Abdomen Flashcards
Describe the greater sac.
It accounts for most of the space of the peritoneal, extending from the diaphragm to the pelvic floor.
Describe the lesser sac (omental bursa).
It is posterior to the lesser omentum stomach, liver and inside the greater momentum.
How do the greater and lesser sacs communicate with each other?
Omental Foramen (AKA the epiploic foramen or foramen of Winslow’s)
What is the difference between males and females in regard to the peritoneal cavity?
Males have a completely closed cavity whereas females have an opening of the fallopian tube into the peritoneal cavity.
What are the peritoneal folds around the stomach called?
Omentum
What are the peritoneal folds around the small intestine called?
Mesentery
What are the peritoneal folds around the large intestine called?
Meso-colon
What is the fate of the ventral mesentery?
The formation of the liver divides it into lesser omentum and falciform ligament.
What organs are completely covered by visceral peritoneum and are freely mobile?
Stomach 1st Part of Duodenum Jejunum Ileum Appendix Transverse Colon Sigmoid Colon Liver Spleen
Describe the nerve supply of the parietal peritoneum.
Somatic nerves of the overlying muscles and skin.
Describe the nerve supply of the visceral peritoneum.
Autonomic nerves with the underlying viscera. It receives sympathetic innervation.
It does not have somatic innervation so it is insensitive to pain.
What is the blood supply of the foregut?
Celiac Trunk at T12
What is the blood supply of the midgut?
Superior Mesenteric Artery at L1
What is the blood supply of the hind gut?
Inferior Mesenteric Artery at L3
What are the celiac trunk, superior mesenteric artery and inferior mesenteric artery all branches off of?
They are all branches of the abdominal aorta and arise from the anterior surface of the abdominal aorta. The branches all anastomose with each other.
What are branches of the celiac trunk?
Splenic Artery
Left Gastric Artery
Common Hepatic Artery
What are the branches of the superior mesenteric artery?
Ileocolic Artery
Right Colic Artery
Middle Colic Artery
Inferior Pancreaticoduodenal
What are the branches of the inferior mesenteric artery?
Left Colic Artery
Sigmoid Branches
Superior Rectal Artery
What is the blood supply of the stomach?
Celiac Trunk
Describe the location of the greater omentum.
It hangs down from the greater curvature of stomach, covering the transverse colon and other abdominal viscera
What is the stomach bed?
It is a group of structures related posteriorly to the stomach, with 4 to the left and 4 transverse.
What are the left structures in the stomach bed?
Left kidney
Left suprarenal
Left colic flexure
Left crus of diaphragm
What embryonic structure is the lesser omentum a derivative of?
Ventral Mesentery
What embryonic structure is the lesser omentum a derivative of?
Ventral Mesentery
Describe the location of the lesser omentum .
It extends from the porta hepatis of liver to the lesser curvature of stomach and the 1st part of duodenum.
What ligaments does the lesser omentum consist of?
Hepatogastric Ligament
Hepatoduodenal Ligament
What ligaments does the lesser omentum consist of?
Hepatogastric Ligament
Hepatoduodenal Ligament
What embryonic structure is the greater omentum a derivative of?
Dorsal Mesentary
Describe the location of the greater omentum.
It hangs down from the greater curvature of stomach, covering the transverse colon and other abdominal viscera
What ligaments does the greater omentum consist of?
Gastrosplenic Ligament
Gastrophrenic Ligament
Gastrocolic Ligament
Lienorenal (splenorenal) Ligament
What is known as the policeman of the abdomen?
Greater Omentum for its role in fighting intra-abdominal infection.
What is the largest gland in the human body?
Liver
What are the branches of the common hepatic artery?
Hepatic Artery Proper
Right Gastric Artery
Gastroduodenal Artery
What is the blood supply of the liver and what are the branches of this vessel?
The liver is supplied by the hepatic artery proper, which branches into the left and right hepatic arteries. The right hepatic artery further branches into the cystic artery.
What is the blood supply of the gall bladder?
Cystic Artery - a branch of the right hepatic artery
What are the 5 peritoneal ligaments of the liver?
Coronary Ligament Falciform Ligament - remnant of the ventral mesentery Right Triangular Ligament Left Triangular Ligament Round Ligament (Ligamentum Teres)
->Lesser Omentum - attaches liver to the stomach
What are the 5 surfaces of the liver?
Right Anterior Posterior Superior Inferior
What are the 5 fissures of the liver?
Fissure for Ligamentum Venosum
Fissure for Ligamentum Teres (round ligament)
Fossa of Gallbladder
Fissure for Inferior Vena Cava
Porta Hepatis (lies transversely between the quadrate and caudate lobes)
How are the structures in the porta hepatis arranged?
