Abdomen 2 - Omentum And Small Intestine Flashcards
What is the peritoneum
Transparent serous membrane that covers the body wall and organs
One continuous layer
What are the 2 subdivisions of the peritoneum?
Parietal peritoneum
Visceral peritoneum
What can the peritoneum form?
Folds such as mesenteries and omenta
Ligaments which may be vascular or avascular
What is the peritoneal cavity?
Space between the parietal and visceral peritoneum
What are the 2 major divisions of the peritoneal cavity termed?
Sacs
What are the 2 main divisions of the peritoneal cavity?
Greater sac
Lesser sac
Through which passage do the greater and lesser sac communicate?
Omental foramen
Where is the omental foramen located?
Posterior to free edge of lesser omentum
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What are the relations of the omental foramen?
Anterior - hepatoduodenal ligament
Posterior - IVC and right crus of diaphragm
Superior - liver
Inferior - superior part of duodenum
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Organs can be described upon how they are peritonised, what are the 2 different kinds?
Intraperitoneal
Retroperitoneal
What are intraperitoneal organs?
Ones which are completed surrounded by visceral peritoneum
What kind of peritnoeum are intrapertoneal organs surrouned by?
Visceral peritoneum
What are retroperitoneal organs?
Only covered by visceral peritoneum on their anterior surface and therefore are firmly attached to the posterior wall
What are examples of retroperitoneal organs?
SupraRenalGlands
Aorta
Duodenum 2-3
Pancreas not tail
Uterus. uriters
Ccolon (not transfervse)
Kidney
oEsophagus
Rectume
What are examples of intraperitoneal organs?
Stomach
Spleen
Liver
Jejenum
Ileum
Transverse colon
Sigmoid colon
Bulb of duodenum
What is A?
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Visceral peritoneum
What is B?
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Mesentery (parietal peritoneum)
What is C?
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Visceral peritoneum
What kind of peritoneum forms mesentery?
Parietal peritoneal
What is present within the peritoneal cavity?
Peritoneal fluid
What does the term extraperitoneal mean?
Describes structures in the abdomino-pelvic cavity which are not covered in peritoneum
Which layer of the peritoneum is more sensitive to pressure, pain and temperature?
Parietal peritoneum
What is A?
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Lesser omentum
What is B?
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Greater sac
What is C?
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Greater omentum
What is D?
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Lesser sac
What is E?
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Omental foramen
What are the attachments of the greater omentum?
Greater curvature of stomach to transverse colon
What are the attachments of the lesser omentum?
Lesser curvature of stomach to liver
What is A?
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Greater omentum
What is B?
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Lesser omentum
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
What is pain from the parietal peritoneum innervated by?
T7-L1
So can be precisely localised
What is pain from the visceral paritoneum innervated by?
Autonomic nerves
So pain is referred and poorly localised
What are the wall muscles of the posterior abdominal wall?
Psoas mejor
Psoas minor
Iliacus
Quadratus lumborum
What are organs/tubes of the posterior abdominal wall?
Thoracic duct
Kidneys
What are the main vessels of the posterior abdominal wall?
Abdominal aorta
IVC
What are the main nerves of the posterior abdominal wall?
Branches of lumbar plexus:
obturator nerve
femoral nerve
What is A?
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Quadratus lumborum
What is B?
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Iliacus
What is C?
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Psoas major
What is D?
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Psoas minor
What is A?
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Femoral nerve
What is B?
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Obturator nerve
Which of the femoral and obturator nerve is more lateral?
Femoral
What is A?
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Caval foramen
What is B?
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Oesophageal hiatus
What is C?
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Aortic hiatus
What are the 3 major openings in the diaphragm?
Caval foramen
Oesophageal hiatus
Aortic hiatus
What is the vertebral level of the caval foramen?
T8
What is the vertebral level of the oesophageal hiatus?
T10
What is the vertebral level of the aortic hiatus?
T12
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
At what vertebral level does the abdominal aortia divide into the 2 common iliac arteries?
L4
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
What is A?
