51. GI anatomy Flashcards
What is the peritoneum?
Two layers (parietal and visceral) of squamous epithelium (mesothelium) and connective tissue that allow the passage of blood vessels and lymph nodes to the abdominal viscera.
Describe the parietal peritoneum?
Lines the internal surface of the abdominopelvic wall. It is derived from somatic mesoderm in the embryo
pain from the parietal peritoneum is well localised due to innervation from abdominal wall. Parietal peritoneum is sensitive to pressure, pain, laceration and temperature.
(just like the pleura)
Discuss the visceral peritoneum
It is derived from splanchnic mesoderm in the embryo.
The visceral peritoneum has the same autonomic nerve supply as the viscera it covers.
Pain from the visceral peritoneum is referred to areas of skin (dermatomes) which are supplied by the same sensory ganglia and spinal cord segments
Invaginated parietal peritoneum (like a balloon)
what is a peritoneal adhesion?
damage to the peritoneum due to infection or injury.
Such adhesions can result in pain and complications such as volvulus, when the intestine becomes twisted around an adhesion resulting in a bowel obstruction.
What organs are retroperitoneal organs?
What organs are primarily retroperitoneal organs
S A D P U C K E R
Primary peritoneal-
What organs are retroperitoneal organs?
What organs are primarily retroperitoneal organs
S Supradrenal glands A Aorta/IVC D Duodenum P Pancreas (minus the tail) U Ureters C Colon (minus transverse) K Kidneys E oesophagus R Rectum
Primary peritoneal- developed and remained outside peritoneum. Oesophagus, rectum and kidneys
What are peritoneal reflections?
highly folded complex structures that provide specific functions.
Mesentery
Greater and lesser omentum
periteneal ligaments
What is the mesentery?
What are the peritoneal ligaments?
mesentery- double layer of visceral peritoneum, pathway for nerves,vessels and lymphatics.
ligaments- double fold of peritoneum that connects viscera together or connects viscera to abdominal wall.
Describe the omentum
Greater Omentum- abdominal policemena. travel from greater curvature of stomach to transverse colon
Lesser Omentum- lesser curve of stomach to proximal part of duodenum. Consists of two parts the hepatoduodenal ligament and the hepatogastric .
What is the peritoneal cavity?
What is contained in peritoneal fluid?
The potential space between parietal and visceral peritoneum. Normally contains peritoneal fluid
Water, electrolytes, leukocytes and antibodies
How do you divide the peritoneal space?
Greater and lesser sac
Explain the greater sac?
The larger portion of the peritoneal cavity, further divided into supra-colic compartment and infra-colic compartment
What are the paracolic gutters?
connections between supra colic and infra colic compartments. Contains a potential for pus and fluid to gather
Discuss the lesser sax
Lies posterior to the stomahc and lesser omentum
Connected to the greater sac by the epiploic foramen
What is the lowest area of the peritoneal cavity in males?
Rectovesical pouch- males
rectouterine puch (douglas)-females Vesicouterine pouch (uterus and bladder)
What is the porta hepatasis?
Where the hepatic ducts and neurovascular structures enter and exit the liver.
What are the border’s of calot’s triangle?
common hepatic duct- medial
Cystic duct- inferior
inferior surface of liver- superior
What are the contents of calot’s triangle?
Right hepatic artery
Cystic artery
Lymphatics (lymph node of lund (first lymph of gallbladder)
What is all the big fuss about calot’s triangle?
There may be anatomical variation and therefore the surgeon needs to identify the contents and borders
What is the inguinal triangle?
Hesselbach’s triangle- weakening in the abdominal wall may be a site for hernia
What is the gubernaculum?
Fibrous cord that decides the descent of the testicles /ovaries from the abdominal wall down
Goes on to form ovarian ligament and round ligament of uterus
What are the boundaries of the inguinal canal?
Anterior wall-aponeurosis of external oblique, internal oblique
Posterior wall- transversalis fascia
Roof- internal oblique, transversus abdominis
Floor- inguinal ligament
What are the contents of the inguinal canal?
spermat cord (males)
Round ligament (females)
Gneital branch of genitofemoral nerve
ilioinguinal nerve
