Abdominal cavity and peritoneum

Question 1

some pathological conditions: cirrhosis and heart failure can lead to… with reference to the abdominal cavity

Answer 1

ascites

paracentesis-therapuetic draining

Question 2

What is the only opening to the peritoneal cavity?

Answer 2

the uterine tubes open into the peritoneal cavity

peritoneal cavity is closed off in males

Question 3

look at the photo and draw the two layers of the peritoneal lining

Answer 3

red=parietal-not in contact with organs

blue=visceral- contact the organ

the peritoneal lining is ONE CONTINUOUS LAYER,

Question 4

differentiate between the suspension of organs from other organs and the suspension of organs from the posterior abdominal wall

Answer 4

1. omentum
   
   1. greater
      
      1. bottom of stomach to the transverse colon
   2. lesser
      
      1. bottom of liver to the top of stomach
2. mesentery

Question 5

define the peritoneal sacs

Answer 5

1. greater sac
   
   1. larger part of the peritoneal cavity
   2. 2. lesser sac
   3. lies posterior to the stomach and lesser omentum

Question 6

describe the pathway of blood vessels and nerves

Answer 6

1. blood vessels and nerves that supply an intraperitoneal organ reasch it throug hthe mesentery.
2. named accordingly to specific parts of the digestive tract
   
   1. transverse mesocolon->transcerse colon
   2. mesentery->small intestine

Question 7

what is the location of the kidney? describe the contact of the layers

Answer 7

1. kidney as an example of retroperitoneal organ covered on only one surface by pariettal peritoneum

Question 8

list intraperitoneal organs

Answer 8

1. abdominal esophagus
2. stomach and proximal duodenum (duodenal cap)
3. Jejunum and ileum
4. cecum
5. transverse colon
6. sigmoid colon
7. liver and gallbladder
8. tail of pancreas
9. spleen

Question 9

list the retroperitoneal organs

Answer 9

1. duodenum( except duodenal cap
2. ascending colon
3. descending colon
4. pancreas (except the tail)
5. kidney and ureters
6. abdominal aory
7. inferior vena cava

Question 10

list peritoneal formations consisting of double layers of peritoneum

Answer 10

1. mesenteries
2. peritoneal ligaments
   
   1. omenta- some are part of the omenta
      
      1. lesser curvature
         
         1. hepatoduodenal ligament
         2. hepatogastric ligament
      2. greater curvature
         
         1. gastrophrenic ligament
         2. gastrosplenic ligament
         3. gastrocolic ligament- curtain like structure
   2. splenorenal ligament
      
      1. some peritoneal ligaments connect an organ to an adjacent organ or the body wall (mesentery)

Question 11

list the distinctive characteristic of the greater omentum

Answer 11

1. greater omentum
   
   1. mobile
      
      1. moves to wall off infection
      2. keeping them localized to prevent generalized peritotnitis

Question 12

What connects the greater peritoneal sac and omental bursa?

1. list the boundaries
2. what pathology is associated with this location?

Answer 12

omental (epiploic) foramen

1. boundary
   
   1. anterior
      
      1. hepatoduodenal ligament
         
         1. forms the free right edge of the lesse omentum
   2. posterior
      
      1. inferior vena cava
   3. superior
      
      1. caudate lobe of the liver
   4. inferior
      
      1. superior (first) part of the duodenum
2. omental foramen is occasionally the site of an internal hernia
   
   1. ​when a loop of small intestine becomes entrapped w/in it
   2. treatment
      
      1. none of the obundaries of the foramen can be insiced
      2. swollen intestine must be docompressed with a needle to free it

Question 13

list the divisions and contents of the greater peritoneal sac

Answer 13

1. supracolinic compartement
   
   1. containing the
      
      1. stomach
      2. liver
      3. spleen
2. infracolic compartment
   
   1. sub compartments
      
      1. right infracolic space
      2. left onfracolic space
   2. containing
      
      1. small intestine
      2. ascending colon
      3. descending colon
         4.

Question 14

How can cancer spread to the pelvic cavity? givespecific pathways.

Answer 14

abdominal cavity communicates with the pelvic cavity, providing pathways for the spread of infection or cancer cells.

two gutters

1. right paracolic gutter
   
   1. lateral to the ascending colon; it connects the supracolic compartment and pelvic cavity
   2. boundary is the ascending colon
2. left paracolic gutter
   
   1. lateral to the descending colon
   2. boundary is the descending colon

Question 15

Discuss the difficulty with a supine patient with suspected abdominal infection.

Answer 15

the lowest part tof the abdominal portion of the peritoneal cavity in the supine posittino is the hepatorenal recess(Morisons pouch)

1. location
   
   1. between the right lobe of the liver and right kidney
2. communicates
   
   1. medially with omental bursa
   2. anteriorly with subphrenic recess
      
      1. between the liver and diaphragm

Question 16

Describe the internal surface of anterolateral abdominal wall

Answer 16

1. covered by fascia, transversalis, fat and parietal peritoneum
2. infraumbilical portion
   
   1. 5 umbilical folds and 6 fossae

Question 17

list the folds and fossae of the abcominal cavity.

Answer 17

folds

1. the median umbilical fold
   
   1. from apex of bladder -> umbilicus
   2. covers the median umbilical ligament (urachus)
2. two medial umbilical folds
   
   1. lateral to the median umbilical fold
   2. cover medial umbilcal ligaments
3. two lateral umbilical folds
   
   1. lateral to medial umbilical folds
   2. cover the inferior epigastric vessels

fossae

1. supravesical fossae
   
   1. between the median and medial umbilical folds
2. medial inguinal fossae
   
   1. between medial and lateral umbilical folds
3. lateral inguinal fossae
   
   1. are lateral to the lateral inguinal folds

Question 18

what is the normal flow of fuid in the peritoneal cavity?

Answer 18

peritoneal fluid normally flows superiorly toward the diaphragm and is rapidly absorbed.

bacterial peritonitis, patients are propped in seated postion~45 degrees so

1. infected fluid flows downward into the pelvic cavity, where absorption is slower
2. infection spreading through the diaphragm to pleura from the subphrenic space is reduced.

Question 19

peritonitis and infection may result in

Answer 19

peritoneal adhesions (fibrous bridges)

1. pain and bowel or uterine tube obstruction