Abdomen 2: Peritoneal cavity Flashcards

1
Q

What is the abdominal cavity space bounded by?

A
  • Diaphragm
  • Anterolateral abdominal wall
  • Posterior abdominal wall
  • Pelvic inlet
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2
Q

What is visceral peritoneum?

A

Visceral peritoneum is when the peritoneum touches the organ

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3
Q

What is the parietal peritoneum?

A

Parietal peritoneum is when the peritoneum doesn’t touch the organ

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4
Q

What does peritoneal fluid in the peritoneal cavity contain?

A

-Peritoneal fluid contains water, electrolytes, interstitial fluid, leukocytes and antibodies

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5
Q

What is type of cavity is the peritoneum in males?

A

In males, peritoneum is a closed cavity

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6
Q

What type of cavity is the peritoneum in females?

A

In females, peritoneum is an open cavity as there’s communication with the exterior via the vagina, uterus and uterine tubes

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7
Q

What is a peritoneum?

A

A thin, serous membrane lining the abdominal and pelvic cavities

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8
Q

What does the parietal peritoneum line?

A

Lines the walls of the abdominal and pelvic cavities

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9
Q

What is the parietal peritoneum sensitive to?

A
  • Pain
  • Temperature
  • Touch
  • Pressure
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10
Q

What is the parietal peritoneum innervated by?

A

Innervated by somatic spinal nerves from T7-L1

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11
Q

What does the visceral peritoneum line?

A

Lines the abdominal and pelvic organs/viscera

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12
Q

What is the visceral peritoneum sensitive to?

A
  • Stretch

- Tearing

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13
Q

What does over distention of the viscera lead to?

A

Over distention of the viscera leads to sensation of pain

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14
Q

What is the visceral peritoneum innervated by and what implications can arise due to the way its innervated?

A
  • Innervated by afferent nerves that travel with autonomic supply to viscera it covers
    • Referred pain implications
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15
Q

What is a dermatome?

A

Dermatome is an area of skin supplied by one spinal nerve root

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16
Q

How are sensory inputs from visceral organs interpreted by the brain as?

A

Sensory input from visceral organs is interpreted by the brain as originating from one of the midline dermatomes

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17
Q

What do dermatomes share a convergent spinal root with?

A

Dermatomes share a convergent spinal root with the autonomic nerve which supplied that

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18
Q

What nerve gives a sympathetic supply to the foregut?

A

Greater splanchnic nerves T5-T9(T10)

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19
Q

What nerve gives a sympathetic supply to the midgut?

A

-Lesser splanchnic nerves T9-T11(T12)

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20
Q

What nerve gives a sympathetic supply to the hindgut?

A

Lumbar splanchnic nerves L1-L2

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21
Q

Convergence example of T7 and visceral organ

A
  • If someone touches the skin at T7, the epigastric region, it activates the somatic sensory nerve from the dermatome
  • It then comes to the level T7
  • Also at T7, we have nerve roots running from the greater splanchnic nerve which travels down to the organ ,so in this case the stomach
  • The cutaneous nerve converges with the autonomic nerve
  • If the stomach is stretched, the visceral peritoneum is also stretched travelling with the greater splanchnic nerve, hitchhiking along is the visceral afferent, a sensory nerve from the visceral peritoneum and it converges into the same spinal nerve root as the dermatome
  • If pain is coming from the visceral peritoneum, it interprets it as its coming from the epigastric region, hence the converging pain.
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22
Q

How are organs like with intraperitoneal organs?

A

Organs are completely covered with visceral peritoneum

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23
Q

How are organs attached to each other or to the abdominal wall?

A

Organs are attached to each other or to the abdominal wall by a double fold of peritoneum:

	- Mesentery
	- Ligaments
            - Omentum
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24
Q

What is the mobility like for intraperitoneal organs?

A

Organs have greater mobility

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25
Q

How are extraperitoneal organs like?

A

Organs are partially or entirely devoid of peritoneum

26
Q

Where do extraperitoneal organs lie?

A

They lie outside peritoneal cavity

27
Q

What can extraperitoneal organs be according to its position?

A
  • According to position, they can be:
    • Retroperitoneal
    • Sub-peritoneal
      • Organs are slightly movable or immovable
28
Q

What does secondary retroperitoneal mean?

A

Secondary retroperitoneal means during the embryological development, they were intraperitoneal but then migrated backwards and the visceral peritoneum split, making the organ retroperitoneal

29
Q

What are the fold of the peritoneal structure?

