Abdomen Week 1 (C) Flashcards
1
Q
What is peritoneum?
A
2
Q
Parietal vs Visceral peritoneum:
A
3
Q
What is the function of the peritoneal cavity? (2)
A
▪Lubricates digestive organs
▪Contains leukocytes & antibodies
4
Q
What are peritoneal organs? (3)
A
5
Q
What are retroperitoneal organs? (3)
A
6
Q
▪ Intraperitoneal organs:
A
Visceral peritoneum
7
Q
▪ Retroperitoneal organs:
A
▪ Retroperitoneal organs – parietal peritoneum
(anterior surface only
8
Q
▪ Primary retroperitoneal –
▪ Secondary retroperitoneaI -
A
▪ Primary retroperitoneal – develop outside
▪ Secondary retroperitoneaIl – move outside during
developmen
9
Q
▪ Retroperitoneal viscera:
SADPUCKER
A
10
Q
Visceral peritoneum innervation: (3)
A
▪ Autonomic supply (same as the viscera)
▪ Pain is referred to equivalent :hard to used clinically dermatomes (poorly localised) —> hard to be used clinically
▪ Sensation limited to stretch and chemical irritation (rupture , enzymes leak out in peritoneum)
11
Q
Autonomic supply of visceral peritoneum: (2)
A
12
Q
Parietal peritoneum innervation: (2)
A
13
Q
▪ Mesentery – double layer of peritoneum that provides: (3)
A
14
Q
▪Small intestine→ the mesentery…
A
Connect/SI to posterior abdomen wall.
15
Q
▪ Colon → _______
(transverse, sigmoid etc. )
A
mesocolon
16
Q
▪ Appendix → ________
A
mesoappendix
17
Q
Omenta: (2)
A
▪ Greater omentum
▪ Lesser omentum
18
Q
What is the greater omentum?
A
Connects stomach to transverse colon
19
Q
What is the lesser omentum? (3)
A
20
Q
What are the contents of the omenta? (3)
A
Portal triad
▪ Common bile duct
▪ Proper hepatic artery
▪ Hepatic portal vein
21
Q
What is the function of peritoneum?
A
Connects organs to each other or to posterior abdominal wall.
22
Q
What are the peritoneal ligaments of the liver? (5)
A
23
Q
What are the peritoneal ligaments of the stomach? (3)
A
24
Q
What are the peritoneal ligaments of the colon?
A
25
What are the peritoneal ligaments of the spleen?
26
What are the compartments of the greater sac? (2)
27
What is the lesser sac?
28
What are the other peritoneal cavity subdivisions? (2)
▪ Peritoneal gutters
▪ Peritoneal recesses
29
Peritoneal Cavity Subdivision
Clinical POV: (2)
▪Pathways for fluid
accumulation
▪Infection and inflammation spread
30
What is the transverse mesocolon?
Superior recess of mental bursa
31
What does the greater peritoneal sac subdivide?
32
What is the greater peritoneal sac connected by?
33
Lesser peritoneal sac ---> omental ____.
bursa
34
What is the lesser peritoneal sac? (4)
▪ Posterior to stomach and lesser omentum
▪ Superior recess extends behind liver
▪ Inferior recess between layers of the greater omentum
▪ Permits free movement of stomach
35
What is the lesser peritoneal sac? (4)
▪ Posterior to stomach and lesser omentum
▪ Superior recess extends behind liver
▪ Inferior recess between layers of the greater omentum
▪ Permits free movement of stomach
36
What does the lesser peritoneal sac communicate with?
37
What are peritoneal recesses?
DISCH
▪Pouches of peritoneum formed by peritoneal folds
38
What are the types of peritoneal recesses? (5)
▪ Duodenal recesses
▪ Caecal recesses
▪ Intersigmoid recess
▪ Subphrenic recesses
▪ Hepatorenal recess
39
What are the ▪ Caecal recesses? (3) SIR
▪Superior ileocaecal
▪Inferior ileocaecal
▪ Retrocaecal
40
What are the peritoneal gutters (allow the passage of fluid)? (2)
▪Paramesenteric gutters
▪Paracolic gutters
41
▪Paramesenteric gutters: (2)
- Right
- Left
42
▪Paracolic gutters: (2)
▪ Right
▪ Left
43
▪Right paracolic gutter→ extensive connections: PHOR = (4)
44
What is the RIGHT paramesenteric gutter defined by? (3)
LAT:
SUP:
MED:
45
What is the LEFT paramesenteric gutter defined by?
