Peritoneum & Upper Abdomen Viscera Flashcards
(47 cards)
1
Q
What does splanchnic mean?
A
related to the viscera
2
Q
What does hepatic mean?
A
associated with liver
3
Q
What does cystic mean?
A
associated with gallbladder
4
Q
What does pancreatic mean?
A
associated with pancreas
5
Q
What does splenic mean?
A
associated with spleen
6
Q
What does gastric mean?
A
associated with stomach
7
Q
What does colic mean?
A
associated with the colon
8
Q
What does recto mean?
A
associated with the rectum
9
Q
What does phrenic mean?
A
associated with diaphragm
10
Q
What is the peritoneum?
A
Thin, translucent, serous membrane
11
Q
Where is the parietal peritoneum?
A
lines inner abd. wall
12
Q
Where is the visceral peritoneum?
A
covers organs
13
Q
Organs behind the peritoneum are called …
A
retroperitoneal
14
Q
True or false: vessels tend to travel between the peritoneal layers
A
True
15
Q
What makes up the peritoneal sac?
A
all visceral & parietal peritoneal membranes
16
Q
What is the peritoneal cavity?
A
- a potential space within sac
- contains only a small amount of serous fluid
- allow organs to move freely without friction
17
Q
What are Marked Ascites & umbilical herniation?
A
- The potential space of the peritoneal cavity can become an actual space
- May contain up to several liters of fluid (ascites)
- Disease, injury or infection can lead to pooling of fluids (blood, bile, pus, feces)
18
Q
What are the Double layered Peritoneal Folds & Ligaments?
A
1) Greater Omentum
2) Lesser Omentum
3) Mesentery Proper
4) Suspensory Ligament of Treitz
5) Mesocolon
6) Falciform Ligament
7) Coronary Ligament
19
Q
Where is the Greater Omentum?
A
- attaches to greater curvature of stomach and transverse colon
- Drapes over small intestines like an ‘apron’
- ‘Apron’ = gastrocolic ligament
- 4 layers of peritoneum
- functionally it can wall off infections & inflammation sites
- results in formation of adhesions
20
Q
What is the Lesser Omentum?
A
- attaches to lesser curvature of stomach and duodenum
- 2 portions connect these structures to the liver
- Hepatogastric ligament
- connects liver to stomach
- Hepatoduodenal ligament
- connects liver to duodenum
- Contains the portal triad
Portal Triad = hepatic a., portal v., & bile duct
21
Q
What is the Mesentery Proper?
A
- Anchors most of the small intestine to posterior abd. wall
- Runs diagonally from duodenojejunal jxn. to ileocecal jxn.
- a distance = 15 to 20 cm in adults
- Note: duodenum anchored by suspensory ligament of Treitz
22
Q
What is the Suspensory Ligament of Treitz?
A
- Fibromuscular ligament descends from the R. crus of diaphragm
- Crosses over L. crus & holds distal duodenum in place
- Prevents duodenojejunal jxn. from sagging
23
Q
What is the Mesocolon?
A
- Anchors portions of the colon to the posterior abdominal wall
- Ascending & Descending colon have no mesentery
- attached directly to the posterior wall
- Transverse Colon anchored by transverse mesocolon
- Sigmoid colon anchored by sigmoid mesocolon
- Rectum only partially covered with peritoneum
24
Q
What is the Falciform Ligament?
A
- Divides liver into R & L lobes
- Anchors liver to diaphragm & anterior body wall
- Round ligament of the liver
*Note: inferior border contains the obliterated umbilical vein.
25
What is the Coronary Ligament?
- Reflections of peritoneum around the bare area of the liver
- Attach liver to inferior surface of diaphragm
- bare area = upper posterior liver
26
What are the Single Layered Peritoneal Folds?
1 median umbilical fold
covers fetal urachus
2 medial umbilical folds
covers fetal umbilical aa.
2 lateral umbilical folds
covers inferior epigastric vessels
27
What are the Infraumbilical peritoneal folds?
median umbilical fold
- from urinary bladder to umbilicus
- covers median umbilical ligament
medial umbilical folds (2)
- covers medial umbilical ligaments
- occuded portions of umbilical aa.
lateral umbilical folds (2)
- covers inferior epigastric vessels
28
What are Peritoneal Pouches?
