Abdominal Cavity general arrangement Flashcards
What structure forms behind the stomach?
The lesser sac - forms due to the stomach’s rotation 90 degrees during embryo formation.
What is the lesser sac?
it is a diveritculum or recess of peritoneum behind the stomach -
the lesser sac contains the epiploic foramen or the foramen of winslow where you could palpate three major structures
The anterior wall of the lesser sac is the lesser omentum which is a fold of peritoneum between the stomach and liver
What three structures can be palpated in the foramen of winslow?
the portal vein most anteriorly
the bile duct most laterally
the hepatic artery most medially
What are the boundaries of the foramen of winslow?
superior, the caudate lobe of the liver. anterior, the hepatoduodenal ligament, containing the components of the portal triad. inferior, the first part of the duodenum.
What level does the oesophagus enter the abdomen behind the diaphragm?
T10 slightly to the left of midline - surrouded by fiberse from the right diaphgragmatic crus forming a sphincter mechanism
What is a hiatus hernia?
arises when part of the stomach pushes its way up into the thorax through the oesophageal opening in the diaphragm.
What are the five regions of the stomach and where are they located?
- Cardia (around oesophageal opening)
- fundus (above the level of the oesophagela opening)
- body
- antrum (lower part)
- pylorus (most distal part) - thickened sphincter mechanism controls the passage of food from the stomach to the duodenum.
find the lesser and greater curvatures of the stomach
What is the opening to the lesser sac called?
The foramen of Winslow
What ligament is attaches the spleen to the kidney?
splenorenal ligament or lienorenal ligament
* bonus points - this arises from the dorsal mesogastrium in development*
What are two names the mesentery that spans from the spleen to the stomach is known by ?
Upper region = gastrosplenic ligament
lower region = forms a double layer of mesentery called the greater omentum- falls down like a curtain covering the intestines
The transverse mesocolon is attached to the undersurface of what major structure?
The greater omentum
What is a mesentery ?
a fold of peritoneum that connects some viscera to the posterior wall of the abdomen
What is the root of the mesentery?
Where the mesentery attaches to the posterior wall
What is an omentum?
The omentum is a membranous double layer of peritoneum that covers and supports the intestines and organs in the lower abdominal area. The omentum is made up of the greater omentum which is an important storage for fat deposits and the lesser omentum which connects the stomach and intestines to the liver.
What is the relationship between the inferior epigastric artery to the deep inguinal ring?
The inferior epigastric artery lies medial to the deep inguinal ring
From which embryological structure does the falciform ligament develop?
It is a remnant of the embryonic ventral mesentery.
what is the ligamentum teres? What did it convey?
Ligamentum teres (or round ligament) of the liver is a cord-like ligament found within the falciform ligament on the inner surface of the anterior abdominal wall and represents a remnant of the umbilical vein, which is a connecting venous structure between the placenta and the umbilical portion of the left portal vein.
Which embryological structures are represented in the median and medial umbilical ligaments?
In the median umbilical ligament - the remains of the urachus
in the medial umbilical ligament (or lateral umbilical ligament) -the remains of umbilical arteries
Where do we find the appendix on clinical inspection?
McBurney’s point
1/3 of the way from the ASIS to the umbilicus
To which costal cartilage is the gall bladder related?
the 9th costal cartilage and its intersection wih the semilunaris
from which embryological structures do the greater and lesser omentum develop?
The greater omentum develops from the dorsal mesentery that connects the stomach to the posterior abdominal wal
The lesser omentum is formed, by a thinning of the mesoderm or ventral mesogastrium, which attaches the stomach and duodenum to the anterior abdominal wall.
What are the lesser and greater sac?
see photo
What are the supra and infra colic compartments?
The supracolic compartment lies above the transverse mesocolon and contains the stomach, liver and spleen.
The infracolic compartment lies below the transverse mesocolon and contains the small intestine, ascending and descending colon. The infracolic compartment is further divided into left and right infracolic spaces by the mesentery of the small intestine.
What is a paracolic gutter? How far superiorly would fluid in the right paracolic gutter extend in the supine position? Would it extend as far on the left?
The supracolic and infracolic compartments are connected by the paracolic gutters which lie between the posterolateral abdominal wall and the lateral aspect of the ascending or descending colon.
The right (lateral) paracolic gutter runs from the superiolateral aspect of the hepatic flexure of the colon, down the lateral aspect of the ascending colon, and around the cecum. It is continuous with the peritoneum as it descends into the pelvis over the pelvic brim. Superiorly, it is continuous with the peritoneum which lines the hepatorenal pouch and, through the epiploic foramen, the lesser sac.
The right paracolic gutter is larger than the left, which together with the partial barrier provided by the phrenicocolic ligament, may explain why right subphrenic collections are more common than left subphrenic collections.
These gutters are clinically important because they allow a passage for infectious fluids from different compartments of the abdomen. For example; fluid from an infected appendix can track up the right paracolic gutter to the hepatorenal recess.
What is a subphrenic recess?
The subphrenic space is a peritoneal space between the anterior part of the liver and the diaphragm, separated into right and left by the falciform ligament, and postero-superiorly bounded by the coronary ligament.