MED:
LAT:
46
What is the LEFT paramesenteric gutter defined by?
MED:
LAT:
47
Where does the RIGHT paracolic gutter run from?
48
Where does the RIGHT paracolic gutter run from?
49
What is the splenic flexure of the colon?
50
What is the splenic flexure of the colon?
51
Peritoneal Fluid Circ:
Supracolic =
52
Peritoneal Fluid Circ:
Infracolic =
53
Peritoneal Fluid Circulation:
▪ Right paracolic gutter =
either superior or inferior depending on position of patient.
54
Peritoneal Fluid Circulation:
▪ Accumulation on the right, between mesentry of ______ and ______ and ascending colon (no exit)
▪ To the left of the root of the mesentery, between mesentery of jejenum and ileum and ______ ____ (exit inferior)
jejenum and ileum
descending colon
55
Peritoneal Fluid Circulation:
▪ Left paracolic gutter:
▪ Left paracolic gutter: towards inferior since phrenocolic ligament block superior drainage in supine position
56
What is the clinical relevance of peritoneal adhesions? (4)
57
What is peritoneum? (2)
* Continuous, transparent serous membrane
* Lines abdominopelvic cavity and invests the viscera
58
Visceral vs Parietal Peritoneum: (6)
59
Similarities between Parietal and Visceral peritoneum: (2)
60
Peritoneal Fluid:
Composition =
* Water, electrolytes and other substances from interstitial fluid in adjacent tissues
* Proteins, desquamated mesothelial cells, macrophages, fibroblasts & lymphocytes
61
Peritoneal Fluid:
Absorption =
62
What is the applied anatomy of peritoneal fluid? (2)
* Abnormal collection of free fluid in peritoneal cavity- Ascites
* Procedure for draining of ascitic fluid- Paracentesis Abdominis
63
What is the mesentery? (6)
* Double layer of peritoneum
* Invagination of the peritoneum by an organ
* Constitutes a continuity of the visceral and parietal
peritoneum
* Provides a means for neurovascular
communications between the organ and the body wall
* Has a core of connective tissue containing
blood and lymphatics, nerves and fat
* Small intestine mesentery is known as ‘the mesentery’
64
* Mesenteries related to other specific parts of the
alimentary canal are named accordingly: (4)
o Transversemesocolon
o Sigmoidmesocolon
o Meso-oesophagus
o Mesogastrium
65
What is the omentum? (2)
* Double layered extension of peritoneum
* Passes from the stomach and proximal part of the duodenum to adjacent organs in the abdominal
cavity
66
What is the omentum? (2)
* Double layered extension of peritoneum
* Passes from the stomach and proximal part of the duodenum to adjacent organs in the abdominal
cavity
67
What is the greater omentum? (4)
68
What is the greater omentum? (4)
69
What is the lesser omentum? (2)
70
Lesser omentum
o Contains the portal triad of structures running between the duodenum and liver in the free edge: (3)
- Portal vein (posteriorly)
- Common bile duct (right anterior)
- Hepatic artery (left anterior)
71
What are the peritoneal ligaments?
* Consists of a double layer of peritoneum that connects an organ with another organ or to the abdominal wall
72
Peritoneal ligaments:
* Connections of the liver =
73
Peritoneal ligaments:
* Connections of the liver =
74
Peritoneal ligaments:
* Connections of the stomach =
75
* Other
oLienorenal/splenorenalligament-
spleen to left kidney
76
What are peritoneal folds?
* Reflection of peritoneum that is raised from the body wall by underlying blood vessels, ducts and ligaments formed by obliterated foetal vessels
77
What are peritoneal folds?
* Reflection of peritoneum that is raised from the body wall by underlying blood vessels, ducts and ligaments formed by obliterated foetal vessels
78
5. Peritoneal recess/fossa
* Blind pouch of peritoneum formed by a peritoneal fold:(8)
79
Compartments of the abdominal cavity
* Transverse mesocolon divides abdominal cavity into _____ and _____ compartments.
infra colic
supra colic
80
* Supracolic compartment
o contains: (3)
§ Stomach
§ Liver
§ Spleen
81
* Supracolic compartment
Divided by...
