Abdomen part 1 Flashcards
What lies between the parietal peritoneum and the muscles of the abdomen and pelvic walls?
a continues layer of fascia, has different names based on the region that it is in
Where is the fascia transversalis
located on the anterolateral body wall
where is the diaphragmatic fascia
in between the diaphragm and parietal peritoneum of the abdomen
where is the quadratus loborum fascia
on the posterior body wall
where is the pelvic fascia
extends down from the parietal peritoneum to cover the contents of the pelvic region
where is the fascia iliaca
located in front of the pubic symphysis
What lies within the abdomino-pelvic fascia?
abdominal blood and lymphatic vessels
What does NOT lie within the abdomino-pelvic fascia?
nerves
Transversalis fascia forms what below the anterior superior illiac spine?
forms the posterior sheath of the rectus abdominis with the peritoneum
(below the arcuate line)
Transversalis fascia also forms what in the inguinal region?
the deep inguinal ring
Transversalis fascia contributes to what fascial layer of the spermatic cord?
internal spermatic fascia
What is peritoneum made of
a single layer of mesothelial cells (squamous epithelium) that secrete a small amount of peritoneal fluid
the peritoneum lines the body wall is called what
the parietal peritoneum
Is the parietal peritoneum sensitive? Why or why not?
Yes! very sensitive due to innervation from the phrenic nerve and thoracoabdominal (segmental ventral rami) nerves
What is the peritoneum that is reflected over the surface of viscera?
visceral peritoneum
Is the visceral peritoneum senstive? why or why not?
no; it is not innervated by nerves
What does it mean to be retroperitoneal?
organs held against the posterior abdominal wall behind the peritoneum
functions of peritoneum
- reduces friction to facilitate free movement
- resists infection by exuding fluid and cells to fight off infection
- stores fat
Peritoneum is arranged into what types?
mesentary, mesocolon, ligaments, folds, omentum, recess
What is the mesentary peritoneum
double layer of peritoneum enclosing an organ and connects it to the abdominal body wall
What is mesocolon peritoneum
it is a mesentery of the colon
what are peritoneum formed ligaments?
double layer connecting an organ with another or the abdominal wall
what are peritoneum formed folds?
peritoneal reflection with a definitive-often sharp- border due to vessels within it
what is the omentum peritoneum
layered sheet of peritoneum, probably like 4 layers; ie. greater omentum and lesser omentum
what is the recess peritoneum
peritoneal fold forming a blind pouch that open into the peritoneal cavity
what forms the greater sac?
it is a peritoneal sac formed by the greater portion of the abdominal cavity
what is the lesser sac
it is a peritoneal sac that is a smaller compartment formed posterior to the stomach by a pouch-like evagination of the dorsal mesentery of the stomach
where does the lesser sac extend down to?
into the greater omentum
how do the lesser omentum and greater omentum communicate?
epiploic foramen; looks like a tiny whole in between the two sacs on a cross section
What should you have in the parietal cavities?
just the right amount of serous fluid
What are the peritoneal folds of the abdomen?
on the posterior aspect of the anterior abdominal wall, there are a series of peritoneum-covered structures that give the impression of being a fold in the peritoneum
Where are these peritoneal folds in reference to the umbilicus?
5 below the umbilicus (three extending to the umbilicus), and one above the. umbilicus
What fold is found superior to the umbilicus?
falciform ligament
The falciform ligament contains what?
ligamentum teres hepatis in its free edge (edge no bound to abdomen)
what was the ligamentum teres hepatis in utero
umbilical vein (now obliterated umbilical vein)
-brought O2 right blood in umbilical cord up to umbilical vein and there was no need to send it to the lungs- bypasses pulmonary system via foramen ovale and ductus arteriosis
What folds are found inferior to the umbilicus?
- 1 median umbilical fold
- 2 medial umbilical folds
- 2 lateral umbilical folds
what is the median umbilical fold
it was the peritoneum covered urachus
What is the fetal urachus
pathway for fetal urine
what are the medial umbilical folds?
the peritoneal-covered obliterated umbilical arteries
what are the lateral umbilical folds
are the peritoneum covered inferior episgastric a. and v.