Vein - Portal Vein
Artery - Hepatic Artery
Duct - Hepatic Duct
VAD
What is the difference between the anatomical division of the liver and the functional division?
Anatomical - divides the liver based on the falciform ligament and the right lobe contains the caudate and quadrate
Functional - divides the liver based on the fossa of the gall bladder and the left lobe contains the caudate and the quadrate
What are the 4 lobes of the liver?
Right
Left
Caudate
Quadrate
What is the blood supply of the quadrate and the caudate?
They are supplied by the left hepatic artery and the left branch of the portal vein
Describe how the blood supply of the liver is met.
75% through the portal vein
25% through the hepatic artery
What is the Sphincter of Oddi?
It is a layer of circular muscle surrounding the lower end of bile duct, pancreatic duct and ampulla, controlling the flow of bile and pancreatic secretions.
What is the venous drainage of the liver?
The hepatic veins drain into the inferior vena cava.
Describe the biliary system from the hepatic ducts to the Ampulla of Vater.
The left and right hepatic ducts merge to form the common hepatic duct.
The common hepatic duct gives off a branch to the gall bladder, which is the cystic duct.
It continues downwards and becomes the common bile duct, where the main pancreatic duct merges.
They lead into the Ampulla of Vater, which opens on the major duodenal papillae at the 2nd part of the duodenum.
What are the 3 parts of the gall bladder?
Fundus
Body
Neck
What is the site of maximum tenderness in the case of in case of acute gall bladder inflammation?
Fundus
Where does the body of the gall bladder lie?
It lies in the gall bladder fossa on the inferior surface of the liver
What is a common site of gall bladder stones?
The neck of the gallbladder in a sac called Hartmann’s Pouch.
What level of the abdominal aorta does the celiac trunk branch out from?
T12
Where does the left gastric artery go?
It goes upwards from the celiac trunk and enters the lesser omentum and it eventually anastomoses with the right gastric artery.
Where does the splenic artery go?
It goes to the left on tortuous path and runs on the superior border of the pancreas. It ends in the lienorenal ligament and gives the spleen 5-6 branches.
What are the branches of the splenic artery?
Short Gastric Arteries
Left Gastroepiploic Artery (Gastromental Artery)
-Both run in the gastrosplenic ligament
What branches does the gastroduodenal artery give off?
Superior Pancreaticoduodenal
Right Gastroepiploic
What branches does the common hepatic artery first give off?
Gastroduodenal
- Superior Pancreaticoduodenal
- Right Gastroepiploic
What are the branches of the hepatic artery proper?
Right and Left Hepatic Arteries
What is a branch of the right hepatic artery?
Cystic Artery
Where is the spleen located?
It is wedged between the stomach and left kidney connected to them
What connects the spleen to the stomach?
Gastrosplenic Ligament
What connects the spleen to the left kidney?
Lienorenal Ligament
What are the two surfaces of the spleen?
Diaphragmatic
Visceral
Describe the diaphragmatic surface of the spleen.
Related to the diaphragm which separates it from left lung & 9th, 10th & 11th ribs.
Describe the visceral surface of the spleen.
Contains the hilum which transmits splenic vessels & gives attachment to gastrosplenic and lienorenal ligaments.
What is the blood supply of the spleen?
It is supplied by the celiac trunk through the splenic artery
Describe the path of the splenic vein.
The splenic vein receives the inferior mesenteric vein and unites with the superior mesenteric vein and gives the portal vein.
What are the unpaired branches of the aorta in the abdomen?
Celiac Trunk
Superior Mesentery Artery
Inferior Mesentery Artery
What is the longest part of the gastrointestinal tract?
Small Intestine
What are the components of the small intestine?
Duodenum
Jejunum
Ileum
Where do the duodenum and pancreas lie?
They lie at lie at the junction between foregut and midgut.
What is the first part of the small intestine and is C-shaped? What are other characteristics of it?
Duodenum. It is the shortest, widest and most fixed part of the small intestine.
What is the the first part of the duodenum and the peritoneum component of it?
It is the duodenal cap and it lies anterolateral to L1 and is an intraperitoneal component.
What is the most common site for duodenal ulcers?
1st Part of the Duodenum
Where does the second part of the duodenum lie?
It lies right to L2-L3
What does the second part of the duodenum receive?
It receives the major duodenal papilla, which is the opening of the bile duct and the main pancreatic duct. It also receives the minor duodenal papilla, which is the opening of the accessory pancreatic duct.
Where does the third part of the duodenum lie and what crosses it?
It lies at the level of L3 and it is crossed by the superior mesenteric artery and vein
Where does the fourth part of the duodenum lie?
It ascends to the left from L3 to L2 and ends at the duodenojejunal flexure
What tethers the duodenojejunal flexure?
Ligament of Treitz (Suspensory Ligament of the Duodenum)