82
* Infracolic compartment-
o contains: (2)
- Small intestine
- Ascending and descending colon
83
* Infracolic compartment lies posterior to the _____ _____.
greater omentum
84
* Infracolic compartment-
o Divided into right and left infracolic spaces by mesentery of the small intestine
- RIGHT:
- LEFT:
- Right- extraperitoneal space corresponds to ‘bare area of the liver’
- Left- around left suprarenal gland & upper pole of left kidney
85
What are the paracolic gutters? (3)
86
Divisions of the peritoneal cavity
* The peritoneal cavity is divided into the _____ and _____ peritoneal sacs
lesser
greater
87
Divisions of the peritoneal cavity
* The peritoneal cavity is divided into the _____ and _____ peritoneal sacs
lesser
greater
88
Divisions of the peritoneal cavity
* Greater sac-
* Lesser sac (omental bursa)-
* Greater sac- main and larger part of the peritoneal cavity
* Lesser sac (omental bursa)- lies posterior to the stomach and lesser omentum
89
Divisions of the peritoneal cavity
* Greater sac-
* Lesser sac (omental bursa)-
* Greater sac- main and larger part of the peritoneal cavity
* Lesser sac (omental bursa)- lies posterior to the stomach and lesser omentum
90
Omental bursa (lesser sac):
* Superior recess =
o Limited superiorly by the diaphragm and posterior layers of the coronary ligament of the liver
91
Omental bursa (lesser sac):
* Inferior recess = (2)
o Between the superior parts of the layers of the greater omentum
* Permits free movement of the stomach on the structures posterior and inferior to it
92
* Omental foramen (epiploic foramen)- (3)
93
* Omental foramen (epiploic foramen)
o Boundaries:
- Anterior
- Posterior
- Superior
- Inferior
94
* Omental foramen (epiploic foramen)
o Boundaries:
- Anterior
- Posterior
- Superior
- Inferior
95
o Internal hernia can occur into omental bursa through _____ foramen
epiploic
96
o Internal hernia can occur into omental bursa through _____ foramen
epiploic
97
Rectouterine pouch of Douglas:
* Most dependent part of peritoneal cavity in standing position & of pelvic cavity in supine position in females
98
Rectouterine pouch of Douglas
* Boundaries:
- Anterior
- Posterior
- Floor
99
Rectouterine pouch of Douglas
* Boundaries:
- Anterior
- Posterior
- Floor
100
* Organs present in each abdominal region:
- Right Hypochondriac: (3)
Liver & Gall bladder
Kidney & suprarenal gland,
Colon (hepatic flexure)
101
* Organs present in each abdominal region:
- Epigastric: (3)
Liver & Transverse colon,
Abdominal aorta & inferior vena cava,
Pylorus & Duodenum (1st part)
102
* Organs present in each abdominal region:
Left Hypochondriac: (3)
Stomach & Spleen
Kidney & Suprarenal gland
Colon (splenic flexure)
103
* Organs present in each abdominal region:
Right Lumbar (Lateral): (3)
Kidney
Ascending colon
Small intestine
104
* Organs present in each abdominal region:
Umbilical: (8)
Transverse colon, Duodenum, pancreas, Abdominal aorta, Inferior vena cava, Small intestine, Iliac vessels
105
* Organs present in each abdominal region:
Left Lumbar (Lateral): (3)
Kidney, Descending colon Pancreas
Small intestine (jejunum)
106
* Organs present in each abdominal region:
Right Inguinal (Iliac): (2)
Caecum, Appendix Small intestine (ileum)
107
* Organs present in each abdominal region:
Hypogastric: (3)
Distensible organs of pelvis e.g. bladder when full;
uterus from 12th week of pregnancy.
Small intestine, Iliac vessels, Spermatic cords
108
* Organs present in each abdominal region:
Left Inguinal (Iliac): (2)
Sigmoid colon
Small intestine
109
* Classification based on relationship of the viscera with the peritoneum
* Intraperitoneal organs:
o Almost completely covered with visceral peritoneum
110
Secondary retroperitoneal organs: (2)
111
What are the Primary retroperitoneal organs? (4)
112
Intraperitoneal Organs: (9)
113
Intraperitoneal Organs: (9)
114
Secondary retroperitoneal organs: (4)
115
Secondary retroperitoneal organs: (4)
116
Primary retroperitoneal organs: (4)
