Peritoneum and Upper Abdomen

Question 1

What are the two types of peritoneum?

Answer 1

1) Parietal Peritoneum

2) Visceral Peritoneum

Question 2

What travels between peritoneal layers?

Answer 2

Vessels

Question 3

What is the collective name for organs behind the peritoneum?

Answer 3

Retroperitoneal organs Duhhh

Question 4

What is the type of membrane that makes up the peritoneum?

Answer 4

Serous membrane

Question 5

What is the Peritoneal Sac

Answer 5

It is all of the visceral and parietal peritoneal membranes

Question 6

What is the peritoneal cavity

Answer 6

It is the potential space within the sac that contains a small amount of serous fluid that allows the organs to move more freely during peristalsis.

Question 7

What can happen within the peritoneal cavity clinically?

Answer 7

Can become an actual space with the build up of fluids bacteria and gas that leads to a condition called ascites. There can be as much as liters of fluid in the space.

Question 8

What are the 4 Main bilayer ligaments of the peritoneum?

Answer 8

1) Hepatoduodenal Ligament (contains the Portal triad)
2) Hepatogastric Ligament
3) Gastrosplenic ligament
4) Splenorenal ligament

Question 9

What is contained in the portal triad?

Answer 9

Hepatic artery, Bile duct and Hepatic portal vein

Question 10

What are the two components of the Lesser omentum?

Answer 10

1) Portal triad

2) Hepatogastric ligament

Question 11

What are the attachments of the Greater Omentum

Answer 11

The greater curvature of the stomach and the transverse colon.

Question 12

How many layers of peritoneum is the Greater omentum composed of?

Answer 12

4 Peritoneal layers

Question 13

What is the function of the apron like structure?

Answer 13

Wall off infection and inflammation sites

Question 14

What is the attachment of the Lesser Omentum

Answer 14

Lesser curvature of the stomach and the Duodenum.

Question 15

What two structures connect the lesser omentum to the Liver

Answer 15

Hepatogastric ligament 
Hepatoduodenal ligament (portal Triad container)

Question 16

What is the overall shape of the Mesentery proper and what is its function

Answer 16

It is overall fan shaped and anchors the small intestine to the posterior abdominal wall

Question 17

What is its span along the small intestine?

Answer 17

Diagonally from the duodenojejunal junction to the ileocecal junction.

Question 18

What anchors the duodenum?

Answer 18

Suspensory ligament of Trietz

Question 19

What is the nature of the Suspensory Ligament of Treitz and where does it extend from?

Answer 19

It is a fibromuscular Ligament that descends from the R. crus of the diaphragm. (Crosses over the L. crus)

Question 20

What are the two portions of the Mesocolon and what do they do?

Answer 20

Transverse mesocolon, anchors the Transverse colon to the posterior wall and the sigmoid mesocolon anchors the sigmoid colon to the posterior wall.

Question 21

How do the ascending and descending colon attach to the posterior abdominal wall?

Answer 21

Directly

Question 22

Which Peritoneal double layer divides the liver into Right and Left Lobes?

Answer 22

The Falciform ligament with the round ligament extending off of it (obliterated umbilical vein)

Question 23

Describe the coronary ligament of the liver.

Answer 23

There is an anterior and a posterior portion, both of which anchor the liver to the diaphragm. There is a space between these two layers that is called the bare area and its located in the upper posterior portion of the liver

Question 24

What are the 5 single layered peritoneal folds again?

Answer 24

1 Median umbilical Fold (fetal urachus)
2 Medial umbilical Folds (fetal umbilical aa.)
2 Lateral umbilical Folds (inferior epigastric vessels)

Question 25

What causes the potential spaces to become actual spaces within the abdomen?

Answer 25

The patient laying down

Question 26

What are the two spaces derived from peritoneal pouches?

Answer 26

Hepatorenal pouch | Rectovesical or the retrouterine pouch (rectouterine)

Question 27

What is the lowest part of the peritoneal cavity?

Answer 27

Hepatorenal Pouch found right behind the liver (Pouch of Morrison)

Question 28

What position causes the fluids in the Rectovesicle (retrouterine pouch) to move to the Hepatorenal pouch

Answer 28

Trendelenburg position

Question 29

What is the general function of the Liver

Answer 29

Detoxifies chemical products and produces bile

Question 30

What is the general function of the gallbladder

Answer 30

stores bile for the emulsification of fats

Question 31

What is the general function of the pancreas

Answer 31

Produces enzymes for digestion

Question 32

What is the general function of the spleen

Answer 32

Produce lymphocytes and filter blood

Question 33

How is the the anatomical Right and Left Lobe of the liver distinguished?

Answer 33

Cross section of the vena cava

Question 34

Explain the position of the gall bladder and the path of bile to the duodenum.

Answer 34

The gall bladder is positioned right underneath the liver and drains into the cystic duct. Bile from the liver travels down the right and left hepatic duct into the common hepatic duct which combines with the cystic duct to form the Common bile duct.

Question 35

What does the common bile duct join as it enters the duodenum?

Answer 35

The main pancreatic duct

Question 36

What are the 5 parts of the pancreas listed from left to right?

Answer 36

Tail, body, neck, Head, and uncinate process

Question 37

What are the two ducts of the pancreas and where do they drain?

Answer 37

The main duct drains into the major duodenal papilla with the common bile duct and the accessory duct drains into the duodenum via the minor duodenal papilla.

Question 38

Which papilla is more superior the Major or Minor duodenal papilla?

Answer 38

Minor Duodenal papilla

Question 39

What are the ribs along which the spleen lies and what are the 3 regions of the spleen?

Answer 39

The spleen lies on ribs 9 through 11 and the three portions are the Gastric Area, Colic Area and the Renal Area

Question 40

What is the first major branch off of the Abd. aorta

Answer 40

Celiac Trunk

Question 41

What 6 Structures does the Celiac trunk supply

Answer 41

Liver, Gall bladder, esophagus, stomach, spleen, and pancreas

Question 42

What are the three main branches of the celiac trunk?

Answer 42

Common hepatic Left Gastric Splenic

Question 43

What are the Two branches of the Common Hepatic Artery

Answer 43

Proper Hepatic Artery | Gastroduodenal Artery

Question 44

What are the Characteristics of the proper Hepatic Artery?

Answer 44

Superior branch of the common hepatic artery. Medial to common bile duct and superficial to the Portal vein (with much variation) and splits into the Right and left lobes of the liver.

Question 45

What are the three branches of the Gastroduodenal A. (inferior branch of the common hepatic artery)

Answer 45

``` Superior pancreaticoduodenal (to pancreas and duodenum) Right Gastroepiploic artery to the greater curvature of the stomach Supraduodenal a. to the superior duodenum ```

Question 46

Where does the Left gastric artery come from and what does it supply?

Answer 46

Branch off of the Celiac trunk that runs to the lesser curvature of the stomach to supply the stomach and the lower esophagus.

Question 47

Where does the splenic artery come from and what does it supply?

Answer 47

Comes from the left side of the celiac trunk to supply the pancreas and spleen.

Question 48

What are the branches of the splenic artery?

Answer 48

Short gastric arteries and the Left gastroepiploic artery to supply the greater curvature of the stomach

Question 49

What does the Cystic Artery come from and what are some common clinical considerations for this artery?

Answer 49

Usually arises from the Right hepatic artery and there is a risk for strangulation and constriction

Question 50

Where does the R. Gastric Artery arise from and what does it supply?

Answer 50

Usually arises from the proper hepatic artery and anastomoses with the Left Gastric Artery to supply the Lesser (more superior) curvature of the stomach.