Abdomen 1.5 Flashcards

1
Q

What is the peritoneal cavity derived from?

A

-the coelomic cavity of the embryo

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2
Q

What are the other cavities?

A
  • pleural cavities

- pericardial cavity of the thorax

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3
Q

What is the peritoneal cavity lined by?

A

a membranous layer called the peritoneum (equivalent to the pleura and pericardium of the thoracic cavities)

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4
Q

What does the lining membrane consist of?

A

Simple layer of squamous epithelium: mesothelium

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5
Q

What is the mesothelium supported by?

A

thin layer of areolar connective tissue

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6
Q

Where does the abdominal part of the gut become suspended from in early development?

A

dorsal (posterior) wall of the abdominal cavity within the free edge of a peritoneal fold called the mesentery

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7
Q

What runs within the thickness of the mesentery (between its two peritoneal layers)

A

blood vessels and nerves that supply the gut

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8
Q

What are the three regions of the abdominal gut?

A
  1. Foregut
  2. Midgut
  3. Hindgut
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9
Q

What does the foregut consist of?

A
  • Intra-abdominal oesophagus
  • part of duodenum
  • stomach
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10
Q

What do all three regions have?

A

Presence of a dorsal mesentery

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11
Q

What does the foregut have that is different?

A

ventral mesentery, and so is suspended between the dorsal and ventral abdominal walls

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12
Q

What are retroperitoneal organs and what are some examples?

A
  • not become suspended in mesenteries but remain behind the parietal peritoneum
  • Kidneys and Suprarenal glands
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13
Q

What happens within the ventral foregut mesentery?

A

the liver grows dividing this mesentery into two parts:

  1. falciform ligament
  2. lesser omentum
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14
Q

What grows in the dorsal foregut mesentery?

A

spleen

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15
Q

What happens as the liver grows?

A

the abdomen is wider than it is deep, so rapid growth of the liver results in the liver moving to the right and the spleen to the left

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16
Q

What is the effect of this liver growth?

A

part of the peritoneal cavity (the bit originally to the right of the dorsal and ventral foregut mesenteries) becomes trapped posterior to the liver and the stomach

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17
Q

What is this semi-isolated pocket of the peritoneal cavity called?

A

lesser sac/omental bursa

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18
Q

What does the omental bursa contain?

A
  1. pancreas
  2. much of the left kidney
  3. left suprarenal gland
  4. posterior surfaces of the liver abdominal aorta that cannot be seen from the main part of the peritoneal cavity
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19
Q

How can it be found?

A

passing a finger below the free lower border of the lesser omentum through the narrow omental or epiploic foramen (otherwise known as the entry to the lesser sac)

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20
Q

What is the greater omentum? Where does it grow out from?

A

double sheet of peritoneum grows out from the dorsal foregut mesentery below the spleen and hangs down like an apron in front of the coils of small intestine

21
Q

What happens as the gut tube lengths?

A

an no longer be accommodated within the abdominal cavity so coils of gut with their mesentery move out into the body stalk

22
Q

What happens to the coils as the abdomen grows?

A

coils are retrieved beginning from the proximal (duodenal) end of the midgut

23
Q

What happens to some segments of the gut?

A

adherent to the posterior abdominal wall and lose their mesentery

24
Q

What does their mesentery fuse with?

A

parietal peritoneum

25
Q

What is the name for these parts of the gut?

A

become secondarily retroperitoneal

26
Q

What are examples of parts of the guy that become secondarily retroperitoneal?

A

ascending and descending parts of colon

27
Q

Which parts of the colon retain their mesentery?

A
  • jejunum
  • ileum
  • transverse
  • sigmoid
28
Q

What does the liver occupy?

A
  • Most of right part of the peritoneal cavity
  • Filling space between. diaphragm and right costal margin
  • tapering like a wedge from its thick right margin to its left extremity near the plane of the left mid- clavicular line
29
Q

Where is the liver suspended?

A
  • Ventral foregut mesentery sporting this mesentery to:
    1. falciform ligament
    2. Lesser omentum
30
Q

What is the bare area of the liver?

A

part of its convex diaphragmatic surface has a direct contact with the diaphragm

31
Q

What does the visceral surface of the liver show?

A

two small lobes separated from the left lobe by the grooves containing ligaments that are remnants of fetal vessels

32
Q

What the ligaments?

A
  1. ligamentum teres from the umbilical vein

2. ligamentum venous an embryological remnant the ductus venosus

33
Q

How are they operated from the right lobe?

A

by the groove occupied by the gall bladder and that occupied by the inferior vena cava

34
Q

What are the small quadrate and caudate lobes of liver part of functionally?

A

left lobe, because they are supplied by the left branch of the hepatic artery and drained by the left hepatic duct

35
Q

What do the left and right hepatic ducts mostly point to form?

A
  1. common hepatic duct close to the hilum
  2. Or porta hepatis of the liver, the common hepatic duct joining the cystic duct to form the bile duct within the free edge of the lesser omentum
36
Q

Is there variation in the relative lengths of these biliary ducts?

A

yes

37
Q

What is the journey of the duct?

A
  1. passes behind the 1st part of the duodenum and the head of the pancreas to enter the duodenum at the foregut-midgut junction half way down its second part
  2. This entry is usually shared with the main pancreatic duct
38
Q

Where does the arterial supply of the liver and biliary system come from?

A

hepatic branch of coeliac trunk

39
Q

How much does the area supply of the total hepatic blood flow?

A

20%, rest coming from portal vein

40
Q

What does the portal vein do?

A

drains the entire gut and its derivatives from the lower part of the oesophagus to the upper part of the rectum, including the pancreas and the spleen

41
Q

What does the portal vein form from?

A

splenic and superior mesenteric veins behind the neck of the pancreas and runs with the bile duct and the hepatic artery in the free edge of the lesser omentum to the hilum of the liver

42
Q

What do the veins draining into the portal system at several sites anastomose with?

A

systemic veins draining to the inferior or superior vena cava

43
Q

Why are these porto-caval anastomoses are clinically important?

A

large volumes of blood can flow through them when the liver is obstructed by disease (such as alcoholic liver disease)

44
Q

What can these dilated, varicose veins can cause?

A

serious haemorrhage at sites such as the lower oesophagus and the rectum

45
Q

Where is the spleen?

A

fist-sized organ lying in the posterior part of the left upper hypochondrium along the axis of the 9, 10 & 11th ribs

46
Q

What are the main functions of the spleen?

A

processor of worn-out red cells and a source of B-lymphocytes

47
Q

Why is the spleen vulnerable to rupture?

A

large blood supply from the splenic branch of the coeliac trunk

48
Q

What could rupture lead to?

A

severe haemorrhage into the epigastrium in trauma caused by such things as road traffic accidents or being kicked