- Potential peritoneal spaces in standing patients
- Becomes actual spaces in recumbent patients
* Hepatorenal pouch
* Rectovesical or retrouterine pouch
- Pathological fluids can accumulate in these recesses
29
What is the Hepatorenal pouch (Pouch of Morrison)?
- Bounded by liver, R kidney, colon & duodenum
* lowest part of peritoneal cavity when recumbent
- fluids may move down to retrovesical/rectouterine pouch – when in reclining position or sitting up
30
What is the Rectovesical pouch?
- Between rectum & bladder (♂)
* another low point of peritoneal cavity when recumbent
* fluids here may move up to hepatorenal pouch – when in Trendelenburg position
31
What is the Rectouterine pouch?
- Between rectum & uterus (♀)
* another low point of peritoneal cavity when recumbent
* fluids here may move up to hepatorenal pouch – when in Trendelenburg position
32
What are the different sides of the liver?
1) Diaphragmatic Liver
| 2) Visceral Liver - has Porta Hepatis
33
What/Where is the Gallbladder?
- Attached to inferior surface of liver
- Contacts duodenum, colon & anterior abdominal wall
- Receives bile produced by liver via bile ducts
- Bile then drains into duodenum thru these ducts
34
What/where are the Bile Ducts?
- R & L hepatic ducts
* receives bile from R & Llobes of liver
- Common hepatic duct
* receives R & L hepatic ducts
- Cystic duct
* connected to gall bladder
- Common bile duct
* receives cystic & common hepatic ducts
35
Where do the bile ducts drain?
- Common bile duct joins main pancreatic duct
| - Both empty into major duodenal papilla in descending part of duodenum
36
Pancreas
- Consists of a head, neck, body, tail and uncinate process
- Retroperitoneal & transverse across posterior abdominal wall
- Surrounded by C-shaped duodenum on R & spleen on L
37
Drainage of Pancreatic Ducts
- Enzymes drain from pancreas via 1 or 2 ducts
- Main pancreatic duct
* enters duodenum with bile duct at major duodenal papilla
- Accessory pancreatic duct
* may enter duodenum as well
* ~ 2 cm superior to major papilla
- Pattern of pancreatic drainage variable
38
What are the surfaces of the spleen?
1) Diaphragmatic surface:
* contacts diaphragm along ribs 9-11
2) Visceral surface
39
Celiac Trunk
- 1st major br. of Abd aorta
- Supplies liver, gb, esophagus, stomach, pancreas & spleen
- 3 main branches
* Common hepatic
* L. gastric
* Splenic aa.
40
Common Hepatic A.
- Right br. of celiac trunk
- Runs toward liver & gallbladder
- 2 terminal branches
* Proper hepatic a.
* Gastroduodenal a.
41
The common hepatic portal run into the ......
- Superior br. of common hepatic a.
- Runs toward liver & medial to bile duct
- Splits into R & L hepatic aa
42
Gastroduodenal A.
- Inferior br. of common hepatic a.
- Runs toward junction of stomach & duodenum
- sends Supr. pancreaticoduodenal aa. to pancreas/duodenum
- sends R gastroepiploic a to gr. curvature of stomach
43
L Gastric A.
- Superior br. of celiac trunk
- Runs L toward lesser curvature of stomach
- supplies stomach & esophagus (via esophageal brs.)
44
Splenic A.
- Left br. of celiac trunk
- Runs toward spleen
- supplies pancreas & spleen
- Sends short gastric aa. & L gastroepiploic a.
* supply greater curvature of stomach
45
Common variations of Hepatic AA
- variations ~ 40%
- R hepatic a. may arise from SMA
- L hepatic a. may arise from L. gastric a.
- Both R and L hepatic aa. may arise from celiac trunk
- Accessory R & L hepatic aa also common
46
What is the Cystic A.?
An Additional Hepatic aa. Variation
- usually arises from R hepatic a.
- 75% run post. to common hepatic duct
- 24% run ant. to common hepatic duct
- 1% are double cystic aa.
- Supplies gallbladder & cystic duct
47
What is the Additional Hepatic aa. Variation?
- usually arises from proper hepatic a.
- May arise from common hepatic or gastroduodenal aa.
- Anastomoses with L. gastric a.
- Supplies lesser curvature of stomach
