Abdominal Organs and the Celiac Trunk

Question 1

What are the two layers of the abdominal cavity

What is there innervation

Answer 1

Parital- lines the body wall and covers the retroperitoneal organs

Visceral- encloses the surface of the intraperitoneal

Innervated by the lower intercostal nerves and the ilioinguinal and the iliohypogastric nerves of the lumbar plexus

Question 2

Describe the mesenterary and its function

Answer 2

DOuble layered peritoneal membrance that suspends part of the GI tract from the body walll and allows for movement of the GI as needed. Also allows vessels, nerves and lymphatics to reach the GI tract

Question 3

What are the four important remnants of the mesentery in the abdomen

Answer 3

The less omentum–attach the liver to the lesser curvature of the stomach and the duodenum.
The greater omentum–attach to the greater curvature of the stomach.

The Mesocolon—attach the body wall to the transverse and sigmoid colon.
Ligaments—reflections of mesenteries between organs or the body wall that are named according to their attachments.

Question 4

What are the layers of fascia of the peritoneum and their function and what defines them?

Answer 4

The fascia create space, cover organs and allow limited movement.

1. Transversalis fascia– deep to the muscles of the abdominal
   wall.
2. Extraperitoneal fascia- deep to the transversalis fascia (lines the abdominal
   cavity. )
3. Peritoneal membrane-defines the peritoneal cavity. has two layers

A. parietal peritoneum (paries = wall) lines the wall of the abdomen. Parietal peritoneum is
very sensitive to somatic pain* and is innervated by the lower intercostal nerves and
nerves of the lumbar plexus. e.g. Inflammation of the parietal peritoneum (peritonitis)
results in sharp pain that is localized over the area. —- reason for severe pain during peritonisis

B. visceral peritoneum-(viscus = organ) encloses the surfaces of the intraperitoneal and is not senstitive to somatic pain

Question 5

intraabodomen fascia identify

Answer 5

Question 6

what does the mesentery form from

Answer 6

Remember that mesenteries form from the ventral and dorsal mesogastrium

Question 7

Major organs- identify

Answer 7

Question 8

Answer 8

Question 9

The ________plus__________ equals Lesser omentum

The epiploic foramen of Winslow connects the_______
to the _______
.
The lesser omentum connects the __________ to the ___________.

Answer 9

The _Heptagastric ligament____plus_heptaduodenal ligament____ equals Lesser omentum

The epiploic foramen of Winslow connects the_lesser sac__ to the greater sac_______
.
The lesser omentum connects the liver__________ to the _lesser curvature of the stomach and the first part of the duodenu,__________.

Question 10

Explain the different regions in the abdominal cavity

Answer 10

1. The abdominal viscera are line by the peritoneum
2. Some organs (e.g. ascending and descending colon) never grow into the cavity and are pressed against the body wall in their retroperitonealposition.
3. Other organs like the pancreas become
   secondarily retroperitoneal
   .

Question 11

Answer 11

Question 12

How is the peritoneal sac cavity divided during developement?

What borders the lesser sac?

How do they communicate?

Answer 12

Peritoneal cavity

1. During development the peritoneal cavity is subdivided into the greater and lesser sacs.
   •
2. The lesser sac is bordered by the posterior abdominal wall (posteriorly) and the gastrocolic ligament, stomach and lesser omentum (anteriorly).
   •
3. The two sacs communicate through the epiploic foramen of Winslow

Question 13

IMportant relationships within the foramen of winslow

Answer 13

Anterior– Hepatoduodenal ligament and the hepatic portal vein
•
Posterior—Inferior vena cava
•
Superior—Caudate lobe of the liver
•
Inferior—First part of the duodenum

Question 14

What organs are intraperitoneal

Answer 14

Stomach

Tail of the pancreas

Liver

Gallbladder

Spleen

1st part of the duodenum

Jejunum

Ileum

Transverse colon

Appendix

Sigmoid colon

Question 15

What organs are retroperitoneal?

What does that mean?

Answer 15

They never had a mesentary– even during development

Head, neck and body of the pancreas

Ascending and descening colon

2nd and 3rd part of the duodenum

Upper rectum

Question 16

What organs are secondarily retroperitoneal?

What does that mean?

