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SHB Exam 2 > Abdomen I > Flashcards

Abdomen I Flashcards

1
Q

What is the peritoneum?

A

A serous membrane w/visceral and parietal layers b/w a peritoneal cavity w/serous fluid

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2
Q

What does the parietal peritoneum line?

A
  • Lines the anterior, posterior, and lateral walls of the abdomen.
  • Lines the inferior surface of the diaphragm and the pelvic cavity
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3
Q

What does the visceral peritoneum line?

A
  • Lines the abdominal viscera (according to their function)

- Leaves the body wall to surround these viscera

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4
Q

What can the peritoneal cavity be subdivided into?

A
  • Greater sac (accounts for most of the space of the peritoneal cavity)
  • Lesser sac (omental bursa)
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5
Q

Where is the lesser sac (AKA omental bursa)?

A
  • It’s small space posterior to the lesser omentum, stomach, liver and inside the greater omentum
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6
Q

How is the lesser sac formed during development?

A

Stomach growth, beds, rotates + growth of liver

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7
Q

Once you open a cadaver for dissection, what space are you in?

A

The greater sac

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8
Q

How does the lesser sac connect to the greater sac?

A
  • It is continuous to the greater through the Omental (epiploic) foramen, or foramen of Winslow
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9
Q

What enters into the peritoneal cavity in males? Females?

A

Males: it’s a closed space
Female: fallopian tube

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10
Q

During development, what suspends the gut tube to the posterior abdominal wall?

A

Dorsal mesentery

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11
Q

During development, the ventral mesentery is divided by growth of the liver into what?

A

Lesser omentum and falciform ligament

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12
Q

The small intestine (and part of the colon) evolve from which part of the gut?

A

Mid-gut

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13
Q

What is a peritoneal fold?

What is the nomenclature of each type?

A

They’re a double-layer of visceral peritoneum (parietal still covers everything)

  • Stomach –> omentum (greater/lesser)
  • Small intestine –> mesentery
  • Large intestine –> meso-colon (meso-apx, transverse mesocolon, sigmoid mesocolon)
  • Organ as liver or spleen –> ligament (e.g. falciform ligament)
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14
Q

What organs are intraperitoneal?

A
  • Stomach
  • 1st part duodenum
  • Jejunum
  • Ileum
  • Apx
  • Transverse colon
  • Sigmoid colon
  • Liver
  • Spleen
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15
Q

What organs are retroperitoneal?

A 
SAD PUCKER
S: Suprarenal glands
A: Aorta (+ IVC)
D: Duodenum (2nd, 3rd, 4th parts)
P: Pancreas
U: Ureters
C: Colon (ascending and descending only)
K: Kidneys
E: Esophagus (upper part)
R: Rectum
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16
Q

Define ligament (in peritoneum).

A

A double layer of visceral peritoneum connects an organ with another or anterior abdominal wall (e.g. falciform ligament)

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17
Q

Define mesentery.

A

A double layer of visceral peritoneum resulting from the invagination of the peritoneum by the intestine

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18
Q

Define omentum.

A

A double layer of visceral peritoneum passing from the stomach and first part of the duodenum to adjacent organs.

  • Greater omentum –> greater curvature of the stomach
  • Lesser omentum –> lesser curvature of the stomach
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19
Q

What is the general nerve supply of the parietal peritoneum?

A
  • Somatic nn. of the overlying mm. and skin (e.g. diaphragmatic peritoneum by phrenic n.)
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20
Q

What is the general nerve supply of the visceral peritoneum?

A

Autonomic nn. w/the underlying viscera

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21
Q

At what vertebral level is the Celiac trunk, and what does it supply?

A

T12

- Foregut

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22
Q

At what vertebral level is the superior mesenteric artery, and what does it supply?

A

L1

- Midgut

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23
Q

At what vertebral level is the inferior mesenteric artery, and what does it supply?

A

L3

- Hindgut

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24
Q

What are 3 common facts of the celiac trunk + superior/inferior mesenteric aa.?

A
  1. They are single, unpaired branches of abdominal aorta
  2. Arise from ant surface of abd aorta
  3. Branches anastomose w/eachother
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25
Q

Organs of the foregut?

