3. Peritoneal Cavity and Mesenteries (Carter)

Question 1

Which embryological structure gives rise to the greater omentum?

Answer 1

The dorsal mesogastrium.

Question 2

What arteries run within the greater omentum?

Answer 2

The posterior gastric arteries.

The short gastric arteries.

The left gastric omental artery.

The right gastric omental artery.

Question 3

What is the lowest place in the abdominal cavity for fluid to collect?

Answer 3

In males, it is the rectovesicular space.

In females it is the rectouterine space.

Question 4

From which mesentery do the hepatoduodenal and hepatogastric ligaments arise?

Answer 4

The ventral mesentery.

Question 5

What arteries run within the hepatogastric ligament?

Answer 5

The right and left gastric arteries.

(Recall that the right gastric artery also runs within the hepatoduodenal ligament.)

Question 6

Which ligament does the splenic artery run in?

Answer 6

The splenorenal ligament.

Question 7

From which mesentery does the falciform ligament arise?

Answer 7

The ventral mesentery.

Question 8

What ligaments make up the greater omentum?

Answer 8

The gastrosplenic ligament.

The gastrocolic ligament.

The gastrophrenic ligament.

Question 9

What arteries run within the gastrosplenic ligament?

Answer 9

The short gastric arteries.

Part of the left gastric omental artery.

Question 10

Where is the lesser omentum found?

Answer 10

In between the stomach and the liver.

Question 11

What are the borders of the lesser sac?

Answer 11

Anterior: lesser omentum (hepatoduodenal ligament / hepatogastric ligament), stomach, gastrocolic ligament.

Posterior: pancreas, left kidney and suprarenal gland, aorta, inferior vena cava, splenic artery and vein.

Superior: diaphragm and liver.

Inferior: transverse mesocolon and 1st part of the duodenum.

Left: hilum of the spleen and gastrosplenic ligament.

Right: epiploic (omental) foramen.

Question 12

What arteries are contained within the mesentery proper?

Answer 12

The jejunal and illeal arteries.

The superior mesenteric artery.

Question 13

Where are the superior mesenteric vein and artery in relation to the pancreas?

Answer 13

Behind the head, and tucking through the hook of the uncinate process.

Question 14

The splenorenal ligament and the gastrosplenic ligament are a part of which mesentery?

Answer 14

The dorsal mesentery.

Question 15

What arteries run within the gastrophrenic ligament?

Answer 15

The posterior gastric arteries.

Question 16

What are the primary retroperitoneal structures?

Answer 16

The kidneys.

The ureters.

The aorta / IVC.

Question 17

Through which mesentery does the sigmoid artery run?

Answer 17

The sigmoid mesocolon

Question 18

At what vertebral levels do we find the pancreas?

Answer 18

The head is at L2, and the tail ascends to about L1.

Question 19

What separates the right and left subphrenic spaces?

Answer 19

The falciform ligament.

Question 20

What are all of the retroperitoneal structures?

Answer 20

Suprarenal glands, Aorta / IVC, Duodenum (second through fourth parts), Pancreas (except the tail), Ureters, Colon (ascending and descending), Kidneys, Esophagus, Rectum.

SADPUCKER

Question 21

What is the orientation of the three vessels of the portal triad?

Answer 21

Hepatic portal vein – posterior.

Common bile duct – anterior and lateral.

Proper hepatic artery – anterior and medial.

Question 22

What arteries run within the gastrocolic ligament?

Answer 22

The right and left gastric omental arteries.

Question 23

Through which mesentery does the iliocolic artery run?

Answer 23

The root of the mesentery proper

Question 24

What are the secondary retroperitoneal structures?

Answer 24

Duodenum (2nd - 4th parts).

Pancreas (the tail).

Ascending/Descending colon.

Question 25

What arteries run within the lesser omentum?

Answer 25

The proper hepatic artery.

The cystic artery.

The right gastric artery.

The left gastric artery.

Question 26

What two ligaments make up the lesser omentum?

Answer 26

The hepatogastric and hepatoduodenal ligaments.

Question 27

Which arteries run within the transverse mesocolon?

Answer 27

The middle colic artery.

The marginal artery (of Drummond)

Question 28

Where do we find the phrenicocolic ligament?

Answer 28

Attaching the splenic flexure of the transverse colon to the diaphragm.

Question 29

What is the visceral peritoneum sensitive to?

Is this pain more localized or generalized?

Answer 29

The visceral peritoneum is sensitive to stretch, chemical irritation, and ischemia.

This pain is more generalized, and less precise.

Question 30

What is the parietal peritoneum sensitive to?

Is this pain localized or generalized?

Answer 30

Pressure, pain, and temperature.

The pain is localized, and usually more precise.

Question 31

What options does fluid exiting the lesser sac have in terms of cavities it can travel through?

Answer 31

Superiorly, the right subphrenic space.

Inferiorly, the right paracolic gutter.

Question 32

What arteries lie within the hepatoduodenal ligament?

Answer 32

The proper hepatic artery and its two branches: the cystic artery, and the right gastric artery.

Question 33

What are the four boundaries to the epiploic (omental) foramen?

Answer 33

Superior: caudate lobe of the liver.

Anterior: hepatoduodenal ligament and the portal triad.

Posterior: inferior vena cava and of the right crus of the diaphragm.

Inferior: 1st part of the duodenum.