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Left gastric artery
What is B?
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Splenic artery
What is C?
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Portal vein
What is D?
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Splenic vein
What is E?
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Inferior mesenteric vein
What is F?
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Superior mesenteric vein
What is G?
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Inferior mesenteric artery
What is H?
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Superior mesenteric artery
What is I?
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Hepatic artery
At what vertebrae level does the celiac trunk form?
T12
At what vertebrae level does the superior mesenteric artery form?
L1
At what vertebrae level does the inferior mesenteric artery form?
L3
What are structures of the foregut?
Abdominal part of oesopahgus
Part of duodenum
What are structures of the midgut?
Most of duodenum
Jejenum
Ileum
Caecum
Ascending colon
Right 2/3 of transverse colon
What are structures of the hindgut?
Left 1/3 of transverse colon
Descending colon
Sigmoid colon
Rectum
Upper part of anal canal
Where is the obturator and femoral nerve found in relation to the psoas muscle?
Obturator is medial and femoral is lateral
What artery supplies the foregut?
Celiac trunk
What artery supplies the midgut?
Superior mesenteric artery
What artery supplies the hindgut?
Inferior mesenteric artery
What are additional foregut and midgut derived organs that are not part of the gut tube?
Liver
Pancreas
Spleen
Appendix
What is A?
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Hepatic portal vein
What is B?
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Superior mesenteric vein
What is C?
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Inferior mesenteric vein
What is D?
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Splenic vein
What does blood from the abdominopelvic gastrointestinal tract drain via?
Portal system to the liver
What is a portal system?
System of blood vessels which has a capillary network at each end
The portan vein is formed by the union of which 2 major veins of the abdominal cavity?
Superior mesenteric vein
Splenic vein
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)
What are the 5 sites of portocaval anastomoses in the body?
Distal oesophagus
Rectal
Paraumbilical
Retroperitoneal
Intrahepatic
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
What is the sympathetic nerve supply to abdominal viscera composed of?
Abdominopelvic splanchnic nerves (greater, lesser and least)
Prevertebral sympathetic ganglia
Abdominal aortic plexuses
What is the parasympathetic nerve supply to abdominal viscera composed of?
Anterior and posterior vagal trunks (vagus nerve)
Pelvic splanchnic nerves (S2-S4)
What effect does the sympathetic and parasympathetic systems have on GI secretions?
Sympathetic - decreases
Parasympathetic - increases
What effect does the sympathetic and parasympathetic systems have on peristalsis of GI motility?
Sympathetic - decreases
Parasympathetic - increases
What effect does the sympathetic and parasympathetic systems have on blood vessels?
Sympathetic - vasodilates
Parasympathetic - vasoconstriction
What is the effect of vagotomy on gastric secretion?
Reduce rate of gastric secretion
What is vagotomy?
Surgical procedure where one or more branches of the vagus nerve are removed
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
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
Between what vertebral levels do the kidneys lie?
Between T12 and L3 on the posterior abdominal wall
Which kidney lies lower and why?
The right kidney due to the liver
What are the 3 main structures travelling through the hilum of the kidneys?
Renal artery
Renal vein
Pelvis of the ureter
What is A?
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Renal artery
What is B?
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Renal vein
What is C?
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Pelvis of ureter
What is the anterior to posterior arrangement of the structures entering the leaving the hilum of the kidneys?
Renal vein
Renal artery
Renal pelvis
How are the kidneys peritonised?
Retroperitoneal
What type of glands are the suprarenal glands?
Endocrine
What are the suprarenal glands also known as?
Adrenal glands
What is the anatomical location of the right adrenal gland?
Contact with IVC antero-medially
Contact with liver anterio-laterally
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What is the anatomical location of the left adrenal gland?
Related to spleenm, stomach, pancreas and left crus of diaphragm
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What are ureters?
Muscular ducts that carry urine from the kidneys to the urinary bladder
What is the term used to describe the expanded upper part of the ureter?
Renal pelvis
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
How are the ureters peritonised?
Retroperitoneal