Abdominal Cavity Flashcards
primary retroperitoneal organs
aorta IVC kidney ureter suprarenal glands
secondary retroperitoneal organs
duodenum
pancreas
ascending colon
descending colon
what is the peritoneal cavity
closed sac the surrounds all of the abdominal organs formed by perineum
what are MOLs
mesentaries, omentum, ligaments
double layer of peritoneum that connects the visceral organs to the body wall and contains blood vessels, lymphatics, and nerves
where are the 3 mesentaries
small intestine- connects to the jejunum and ilium
transverse mesocolon- below the transverse colon
sigmoid mesocolon- above sigmoid colon
where are the omenta
greater omenta- along greater curvature of stomach
lesser omentum- along lesser curvature of stomach
what is the peritoneal cavity
closed space surrounding the organs
**uterine tubes open into it
define peritonitis
inflammation of peritoneum caused by infection or spill of GI contents
what is paracentesis
insertion of a needle into the peritoneal cavity to remove fluid
what surgical procedures can be done without disrupting the peritoneal cavity
bladder
uterine
kidney
suprarenal
what is ascities
filling of the peritoneal cavity with fluid
what causes ascities
portal hypertension liver disease
peritonitis
cancer
hypoalbuminemia
what are features of ascities that are used to diagnose t
distension and discomfort of abdomen respiratory difficulty central tympany- fluid filled areas are dull shifting dullness fluid wave
what are the compartments of the peritoneal cavity
supracolic
infracolic
omental bursa
location of supra colic compartment
superior to the stomach, the transverse colon and the transverse mesocolon
most superficial area, blanket for the alien
location of omental bursa
behind the stomach, anterior to pancreas
where the alien sits
extends up behind liver and down in front of the transverse colon, behind the supra colic compartment
accessable via epiploic foreman of winslow
blocked on left by gastrosplenic ligament
location of infracolic compartment
below the transverse colon and mesocolon
surrounds the small intestine
alien chair
what is the greater sac
supracolic + infracolic compartments
area above and in front of the small and large intestine
what is the lesser sac
omental bursa area
where alien sits
infections of which peritoneal cavity space tend to stay confined and why
right infra colic space because it is separated from the left by the root of mesentary
what are the paracolic gutters
spaces on the outside of the ascending and descending colons that connect to the pelvic cavity
what drains into pelvic cavity
left infracolic space
right paracolic space
left paracolic space
where is the hepatorenal recess and why is it significant
between the liver and right kidney in the greater sac
significant because it is the lowest point in the peritoneal cavity in the supine position so all the other connecting compartments drain into it
AND the appendix can drain superiorly into it
drainage path of the hepatorenal recess
inferiorly via right colic gutter to pelvic cavity
what recesses are in communication with each other
subphrenic and hepatorenal recesses
where is the subphrenic recess and why is it significant
above the liver and below diaphragm
if it is inflamed it can irritate the diaphragm and cause a subphrenic access, leading to referred shoulder pain
supply of foregut
celiac artery
supply of midgut
superior mesenteric artery
supply of hindgut
inferior mesenteric artery
structures of the foregut
stomach first and 1/2 second duodenum liver gall bladder spllen 1/2 head, body, tail of pancreas
structures of midgut
1/2 second and third duodenum 1/2 head of pancreas jujunum ileum cecum appendix ascending colon 2/3 transverse colon
structures of hindgut
1/3 transverse colon descending colon sigmoid colon rectum upper 1/2 anal canal
autonomic and referred pain pathway- foregut
greater splanchnic nerve T5-9
autonomic and referred pain pathway- midgut
lesser splanchnic nerve T10-11
autonomic and referred pain pathway- hindgut
lumbar splanchnic nerve L1-2
pelvic splanchnic nerve S2-4
what is formed by the ventral mesentary
falciform ligament and lesser omentum
what is formed by the dorsal mesentary
greater momentum and splenorenal ligament
what is the epiploic foreman of winslow
communication between the omental bursa and greater sac
what is formed by the left side of the peritoneal cavity
greater sac
what is formed by the right side of peritoneal cavity
lesser sac/omental bursa
what are the 3 ligaments holding the greater omentum and where are they
gastrocolic ligament- along greater curvature
gastrosplenic ligament- left side of greater curvature
gastrophrenic ligament- top of greater curvature
what are the 2 ligaments of the lesser omentum and where are they
hepatogastric ligament- left side
hepatoduodenal ligament- right side
what are the structures in the hepatoduodenal ligament and how are they arranged
hepatic artery- left
portal vein- large, posterior
common bile duct- right
3 main branches of celiac artery
common hepatic
left gastric
splenic
branches of common hepatic artery and destinations
proper hepatic- goes into liver area
right gastric- right side of lesser curvature
gastroduodenal- passes behind pylorus
branches of proper hepatic artery
left and right hepatic branches
cystic
branches of gastroduodenal artery
supraduodenal- superior to duodenum
right gastro-omental artery- right side of greater curvature
superior pancreaticoduodenal artery- supplies duodenum
which branches anastamose and where
left and right gastric- lesser curvature
left and right gastro-omental- greater curvature
what are the branches of the left gastric artery
esophageal
what are the branches of the splenic artery
left gastro-omental- left side of greater curvature
splenic branches- into spleen
short gastric arteries- left side of greater curvature above left GOA
posterior gastric- back of stomach
describe stomach rotation
left side moves anteriorly
right side moves posteirorly
duodenum moves superiorly and to the right
liver development source
ventral foregut endoderm
pancreas development
ventral and dorsal foregut buds
ventral- gives uncinate process of head
dorsal- rest of head, body and tail
describe herniation of midgut
rotates 270 CCW around the axis of the SMA
- 9 week moves into physiological herniation- completely outside- by rotating 90 degrees
- 10+ weeks- 180 degree rotation and moves back inside peritoneal cavity
how are the secondary retroperitoneal organs formed
during midgut rotation they are pushed back into the retroperitoneal space
what are the abnormalities that can occur during midgut rotation
failure of rotation reversal of rotation Meckel's diverticulum vitelline cyst, ligaments, fistulas omphalocele gastroschisis
what is omphalocele
failure of the midgut to return to the peritoneal cavity
covered by amniotic membrane
what is gastroschisis
herniation of stomach and small intestine through a defect in the anterior abdominal wall
not covered by amniotic membrane
what happens to the vitalline duct
obliterates, but if it doesn’t can fom:
vitalline cyst- enlargment from failure to obliterate completely
vitalline fistulas- no obliteration, abnormal connection between
Meckel’s diverticulum- buldge in small intestine at the attachment of vitalline duct to to stenosis of the duodenum