A
  • Stomach
  • Liver
  • GB
  • Spleen
  • Top 1/2 pancreas
  • First 1/2 duodenum
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26
Q

Arteries supplying foregut?

A

Celiac trunk:

  • Splenic a.
  • Left gastric a.
  • Common hepatic a.
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27
Q

Organs of the midgut?

A
  • Bottom 1/2 pancreas
  • 2nd 1/2 duodenum
  • Jejunum
  • Ileum
  • Cecum
  • Ascending colon
  • Right 2/3 transverse colon
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28
Q

Arteries supplying midgut?

A

Superior mesenteric a:

  • Middle colic a.
  • Right colic a.
  • Ileocolic a.
  • Inferior pancreaticoduodenal a.
  • 11-15 iliojejunal aa.
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29
Q

Organs of the hindgut?

A
  • Left 1/3 transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
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30
Q

Arteries supplying hindgut?

A

Inferior mesenteric a:

  • Left colic a.
  • Sigmoid a. branches
  • Superior rectal aa.
  • Marginal aa. (of Drummond)–connect all the colic branches together
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31
Q

What does the left gastric a. run in?
What are its branches?
What does it anastomose w/?

A
  • Lesser omentum
  • Esophageal and gastric branches
  • Right gastric a. (from hepatic a. proper)
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32
Q

Where does the splenic a. run?

What are its main branches?

A
  • Runs along sup pancreas to give pancreatic branches

- Short gastric and left gastro-omental (AKA gastro-epiploic) aa. go to greater curvature of stomach/lesser omentum

33
Q

What is the first branch of the common hepatic a.?

A

Gastroduodenal a.

34
Q

What are the branches of the gastroduodenal a.?

A
  • Superior pancreoduodenal a.

- Right gastro-omental a.

35
Q

What does the common hepatic a. turn into?

A

Hepatic artery proper

36
Q

What is the branch of the hepatic artery proper?

A

Right gastric a.

37
Q

What does the hepatic artery proper turn into?

A

Right and left hepatic aa.

38
Q

What is the branch of the right hepatic a.? Left?

A

Right: Cystic artery branch
Left: None

39
Q

What are the 2 ends of the stomach?

A

Cardiac and pyloric ends

40
Q

What are the 2 surfaces of the stomach?

A

Ant and post

41
Q

What are the chambers of the stomach?

A
  • Cardia (under esophagus)
  • Fundus (most sup)
  • Body
  • Pylorus
42
Q

What are rugae?

A

Folds that allow for dilation of the stomach

43
Q

What a. supplies the stomach?

A

Celiac trunk

44
Q

What is the stomach bed?

What are in it?

A
  • Group of structures related posteriorly to the stomach, separated from it by lesser sac
  • Spleen + 4 left + 4 transverse
  • 4 left: left kidney, left suprarenal gland, left colic flexure, left crus of diaphragm
  • 4 transverse: transverse colon, transverse mesocolon, body of pancreas, splenic a.
45
Q

What/where is the lesser omentum?

What type of fold is the lesser omentum?

A
  • Double layer of peritoneum, extends from porta hepatis of liver to lesser curvature of stomach and 1st part of duodenum
  • Ventral mesentery
46
Q

What ligaments make up the lesser omentum?

A
  • Hepatogastric ligament

- Hepatoduodenal ligament

47
Q

What 3 structures are at the free border of the lesser omentum?

A
  • Bile/hepatic duct (right)
  • Hepatic a. (left)
  • Portal v. (posterior)
48
Q

What/where is the greater omentum?

What type of fold is the greater omentum?

A
  • Double layer of peritoneum, hangs down from greater curvature of stomach, covering the transverse colon and other abdominal viscera
  • Dorsal mesentery
49
Q

What ligaments make up the greater omentum?

A
  • Gastrosplenic ligament
  • Gastrophrenic ligament
  • Gastrocolic ligament
  • Splenorenal/Lienorenal ligament
50
Q

Why is the greater omentum considered the policeman of the abdomen?

A

Surrounds an infection in the area to keep it from spreading

51
Q

Directionally, how does the stomach rotate during development?

A

90 degrees clockwise

52
Q

If you lift the stomach, what do you take w/you in the greater omentum?

