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Peritoneal Cavity & Mesenteries Flashcards

(49 cards)

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1
Q

What supplies blood to the parietal peritoneum?

A

-the same blood supply that services the region of the wall it lines

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2
Q

What innervates parietal peritoneum?

A

-the same somatic nerve supply as the region of the wall it lines

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3
Q

Regarding nerve supply, to what is parietal peritoneum sensitive?

A
  • pressure
  • pain
  • temperature
  • laceration
  • produces localized sensation
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4
Q

What lymphatic vessels are associated with the parietal peritoneum?

A

-the same lymphatic vessels as the region of the wall it lines

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5
Q

What supplies blood to the visceral peritoneum?

A

-the same blood supply as the organ it covers

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6
Q

What innervates the visceral peritoneum?

A

-the same visceral nerve supply as the organ it covers

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7
Q

Regarding nerve supply, to what is the visceral peritoneum sensitive?

A
  • stretch
  • chemical irritation
  • produces sensation that is NOT localized
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8
Q

What lymphatic vessels are associated with the visceral peritoneum?

A

-the same lymphatic vessels as the organ it covers

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9
Q

Technically, what IS mesentery?

A

-double fold of peritoneum

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10
Q

What is the dorsal mesentery in embryonic development?

A
  • connects organs to the dorsal body wall

- runs entire GI tract

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11
Q

What are the adult derivatives of the dorsal mesentery?

A
  • greater omentum
  • small intestine mesentery (“the mesentery”)
  • mesoappendix
  • transverse mesocolon
  • sigmoid mesocolon
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12
Q

What ligaments make up the greater omentum?

A
  • gastrosplenic ligament
  • gastrocolic ligament
  • splenorenal ligament
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13
Q

What is the ventral mesentery in embryonic development?

A
  • found b/w ventral wall and foregut

- runs from septum transversum to umbilical vein

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14
Q

What are the adult derivatives of the ventral mesentery?

A
  • lesser omentum
  • falciform ligament (of the liver)
  • coronary ligament (of the liver)
  • triangular ligaments (of the liver)
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15
Q

What ligaments make up the lesser omentum?

A
  • hepatogastric ligament

- hepatoduodenal ligament

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16
Q

What are the retroperitoneal organs?

A

suprarenal glands, aorta, IVC, anus, duodenum (parts 2-4), pancreas (head and neck), ureters, ascending and descending colon, kidneys, esophagus, rectum

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17
Q

What are the intraperitoneal organs?

A

stomach, spleen, liver, jejunum, ileum, cecum, appendix, sigmoid colon

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18
Q

What arteries are found within the hepatoduodenal ligament?

A

proper hepatic artery

cystic artery

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19
Q

What arteries are found within the hepatogastric ligament?

A

left and right gastric arteries

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20
Q

What arteries are found within the gastrophrenic ligament?

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A

posterior gastric arteries

21
Q

What arteries are found within the gastrosplenic ligament?

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A

short gastric arteries

22
Q

What arteries are found within the splenorenal ligament?

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A

splenic artery

23
Q

What arteries are found within “the mesentery”?

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A

jejunal and ileal arteries

24
Q

What arteries are found within the sigmoid mesocolon?