-we still have these
peritoneal compartments can be ____ or ____
supracolic or infracolic
what does supracolic mean?
above the transverse colon, anterior to the greater omentum, limited superiorly by the inferior aspect of diaphragm
-difficult to see so you can palpate the various organs
what are the muscles of the supracolic compartment
-last 1/2 of the esophagus
-stomach
-1st part of duodenum
-liver
gall bladder
-spleen
What does the falciform ligament do in regard to the surface of the liver?
it prevents passing right to left across anterior surface of liver (appears to be going straight through middle of liver)
when the body is in supine position, infected peritoneal fluid will accumulate where
- pelvis
- sub-hepatic space
- sub-phrenic space
the left subhepatic space is also the what
the lesser sac
in the falciform ligament on the liver, what is present on inferior surface of liver?
ligamentum teres hepatis
what must you reflect to see the infracolic peritoneal compartment
reflect the greater omentum superiorly over the costal margin
laterally, on either side of the abdominal cavity, there is a ___ gutter
paracolic
the right paracolic gutter communicates with what
the supracolic compartment- in particular the right subhepatic space
the left paracolic gutter is limited superiorly by what
a peritoneal fold between the diaphragm and the left colic flexure called the phrenicocolic ligament
reminder: look at page 190 of notes to see placement of the spaces and gutters
location of greater omentum
sheet-like peritoneal fold hanging from the greater curvature of the stomach down in front of the transverse colon to which it is attached
greater omentum is composed of what 3 fused ligaments
- gastrocolic ligament (on same side as liver)
- gastrosplenic ligament (next the spleen)
- gastrophrenic (lateral portion of the left side where phrenic nerve inserts in to diaphragm)
the lesser omentum connects what
the lesser curvature and first part of the duodenum to the liver
what. is under the free edge of the lesser omentum
epiploic foramen
in the free edge of the lesser omentum runs the what
portal triad
portal triad is made up of what
-common bile duct
-portal vein
-hepatic artery
(from lateral to medial)
the lesser omentum is compased of two fused ligaments:
- hepatogastric ligament
- hepatoduodenal ligament
Which vein is responsible for returning nutrients from the gut to the liver?
Hepatic portal vein
The esophagus passes into the abdomen via what structure
through the muscular part of the diaphragm (left of the midline surrounded by a loop of muscle fibers from the right crus)
What vertebral level does the esophagus pass into the abdomen?
T9-10
What two things accompany the esophagus into the abdomen?
the anterior and posterior vagal trunks
the esophagus joins the cardiac region of the stomach at what junction?
gastroesophageal junction
Why is the last inch of the esophageal physiologically important?
because it comprises the functional sphincter called the cardiac sphincter- this is not an anatomical sphincter at this junction
-not considered an anatomical sphincter because there is not a defined ring of smooth muscle there
What is it called when the cardiac portion of the stomach moves up into the thorax?
hiatal hernia
left vagal trunk goes anterior or posterior in reference to the esophagus passing into the abdomen
anterior
right vagal trunk goes anterior or posterior in reference to the esophagus passing into the abdomen
posterior
In tall people, the stomach is often what shape
J-shaped
In shorter people, the stomach is often what shape
steer horn configuration
Shape of the stomach ultimately depends on what
the degree to which it is filled
the stomach is covered by what
peritoneum (serosa)
the peritoneum/serosa of the stomach continues out into what
the greater and lesser omenta from the greater and lesser curvatures
What are rugae?
ridges in the stomach, food churns against these ridges to be mechanically broken down
why does the inside of the stomach have a mucosal lining
need adapted mucosal lining to protect stomach wall from acid
what happens if your stomach wall is not protected by mucosal lining
ulcer
the gastroesophogeal and gastrodudenal junctions are relatively _____
fixed by piercing the diaphragm and the duodenum passing retroperitoneally
structures with an anterior/superior relationship to the stomach
- anterior abdominal wall
- left costal margin
- diaphragm
organ to the left of the stomach
spleen
structures to the right of the stomach
quadrate and left lobes of the liver
structures with a posterior relationship to the stomach
diaphragm, left suprarenal gland, upper pole of left kidney, pancreas, left colic flexure
Even though the structures posterior to the stomach have a direct relationship with it, they are still separated by what?
peritoneum