A

Transverse colon

53
Q

What is the largest gland in the human body?

A

Liver

54
Q

All of the liver is w/in the peritoneum except the ____________.

A

Bare area (b/w upper & lower areas of coronary ligaments)

55
Q

What are the 5 peritoneal folds (ligaments) of the liver?

A
  1. Falciform ligament
  2. Coronary ligament
  3. /4. Right and left triangular ligaments
  4. Lesser omentum
56
Q

Besides the lesser omentum, what do the ligaments of the liver attach it to?

A

Diaphragm and abdominal wall

57
Q

What is the falciform ligament a remnant of?

A

Ventral mesentery artery

58
Q

What are the 5 surfaces of the liver?

Which contact the diaphragm?

A
  • Right, sup, inf (visceral), ant, post

- Sup, ant, post

59
Q

What is the porta hepatis?

A

Basically the hilum to the liver

60
Q

What are the 5 H-shaped fissures of the liver?

A

Lateral superior: Fissure for IVC
Lateral inferior: Fossa of GB
Middle: Porta hepatis
Medial superior: Fissure for ligamentum venosum (ductus venosus)
Medial inferior: Fissure for round ligament AKA ligamentum teres (obliterated umbilical v.)

61
Q

What lobes are on either side of the porta hepatis?

A

Caudate lobe (superior) and quadrate lobe (inferior)

62
Q

What is the arrangement of vessels of the porta hepatis, post to ant?

A

VAD

  • portal Vein
  • hepatic Artery
  • hepatic Duct
63
Q

What are the 4 lobes of the liver?

A

Right (containing caudate & quadrate) and left

64
Q

What vessels supply the liver?

A
  • Hepatic a. proper
  • Portal vein
    (each branch into left and right)
65
Q

What vessels supply the caudate and quadrate lobes, specifically?

A
  • Left hepatic a.

- Left branch of portal v.

66
Q

Explain the general venous drainage of the liver

A

Blood sinusoids -> central veins -> hepatic veins -> IVC

67
Q

What % of blood does the hepatic a. proper and portal v. supply to the liver?
What % of O2?

A
  • Hepatic a: 25% blood
  • Portal v: 75% blood
  • O2 split 50%/50%
68
Q

*Explain the flow of the biliary system, or “Tree”

A
  • Right and left hepatic ducts fork together to form common hepatic duct.
  • GB comes into common hepatic duct via its cystic duct
  • Post to duodenum, common hepatic duct becomes CBD
  • Main pancreatic duct forks in with CBD to become hepatopancreatic ampulla (ampulla of Vater) at 2nd part of duodenum
69
Q

*What controls the bile and pancreatic secretions from the distal bile duct, pancreatic duct, and ampulla?

A

Sphincter of Oddi

there’s also a sphincter of pancreatic duct and sphincter of bile duct.

70
Q

What are the 3 parts of the GB (inf to sup)?

A

Fundus, body, neck

71
Q

Where would you find the fundus of the GB? Why would you want to find this part of the GB?

A
  • 9th costocartilage at the linea semilunaris

- Maximum tenderness here w/cholecystitis

72
Q

Where is Hartmann’s pouch? Why is it important?

A
  • Posteromedial wall of neck of GB

- Common site of gallstones

73
Q

What does the left gastro-omental a. anastomose with?

A

Right gastro-omental a. (rt. gastro-epiploic a)

74
Q

Where is the spleen located?

A

Wedged b/w stomach and left kidney, (connected by gastrosplenic ligament and lienorenal ligament respectively)

75
Q

What are the 2 surfaces of the spleen?

A
  • Diaphragmatic (separates it from left lung and ribs 9/10/11)
  • Visceral (contains hilum)
76
Q

What is Murphy’s sign?

A

Put your hand on RUQ, ask pt to breath. If hurts, positive for cholecystitis

77
Q

What is the venous drainage of the spleen?

A

Splenic v. receives inf mesenteric v., unites w/sup mesenteric v., gives portal v.

78
Q

What is the arteriole supply to the spleen?

A

Splenic a. of celiac trunk

79
Q

Where would you go to find the epiploic foramen (foramen of Winslow)?

A

Just below the neck of the GB, b/w liver and duodenum

SHB Exam 2 (17 decks)

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