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A

sigmoid arteries

25
What arteries are found within the transverse mesocolon?
middle colic artery
26
What arteries are found along the lesser curvature of the stomach?
left and right gastric arteries
27
What arteries are found along the greater curvature of the stomach?
left and right gastro-omental arteries
28
What is the opening from the lesser sac (omental bursa) into the greater sac?
epiploic foramen
29
Where is the lesser sac located?
b/w the lesser omentum and the greater omentum
30
What are two more common clinical situations that can impact the lesser sac?
- posterior stomach wall ulcer | - injured/inflamed pancreas may cause pancreatic fluid to leak into the omental bursa
31
What is the clinical significance of the paracolic gutters and subphrenic spaces?
- fluid, bacteria, intestinal contents, etc (ex: d/t injury) can get into the paracolic gutters and subprenic spaces - causes peritonitis, which can be transported to other portions of the peritoneal cavity
32
What are the pararectal spaces and their importance?
- lateral reflections of the peritoneum from the superior third of the rectum - permit the rectum to distend as it fills w/ feces
33
Clinical Box: Patency and Blockage of Uterine Tubes
- a mucus plug blocks the external opening of the uterus to most pathogens (not sperm) - patency of uterine tubes can be tested by hysterosalpingography
34
Clinical Box: Peritoneum and Surgical Procedures
- peritoneum is well-innervated | - open incisions are more painful that laparoscopic or vaginal opening surgeries
35
Clinical Box: Peritoneum and Surgical Procedures (serosa)
- serosa (visceral peritoneum) makes watertight anastomoses of intraperitoneal organs (reperitonealization) - this is harder for extraperitoneal organs
36
Why do surgeons try to remain outside of the peritoneal cavity, if possible?
-the reperitonealization causes an increased risk of adhesions and peritonitis
37
Clinical Box: Peritonitis
- infection or inflammation of the peritoneum - exudation of serum, fibrin, cells and pus in the cavity - pain in overlying skin - increased tone in anterolateral abdominal muscles
38
Clinical Box: Ascites
- excess fluid in peritoneal cavity - d/t internal bleeding, portal HTN, metastasis of CA cells to abdominal viscera, and starvation -can cause subphrenic abscesses d/t diaphragm suction
39
Clinical Box: Peritoneal Adhesions and Adhesiotomy
- damaged peritoneum becomes sticky w/ fibrin - abnormal attachments b/w visceral peritoneum - abnormal attachments b/w peritoneum and wall - cause pain or intestinal volvulus
40
Clinical Box: Abdominal Paracentesis
- most cases of peritonitis are secondary to surgery - could be caused by cirrhosis and infected ascites - paracentesis to remove fluid and culture it - -needle is inserter superior to empty bladder - -avoid inferior epigastric A.
41
Clinical Box: Peritoneal Dialysis
- subdiaphragmatic portion of peritoneum overlies extensive blood/lymph capillary beds - sterile solution injected into one side of cavity and drained from the other
42
What is the mechanism behind how peritoneal dialysis works?
-waste products are transferred rapidly from blood to peritoneum due to the concentration gradient between the two compartments
43
Clinical Box: Functions of Greater Omentum
- prevents visceral peritoneum from adhering to parietal - forms adhesions adjacent to inflamed organs - -"walls them off" to protect other viscera - cushions organs against injury - forms insulation against loss of body heat
44
Clinical Box: Flow of Ascitic Fluid and Pus to Pelvis
- purulent material in abdomen can be transported along the paracolic gutters into the pelvis - -absorption of toxins is relatively easy to drain from pelvic cavity - -facilitate flow by having patient above 45 degrees
45
Clinical Box: Flow of Ascitic Fluid and Pus from Pelvis
-infections in pelvis may extend superiorly to a subphrenic recess when a person is supine
46
What is the relevance of paracolic gutters to cancer spread?
-paracolic gutters provide pathway for the spread of cancer cells that sloughed from ulcerated tumors and entered peritoneal cavity
47
Clinical Box: Internal Hernia through Epiploic Foramen
- loop of small intenstine may pass through the foramen and into lesser sac - -strangulated by edges of foramen, which can't be cut d/t blood vessels - -intestine must be decompressed with a needle
48
Clinical Box: Temporary Control of Hemorrhage from Cystic Artery
- cystic A. can be accidentally severed before adequate ligation during a cholecystectomy - surgeon can control hemorrhage by compressing hepatic A. as it goes through hepatoduodenal L.
49
How does a surgeon maneuver to find the hepatic A. within the hepatoduodenal L.?
- index finger through epiploic foramen - thumb on anterior of ligament -compression and release (alternating) to find artery in order to clamp it

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