crosses the pelvic brim

124

Taenia Coli

Longitudinal muscle layer forms 3 stripes on surface of large intestine

125

Haustra

Sacculations of large intestine (can see well in radiographs)

126

Appendicies epiploicae

Fat-filled peritoneal sacs become filled with waste in dicerticulosis

127

What are the 2 fluxures present in the large intestine

Hepatic fluxure and splenic fluxure

128

Hepatic fluxure

Ascending to transverse colon

129

Splenic fluxure

Transverse to descending colon

130

Arterial supply to the large intestine

Branches off the inferior and superior mesenteric a.a

131

Where does the rectum start and end?

Starts: S3 and ends at anal canal

132

Gastric ulcer

Lesions of the wall of the stomach that may disrupt the splenic a. causing sever hemorrhage. Gastric juices can also be released into the omental bursa and cause periontitis

133

Appendicitis

Acute inflammation of the appendix

134

Ascites

Effusion of peritoneal cavity with fluid

135

Peritonitis

Inflammation of pariteoneal cavity

136

Adhesions

Scar tissue connecting parietal and visceral paritoneum