A

A reflection of peritoneum that connects organs to another organ or to the abdominal wall:

- Omenta
- Mesenteries
- Ligaments
30
Q

What are folds of the peritoneum raised from the body wall by?

A

A reflection of peritoneum that is raised from the body wall by underlying blood vessels, duct and ligaments formed by obliterated foetal vessels

31
Q

What is the function of peritoneal folds?

A
  • Route of blood vessels, lymphatic, nerves.
  • May contain embryological remnants
    • E.g. Falciform ligament of liver: Umbilical vein
  • Contains varying amount of fat
    • Greater omentum (high volume)
    • Lesser omentum (devoid of fat)
  • May contain intraperitoneal parts of organs
    • Tail of pancreas lies in splenorenal ligament
  • Immunity
  • Greater omentum: Policeman of abdomen
  • Prevents effects of gravity
32
Q

What is the mesentery?

A

double fold of peritoneum

33
Q

What is the developing foregut suspended from the anterior body wall by?

A

by ventral mesentery/mesogastrium

34
Q

What is the developing foregut suspended from the posterior body wall by?

A

by dorsal mesentery/mesogastrium

35
Q

Where does the liver start to develop?

A

Liver starts to develop in ventral mesentery

36
Q

What does the peritoneal cavity split the ventral mesentery into?

A

Splits ventral mesentery into:

- Lesser omentum (Passing from liver to stomach)
   - Falciform ligament (Passing from liver to anterior abdominal wall)
37
Q

What does the stomach rotate around during embryological development of peritoneal cavity and where do the pyloric and cardiac parts move?

A
  • Pyloric part moves to right and upwards

- Cardiac part moves to the left and downwards

38
Q

Where is the dorsal mesogastrium pulled to, what does it trap and what is this known as?

A

Dorsal mesogastrium is pulled to the left, trapping part of the peritoneal cavity behind the stomach and this is known as the lesser sac/omental bursa

39
Q

An incision through what enters the peritoneal cavity?

A

A surgical incision through the anterior abdominal wall enters into the greater peritoneal sac

40
Q

Where is the lesser sac?

A

Space posterior to stomach

41
Q

What does the lesser sac allow?

A

Allows stomach to expand

42
Q

What does the lesser sac communicate with the greater sac through?

A

Communicates with greater sac through epiploic foramen of Winslow

43
Q

What is the lesser omentum?

A

Double fold of peritoneum that connects the inferior surface of the liver to the lesser curvature of the stomach and first part of duodenum

44
Q

Where does the portal triad run relative to of the lesser omentum?

A

Portal triad runs in free edge of lesser omentum (hepatoduodenal ligament)

45
Q

What does the portal triad consist of?

A
  1. Common bile duct
  2. Proper hepatic artery
  3. Hepatic portal vein
46
Q

What is the epiploic foramen the opening into ?

A

Opening into lesser sac (Omental Bursal)

47
Q

What is the superior boundary of the epiploic foramen?

A

-Superior: Caudate process of liver

48
Q

What is the inferior boundary of the epiploic foramen?

A

1st part of duodenum

49
Q

What is the posterior boundary of the epiploic foramen?

A

Inferior vena cava and right crus of diaphragm

50
Q

What is the anterior boundary of the epiploic foramen?

A

Portal triad(in free edge of lesser omentum)

51
Q

What is the greater omentum?

A

Double fold of peritoneum folded back on its self(four layers), forming an apron like structure that hangs from the greater curvature of the stomach

52
Q

What is the greater omentum formed from?

A

Formed from a downwards extension of the dorsal mesogastrium

53
Q

What layers fuse to form the greater omentum?

A

Anterior layers and posterior layers fuse to form greater omentum

54
Q

What can surgeons do to the layers of the greater omentum to give access to the lesser sac and what recess is the access through?

A

Layers can be separated by surgeons to give passageway into the lesser sac through the inferior recess

55
Q

What is a transverse mesocolon?

A

Double fold of peritoneum that connects transverse colon to the posterior abdominal wall

56
Q

What is the anterior layer of the transverse mesocolon attached to?

A

Anterior layer of transverse mesocolon is attached to the posterior layer of greater omentum

57
Q

What is the mesentery?

A

Fan-shaped double fold of peritoneum that suspends the jejunum and ilium from the posterior abdominal wall

58
Q

What does the mesentery contain?

A
  • 1 Superior mesenteric artery

- 2 superior mesenteric veins

59
Q

What is the approximate length of the root of the mesentery?

A

Approx 15cm long

60
Q

What is the course of the root of the mesentery?

A

Oblique course