Abdomen 2 Flashcards

1
Q

What is the peritoneum

A

Transparent serous membrane that covers the body wall and organs

One continuous layer

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2
Q

What are the 2 subdivisions of the peritoneum?

A

Parietal peritoneum

Visceral peritoneum

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3
Q

What can the peritoneum form?

A

Folds such as mesenteries and omenta

Ligaments which may be vascular or avascular

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4
Q

What is the peritoneal cavity?

A

Space between the parietal and visceral peritoneum

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5
Q

What are the 2 major divisions of the peritoneal cavity termed?

A

Sacs

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6
Q

What are the 2 main divisions of the peritoneal cavity?

A

Greater sac

Lesser sac

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7
Q

Through which passage do the greater and lesser sac communicate?

A

Omental foramen

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8
Q

Where is the omental foramen located?

A

Posterior to free edge of lesser omentum

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9
Q

What are the relations of the omental foramen?

A

Anterior - hepatoduodenal ligament

Posterior - IVC and right crus of diaphragm

Superior - liver

Inferior - superior part of duodenum

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10
Q

Organs can be described upon how they are peritonised, what are the 2 different kinds?

A

Intraperitoneal

Retroperitoneal

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11
Q

What are intraperitoneal organs?

A

Ones which are completed surrounded by visceral peritoneum

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12
Q

What kind of peritnoeum are intrapertoneal organs surrouned by?

A

Visceral peritoneum

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13
Q

What are retroperitoneal organs?

A

Only covered by visceral peritoneum on their anterior surface and therefore are firmly attached to the posterior wall

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14
Q

What are examples of retroperitoneal organs?

A

Duodenum

Caecum

Ascending colon

Descending colon

Pancreas

Kidneys

Aorta

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15
Q

What are examples of intraperitoneal organs?

A

Stomach

Spleen

Liver

Jejenum

Ileum

Transverse colon

Sigmoid colon

Bulb of duodenum

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16
Q

What is A?

A

Visceral peritoneum

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17
Q

What is B?

A

Mesentery (parietal peritoneum)

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18
Q

What is C?

A

Visceral peritoneum

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19
Q

What kind of peritoneum forms mesentery?

A

Parietal peritoneal

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20
Q

What is present within the peritoneal cavity?

A

Peritoneal fluid

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21
Q

What does the term extraperitoneal mean?

A

Describes structures in the abdomino-pelvic cavity which are not covered in peritoneum

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22
Q

Which layer of the peritoneum is more sensitive to pressure, pain and temperature?

A

Parietal peritoneum

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23
Q

What is A?

A

Lesser omentum

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24
Q

What is B?

