Abdominal Cavity MD4 Flashcards
Lesser Omentum
- double layer of peritoneum extending from liver to lesser curvature of stomach and duodenum
- anterior wall of lesser sac
- left and right gastric vessels travel b/w its two layers
- Hepatogastric & Hepatoduodenal lig
- right margin contains portal triad (bile duct, proper hepatic aa, portal vv.)
Greater Omentum
- double sheet folded in on itself (four layers) of peritoneum-> apron down from greater curvature to cover transverse colon and other abdominal viscera
- adheres to/covers inflamed viscera, preventing spread of peritonitis
- transmits left and right gastroepiploic vessels b/w layers
- contains: gastrophrenic, gastrosplenic, gastrocolic, splenorenal lig.
Epiploic/Omental Foramen (Foramen of Winslow)
- opening b/w lesser and greater sac
- bordered by hepatoduodenal lig./portal triad
Inferior recess
- lower recess of lesser sac, b/w anterior and posterior two layers of greater omentum
Superior recess
- of lesser sac
Peritoneal Ligaments
- Hepatorenal lig. (fold of peritoneum from lower posterior liver to anterior right kidney), part of the right margin of epiploic foramen
- Gastrophrenic, Gastrosplenic, Gastrocolic, Splenorenal (greater omentum)
- hepatoduodenal, gastrohepatic (lesser omentum)
Paracolic Gutters
- spaces b/w colon and abdominal wall, collections of fluids can travel along to end up in places remote from origin
- Right Paracolic gutter (lateral to ascending colon), left (lateral to descending colon), right bigger than left
Hepatorenal recess (Morrison’s pouch)
- peritoneal pockett that is the most gravity dependent (fluid collection) in supine position
- communicates w/ lesser sac via epiploic foramen & pelvic cavity via right paracolic gutter
Bare Area of Liver
- region not covered by peritoneum
- represents possible route of transmission of infxn from abdominal cavity to thoracic
Coronary Lig.
- reflections of peritoneum that attach liver to inferior surface of diaphragm
Right Triangular Lig.
- formed by joining of upper and lower aspects of coronary lig.
- connects right border of bare area of liver to diaphragm
Left Triangular Lig.
- fold of peritoneum that connects upper left lobe of liver to diaphragm
- joins with falciform lig. anteriorly
Falciform Lig.
- attaches liver to anterior abdominal wall
- can become canalised in portal HTN
- separates liver into R & L lobes
Liver
- largest gland in body
- GI-absorbed nutrients travel to liver first thru portal venous system
- contains R & L lobes, caudate lobe, quadrate lobe
Inferior Vena Cava
-b/w caudate lobe and right lobe
Ligamentum venosum
- remnant of ductus venosus of fetus
- b/w caudate lobe & lateral aspect of left lobe
Ligamentum teres (Round lig.)
- b/w left lobe and quadrate lobe
- remnant of umbilical vein (in fetus, supplied ductus venosus)
Hepatic Duct
Portal Vein
- part of portal triad
- takes blood from GI tract and spleen to liver
- part of blood supply to liver (75%)
Hepatic Artery (Proper)
- from common hepatic artery
- part of portal triad
- can give rise to right gastric and gastroduodenal aa.
Gallbladder
- cholesterol stones (80%)
- pigment stones
R & L hepatic ducts->
common hepatic duct + cystic duct (GB)
- > common bile duct + main pancreatic duct
- > duodenum (ampulla of vater)
- Triangle of Calot: common hepatic duct, cystic duct, visceral surface of liver
Stomach, Pylorus, Duodenum, Jejunum, Ileum, Ascending & Transverse & Descending Colon, Sigmoid Colon, Rectum, R colic flexure (hepatic flexure), L colic flexure (splenic flexure)
Mesoappendix- mesentery attaching ileum to appendix
Appendix- vestigial? no real function
Cecum- pouch, first part of bowel
Esophagus
Spleen
Major duodenal papilla: opening of common bile duct and main pancreatic duct into 2nd part of duodenum
Minor duodenal papilla: opening of accessory pancreatic duct (in some people) into 2nd part of duodenum
uncinate process of pancreas- hooked part @ head of pancreas that wraps around SMV, sometimes SMA
-tail of pancreas touches spleen
Arcades
-anastomoses of jejunal & ileal arteries (branches of SMA)
Vasa Recta
- loops of arteries coming off of arcades
- Jejunum- long and few, fewer arcades (greater vascularity)
- Ileum- short and many vasa recta
ileocecal junction
- has valve sphincter to prevent backflow
- b12 and bile absorption
Superior Mesenteric Artery
- branch off abdominal aorta just below celiac trunk, behind neck of pancreas
- supplies lower duodenum and head of pancreas (inferior pancreaticoduodenal), jejunum and ileum (intestinal-> give rise to arcades), ileum, cecum, appendix (ileocolic), right colic (ascending colon), middle colic (transverse colon, 2/3)
Marginal Artery
-anastomoses of left colic (from inferior mesenteric aa) w/ superior mesenteric aa (middle, right, ileocolic aa), supplying the inner border of the colon
