Abdominal Organs And Peritoneum

Question 1

What is the peritoneal cavity?

How does it differ in men and women?

Answer 1

Potential space between parietal and visceral layers of peritoneum
Closed in males; has two holes in women for communication with outside (uterus/vagina)

Question 2

Name 6 intraperitoneal organs

Answer 2

Stomach, jejunum, ileum, transverse colon, sigmoid colon, and spleen

Question 3

Name 9 retroperitoneal structures

Against posterior abdominal wall; only covered by peritoneum anteriorly

Answer 3

Most of duodenum and pancreas, ascending colon, descending colon, kidneys, ureters, suprarenal glands, abdominal aorta and IVC

Question 4

Falciform ligament connects?

Answer 4

Diaphragmatic surface of the liver to the diaphragm and anterior abdominal wall (coronary ligament also connects liver to the diaphragm)

Question 5

Structure of ligaments between organs?

Answer 5

Peritoneal folds

Question 6

Lesser omentum consists of what two ligaments

Which is thicker

Answer 6

Hepatogastric and hepatoduodenal

Hepatoduodenal (all structures running to or from the liver)

Question 7

What is mesentery?

Answer 7

2 layered peritoneal fold that connects INTESTINES to posterior abdominal wall (how vessels/nerves reach intestines from post abd wall)

Question 8

Name the 3 different mesenteries

Answer 8

Mesentery of small instestine, transverse mesocolon, and sigmoid mesocolon (connects these structures to posterior abdominal wall)

Question 9

Are organs with mesentery more less mobile?

Answer 9

More mobile

Question 10

What is a secondary retroperitoneal organ

Answer 10

During development all organs are intraperitoneal with a mesentery; further into development some organs adhere to posterior abdominal wall, loose their mesentery and become retroperitoneal (more fixed in position)

Question 11

Not all retroperitoneal organs are secondary (some were always just retroperitoneal)…What organs ARE secondary retroperitoneal organs (4)

Answer 11

Most of duodenum, most of pancreas, ascending and descending colon

Question 12

Location of lesser sac of peritoneal cavity

Answer 12

Posterior to lesser omentum and stomach (rest of peritoneal cavity is greater sac)

Question 13

Boundaries of the epiploic foramen (right hand side opening of lesser sac)(foramen of winslow)

Answer 13

Anterior: hepatoduodenal ligament
Posterior: IVC
Superiorly: caudate lobe of liver
Inferiorly: 1st part of duodenum

Question 14

What is the function of the epiploic foramen?

Answer 14

Communication between lesser sac and greater sac

Question 15

Name the peritoneal folds of the lower part of the anterior abdominal wall

Answer 15

1 median, 2 medial, and 2 lateral umbilical folds

Question 16

Median umbilical fold covers what?

Answer 16

Covers the median umbilical ligament which is a remnant of allantois of embryo (invagination originally of yolk sac)

Question 17

2 medial umbilical folds represent?

Answer 17

(From pelvis to umbilicus) Covers the distal, obliterated parts of umbilical arteries (2). (Umbilical vein became the round ligament of the liver)

Question 18

2 lateral umbilical folds cover?

Answer 18

Inferior epigastric vessels

Question 19

1. What is located between the median and medial umbilical folds?
2. What is located between medial and lateral umbilical folds?
3. What is located lateral to the lateral umbilical fold?

Answer 19

1. Supravesical fossa (rises and falls with urinary bladder)
2. Medial inguinal fossa (site of Hesselbachs triangle - potential site for direct inguinal hernia)
3. Lateral inguinal fossa (site of deep inguinal ring- potential site for indirect inguinal hernia)

Question 20

What divides the abdominal cavity into supracolic and infracolic compartments

Answer 20

Transverse colon and its mesentery

Question 21

Name the 3 parts of the peritoneal cavity in supracolic compartment and their location

Answer 21

Right and left subphrenic recess - between diaphragm and liver

Hepatorenal recess - between liver and right kidney

Question 22

Two sections of the infracolic compartment and what they are divided by?

Answer 22

Right and left infracolic spaces divided by mesentery of small intestine

Question 23

How does the supracolic and infragolic compartments communicate with each other?

Answer 23

Free communication via paracolic gutters (grooves between lateral aspects of ascending and descending colon and abdominal wall)

Question 24

Innervation of parietal peritoneum:

1. Central part of undersurface of diaphragm?
2. Peripheral part of undersurface of diaphragm?
3. Remaining parietal peritoneum?

Answer 24

1. Phrenic nerve (pain referred to shoulder)
2. Lower 5 intercostal nerves/subcostal nerve
3. Lower 5 intercostal nerves/subcostal nerve/iliohypogastric and ilioinguinal nerves

Question 25

Visceral peritoneum is innervated by?

Answer 25

Visceral sensory fibers that travel with sympathetic and parasympathetic fibers that supply organs

Question 26

Pain originating from parietal peritoneum vs visceral peritoneum

Answer 26

Parietal - usually more intense and well localized

Visceral - usually dull and poorly localized (referred pain)

Question 27

What forms the common bile duct?

Answer 27

Common hepatic duct descends (within hepatoduodenal ligament) and is joined by cystic duct to form common bile duct

Question 28

Bile is produced by

Answer 28

Hepatocytes

Question 29

Boundaries of the cystohepatic triangle

What is located in this triangle

Answer 29

The cystic duct, the common hepatic duct and the visceral surface of the liver

Cystic artery

Question 30

Inflammation of gallbladder can lead to ?

Answer 30

Adhesions between gallbladder and duodenum or transverse colon as well as formation of fistulas between gallbladder and these parts of the intestines

Question 31

What is a fistula

Answer 31

An abnormal communication - communication between two organs that should not be directly communicating with each other (so gallstones can pass to intestines)