Abdomen: Viscera Flashcards
Innervation of peritoneum
Parietal: spinal somatic fibres: localised pain
Visceral: visceral afferents: referred pain
Greater sac and lesser sac (omental bursa)
Greater sac contains most of the abdomen
Lesser sac: posterior to stomach and liver
Omental epiploic foramen
Joins lesser sac to greater sac
Structures anterior to omental (epiploic) foramen
Portal vein
Hepatic artery proper
Bile duct
Structures posterior to epiploic foramen
inferior vena cava
Structures inferior to epiploic foraman
1st part of duodenum
Structures superior to epiploic foraman
caudate lobe of liver
Greater omentum
Greater curvature of stomach
Drapes down anterior to transverse colon, ileum and jejunum
Loops back up and joins transverse colon peritoneum
Lesser omentum
Lesser curvature of stomach to inferior liver
Mesenteries
Mesentery
Transverse mesocolon
Sigmoid mesocolon
Mesentery
The only double layered fold of peritoneum
connects jejunum and ileum to posterior wall
Structures entering through the diaphragm
Vena cava + right phrenic T8
Oesophagus + vagus T10
Aorta + thoracic duct T12
Blood supply to abdominal oesophagus
Left gastric artery
Inferior phrenic artery
Different parts of stomach
Note: cardial notch: superior angle where oesophagus enters stomach
Angular incisure: bend on lesser curvature
Arterial supply of stomach
Left gastric
Short gastric
Gastro-epiploic arcade
Parts of duodenum
Superior
Descending
Inferior
Ascending
Duodenum intra or extraperitoneal
First part: extra peritoneal
Rest: intra peritoneal
Blood supply to deudenum
Gastro duodenal artery
Difference in blood supply to ileum and jejunum
Supplied by SMA
Jejunum: longer vasa recta, smaller arcade
Ilieum: smaller vasa recta, more developed arcade
Source of bleeding from a deudonal ulcer
Posterior wall
Pancreatodeudonal artery
Different positions of appendix
Retrocaecal 74%
Pelvic 21%
Postileal
Subcaecal
Paracaecal
Preileal
Identification of appendix during surgery
Caecal taenia coli converge at base of appendix and form a longitudinal muscle cover over the appendix.
Blood supply to appendix
Appendicular artery (branch of ileo-colic artery)
Colon, intra or retroperitoneal
Appendix and caecum: intra
Ascending: retro
Transverse: intra
Descending: retro
Sigmoid: intra
Rectum: (distally) retro
Arterial supply of colon
Ascending: ilio-colic and right colic (joined by marginal artery)
Transverse: middle colic
Descending: Inferior mesenteric artery (left colic)
Arterial supply of rectum
Superior rectal artery (IMA)
Middle rectal artery (internal iliac)
Inferior rectal artery (internal pudendal, from internal iliac)
Recesses around liver
Hepatorenal recess
Subphrenic recess