A

Greater sac

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25
What is C?
Greater omentum
26
What is D?
Lesser sac
27
What is E?
Omental foramen
28
What are the attachments of the greater omentum?
Greater curvature of stomach to transverse colon
29
What are the attachments of the lesser omentum?
Lesser curvature of stomach to liver
30
What is A?
Greater omentum
31
What is B?
Lesser omentum
32
What are some clinical notes for the greater omentum?
In infection inflammatory exudate causes the omentum to adhere to the site of infection and wrap itself around the infected organ This localises the infection to a small area protecting against serious diffuse peritonitis
33
What is pain from the parietal peritoneum innervated by?
phrenic nerve? T7-L1 So can be precisely localised
34
What is pain from the visceral paritoneum innervated by?
Autonomic nerves So pain is referred and poorly localised
35
What are the wall muscles of the posterior abdominal wall?
Psoas mejor Psoas minor Iliacus Quadratus lumborum
36
What are organs/tubes of the posterior abdominal wall?
Thoracic duct Kidneys
37
What are the main vessels of the posterior abdominal wall?
Abdominal aorta IVC
38
What are the main nerves of the posterior abdominal wall?
Branches of lumbar plexus: obturator nerve femoral nerve
39
What is A?
Quadratus lumborum
40
What is B?
Iliacus
41
What is C?
Psoas major
42
What is D?
Psoas minor
43
What is A?
Femoral nerve
44
What is B?
Obturator nerve
45
Which of the femoral and obturator nerve is more lateral?
Femoral
46
What is A?
Caval foramen
47
What is B?
Oesophageal hiatus
48
What is C?
Aortic hiatus
49
What are the 3 major openings in the diaphragm?
Caval foramen Oesophageal hiatus Aortic hiatus
50
What is the vertebral level of the caval foramen?
T8
51
What is the vertebral level of the oesophageal hiatus?
T10
52
What is the vertebral level of the aortic hiatus?
T12
53
What are the 3 main branches of the abdominal aorta that supplies blood to the gut tube?
Celiac trunk Superior mesenteric artery Inferior mesenteric artery
54
At what vertebral level does the abdominal aortia divide into the 2 common iliac arteries?
L4
55
How is the inferior vena cava formed in the abdomen?
Begins anterior to L5 vertebrae Ascends on right side of bodies of vertebrae L3-L5 to right of aorta Travels through caval foramen to thorax
56
What is A?
Left gastric artery
57
What is B?
Splenic artery
58
What is C?
Portal vein
59
What is D?
Splenic vein
60
What is E?
Inferior mesenteric vein
61
What is F?
Superior mesenteric vein
62
What is G?
Inferior mesenteric artery
63
What is H?
Superior mesenteric artery
64
What is I?
Hepatic artery
65
At what vertebrae level does the celiac trunk form?
T12
66
At what vertebrae level does the superior mesenteric artery form?
L1
67
At what vertebrae level does the inferior mesenteric artery form?
L3
68
What are structures of the foregut?
Abdominal part of oesopahgus Part of duodenum
69
What are structures of the midgut?
Most of duodenum Jejenum Ileum Caecum Ascending colon Right 2/3 of transverse colon
70
What are structures of the hindgut?
Left 1/3 of transverse colon Descending colon Sigmoid colon Rectum Upper part of anal canal
71
Where is the obturator and femoral nerve found in relation to the psoas muscle?
Obturator is medial and femoral is lateral
72
What artery supplies the foregut?
Celiac trunk
73
What artery supplies the midgut?
Superior mesenteric artery
74
What artery supplies the hindgut?
Inferior mesenteric artery
75
What are additional foregut and midgut derived organs that are not part of the gut tube?
Liver Pancreas Spleen Appendix
76
What is A?
Hepatic portal vein
77
What is B?
Superior mesenteric vein
78
What is C?
Inferior mesenteric vein
79
What is D?
Splenic vein
80
What does blood from the abdominopelvic gastrointestinal tract drain via?
Portal system to the liver
81
What is a portal system?
System of blood vessels which has a capillary network at each end
82
The portan vein is formed by the union of which 2 major veins of the abdominal cavity?
Superior mesenteric vein Splenic vein
83
Where does blood from the gut tube superior to the diaphragm and inferior to the pelvic floor drain via?
Systemic venous system Meaning that an anastomosis is present at these watersheds (porto-systemic [portocaval] anastomoses)
84
What are the 5 sites of portocaval anastomoses in the body?
Distal oesophagus Rectal Paraumbilical Retroperitoneal Intrahepatic
85
What is the clinical significance of portocaval anastomoses?
Fibrosis of liver causes portal hypertension due to bleeding portal veins, producing enlarged varicose veins that may rupture
86
What is the sympathetic nerve supply to abdominal viscera composed of?
Abdominopelvic splanchnic nerves (greater, lesser and least) Prevertebral sympathetic ganglia Abdominal aortic plexuses
87
What is the parasympathetic nerve supply to abdominal viscera composed of?
Anterior and posterior vagal trunks (vagus nerve) Pelvic splanchnic nerves (S2-S4)
88
What effect does the sympathetic and parasympathetic systems have on GI secretions?
Sympathetic - decreases Parasympathetic - increases
89
What effect does the sympathetic and parasympathetic systems have on peristalsis of GI motility?
Sympathetic - decreases Parasympathetic - increases
90
What effect does the sympathetic and parasympathetic systems have on blood vessels?
Sympathetic - vasodilates Parasympathetic - vasoconstriction
91
What is the effect of vagotomy on gastric secretion?
Reduce rate of gastric secretion
92
What is vagotomy?
Surgical procedure where one or more branches of the vagus nerve are removed
93
What is the functional difference between the greater, lesser and least splanchnic nerves and the pelvic splanchnic nerves?
Greater, lesser and least splanchnic nerves are sympathetic Pelvic splanchnic nerves are parasympathetic
94
What are the chief differences in the arrangement of ganglia in the sympathetic and parasympathetic nervous systems?
Sympathetic - next to vertebral column forming sympathetic chain Parasympathetic - next to target
95
Between what vertebral levels do the kidneys lie?
Between T12 and L3 on the posterior abdominal wall
96
Which kidney lies lower and why?
The right kidney due to the liver
97
What are the 3 main structures travelling through the hilum of the kidneys?
Renal artery Renal vein Pelvis of the ureter
98
What is A?
Renal artery
99
What is B?
Renal vein
100
What is C?
Pelvis of ureter
101
What is the anterior to posterior arrangement of the structures entering the leaving the hilum of the kidneys?
Renal vein Renal artery Renal pelvis
102
How are the kidneys peritonised?
Retroperitoneal
103
What type of glands are the suprarenal glands?
Endocrine
104
What are the suprarenal glands also known as?
Adrenal glands
105
What is the anatomical location of the right adrenal gland?
Contact with IVC antero-medially Contact with liver anterio-laterally
106
What is the anatomical location of the left adrenal gland?
Related to spleenm, stomach, pancreas and left crus of diaphragm
107
What are ureters?
Muscular ducts that carry urine from the kidneys to the urinary bladder
108
What is the term used to describe the expanded upper part of the ureter?
Renal pelvis
109
What are the 3 locations where the ureter is constricted?
At the junction of the ureters and renal pelvis (pelviuretic junction) Where ureters cross brim of pelvis inlet Passage through wall of urinary bladder
110
How are the ureters peritonised?
Retroperitoneal