Flashcards in The Peritoneum Deck (45):
The pancreas is a _________ organ.
Name of the peritoneal fold of the stomach?
Omentum - Lesser and greater omentum
Name of the peritoneal fold of the small intestine?
Name of the peritoneal fold of the large intestine?
Meso-colon - Mesoappendix, transverse mesocolon, sigmoid mesocolon
What are the retroperitoneal, partially covered structures?
Aorta and IVC
Duodenum (2nd, 3rd, 4th parts)
Colon (Ascending and Descending)
How do you find the greater and lesser sacs of the peritoneum communicate?
Through the Epiploic foramen or Foramen of Winslow’s.
What generates the lesser sac of the peritoneum?
Stomach rotation and growth of the liver
The liver and stomach are connected by the __________.
What are the single branches of the anterior surface of the abdominal aorta and their levels?
Foregut - Celiac Trunk - T12
Midgut: Superior mesenteric artery (SMA) - L1
Hindgut: Inferior mesenteric artery (SMA) - L3
What are the branches of the celiac trunk?
Left gastric (upward)
Splenic artery (to the left)
Common hepatic (to the right)
What is the route and target organs of the left gastric artery?
Enters into the lesser omentum and sends branches to the esophagus and lesser curvature of the stomach.
Name the anastomosis of the left gastric artery.
The left gastric artery ends by anastomosing with the right gastric artery at lesser curvature of stomach.
What is the route of the splenic artery?
Tortuous artery runs behind the stomach along the superior border of pancreas and ends in the lienorenal ligament.
What are the target organs and branches of the splenic artery?
Gives the stomach short gastric arteries and the left gastroepiploic artery (both run in the gastrosplenic ligament)
It also supplies the spleen.
Name the anastomosis of the left gastroepiploic (gastro-omental) artery.
The left gastroepiploic (gastro-omental) artery ends by anastomosing with right gastroepiploic artery at the greater curvature of stomach.
Name the 1st branch of the common hepatic artery and its branches.
First branch: gastroduodenal artery
Gives off the superior pancreatic duodenal artery and the right gastro-omental
Name the continuation of the common hepatic artery and its branches.
Continues as hepatic proper (to liver). Gives off the right gastric artery.
Name the final continuation of the common hepatic artery and its branches.
Continues as the right and left hepatic which give the cystic artery branch (to gall bladder) of the right hepatic artery.
Why is the greater omentum the policeman of the stomach?
It prevents the spread of infection.
What are the parts of the stomach?
Pylorus (antrum, canal and sphincter).
What structures are in the free border/epiploic foramen of the lesser omentum?
Three structure are in its free border:
Right: Hepatic duct
Left: Hepatic artery
Posterior: Portal vein (duct and artery)
What ligaments make-up the lesser omentum?
Hepatogastric and Hepatoduodenal ligaments
What ligaments make-up the greater omentum?
Gastrosplenic, Gastrophrenic, Gastrocolic and lienorenal (splenorenal)
Which part of the small intestine is in the intraperitoneal cavity?
The 1st part of the duodenum is held in the intraperitoneum due to the hepatoduodenal ligament.
What are the peritoneal ligaments of the liver?
Anterior and posterior coronary ligaments
Right and left triangular ligaments
What are the fissures of the liver?
Fissure for Ligamentum venosum (From ductus venosus)
Fissure for Ligamentum teres (round ligament) - (from obliterated umbilical vein)
Fossa of gall bladder
Fissure for IVC
Porta Hepatis (portal triad)
What are the anatomical and functional divisions of the liver?
The falciform ligament and fissures for ligamentum teres and venosum divide the liver into right anatomical lobe (contain the caudate and quadrate) and left lobe.
Fossas of gallbladder and IVC divide the liver into right lobe and left functional lobe (contain the caudate and quadrate)
What is the arterial and oxygen supply of the liver?
Hepatic proper artery (25%) and portal vein (75%). Each provides 50% of the oxygen supply to the liver.
What is the blood supply of the caudate and quadrate lobes of the liver?
Caudate and quadrate lobes are supplied by the left hepatic artery and left branch of the portal vein.
Build the biliary tree (3 steps).
The right and left hepatic ducts form the common hepatic duct.
The common hepatic duct receives the cystic duct from the gall bladder. Together, they form the common bile duct.
The common bile duct receives the main pancreatic duct. Together they empty into the ampulla of vater (at 2nd part of duodenum in major duodenal papillae).
What duct drains the gall bladder?
the cystic duct
What is the function of the Sphincter of Oddi?
Sphincter of Oddi is a layer of circular muscle surrounding the lower end of bile duct, pancreatic duct and ampulla, controlling the flow of bile and pancreatic secretions.
The __________ ligament is continuous with the falciform ligament.
What are the surfaces of the spleen?
Diaphragmatic surface (9,10,11)
What area results in a ruptured spleen?
A fracture to the 9th, 10th or 11th rib can rupture the spleen.
What is the location and ligaments of the spleen?
The spleen is wedged between the stomach and left kidney.
It is connected to them by the gastrosplenic and lienorenal (splenorenal) ligaments. The splenocolic ligament holds the spleen in place.
What 2 vessels cross the body and uncinate process of the pancreas?
Superior mesenteric artery and Superior mesenteric vein
The _____________ artery runs at the upper border of the pancreas.
The _________ vein and the ___________ vein unite at the neck of the pancreas to form the ___________ vein.
The splenic vein and the superior mesenteric vein unite at the neck of the pancreas to form the portal vein.
What structure is at the tail of the pancreas?
The splenorenal ligament
What is the function of the main pancreatic duct of Wirsung?
The main pancreatic duct (of Wirsung) drains the tail, body, neck and upper part of the head. It joins the bile duct to form a short tube called Hepatopancreatic ampulla (ampulla of Vater), the ampulla opens on the major duodenal papilla at 2nd part of duodenum
At what level is the superior portion of the duodenum and what is attached?
L1 - attached by the hepatoduodenal ligament
At what level is the descending (2nd) portion of the duodenum and what does it contain?
L2 - contains major duodenal papillae and Ampulla of Vater
At what level is the inferior (3rd) portion of the duodenum and what does it contain?
L3 - location of the uncinate process and SMV/SMA