Answer 16

They had a mesentary but lost it during development (A.I.L. plus kidney stuff)

Kidneys

Adrenal gland

Ureters

Aorta

Inferior vena cava

Lower rectum

Question 17

The stomach has a ___________curvature, which is connected to the_________
of the liver by
the ___________ (_____________), and a left
______________ from which the ____________ is suspended.

Answer 17

The stomach has a right lesser curvature, which is connected to the porta hepatis of the liver by the lesser omentum (hepatogastric ligament), and a left greater curvature from which the greater
omentum is suspended.

Question 18

Explain what main thing happens at each part of the stomach

What two organs does the stomach attach to by the lesser omentum

Answer 18

Fundus- dome- shaped upper portion of the stomach, which is normally filled with air. Rest on left dome of diaphragm

Body- The main central part of thestomach .

The pyloric portion- (under the body) of the stomach has a thick muscular wall and narrow lumen that empties into the duodenum approximately in the transpyloric plane (L1 vertebra)

Liver and gallbladder by lesser omentum

Question 19

When does a sliding hiatal occur?

What can be damaged?

Answer 19

Sliding hiatus occurs when the cardia of the stomach herniates through the esophageal hiatus of the diaphragm. This can damage the vagal trunks as they pass through the hiatus

Question 20

Parts of the stomach

Answer 20

Question 21

What are the livers two surfaces?

What surronds it?

Where is it place and what protects it?

Answer 21

Superior diagphgramtic surface and inferior visceral surface

Surronded by visceral peritoneum

Protected by the rib cage and in the right abdominal cavity

Question 22

What are the reflections of visceral of the liver?

Answer 22

falciform ligament– between the diaphragmatic surface of the liver and the diaphragm. attaches to the anterior abdominal wall
•coronary ligament– the reflection point from the liver and has right and left
triangular ligaments.
• The lesser omentum–extends between the visceral surface of the liver (hepatogastric ligament) and the first part of the duodenum (hepatoduodenal ligament.

Question 23

Explain the two lobes in terms of size and relation to the other two lobes

Answer 23

Right larger than left

Quadrate and cuadate lobes are anatomically with right lobe but functionally with the smaller left lobe

Question 24

Identify Superior Surface of LIver

Answer 24

Question 25

What are the structures seen on the inferior portion of the liver?

Answer 25

ligamentum teres and the ligamentum venosum
•porta hepatis
•fossa for the gallbladder
•quadrate lobe, and the caudate lobe

Question 26

The portal triad is located in the hepatoduodenal ligament at the right free border of thelesser omentum and contains

Answer 26

Arterial supply from the hepatic artery.
•Porta hepatis, which receives venous blood from the portal vein.
•Common bile duct which collects bile produced by the liver.

Question 27

How does the hepatic vein work

Answer 27

Collects blood from the livers sinosoids and drains them into the inferior vena cava

Question 28

explain the bare area in the liver

Answer 28

The liver and diaphragm have a common embrologivcal origin and maintain part of the connect in adult where the bare area of the liver is directly attached to the diaphragm

Question 29

What are the peritoneal reflectiosn associated with the liver

Answer 29

falicform ligament- attached to the anterior abdominal wall by the

heptaogastric ligament- connect the liver to the stomach

heptaduodenal ligament — connect the liver to the duodenum

Coronary ligament (at bare region) and triangular (where coronary come together) ligaments- connect the diaphragm to the liver

Question 30

Explain what happens at the bare region

Answer 30

The bare area of the liver has a boundary where the parietal peritoneum reflects onto the liver thus becoming visceral peritoneum.
•
This reflection is called the coronary ligament. The extreme margins of the coronary are the right and left triangular ligaments

Question 31

What area of the abdominal cavitiy is the spleen in?

Deep to what ribs on what side?

What does the visceral of the spleen come in contact with

How does the spelnic artery and vein reach the spleen

Answer 31

Intraoperitoneal organ (suspended by mesentary)

In the upper left quadrant protected by ribs 9,10, and 11 (hence the spleen can be lacerated by fracture of these ribs)

comes in contact with colic flexure, stomach and left kidney

Reach spleen hilum by tranversing the splenorenal ligament

Question 32

Location and parts of the pancrease

Answer 32

Deep to the stomach at the transpyloric place

4 parts:
•Head– within the C-shaped area of the duodenum; traversed by the common bile duct. Has an uncinate process.
•Neck–posterior to the neck is the hepatic portal vein and superior mesenteric vessels..
•Body–anterior to the aorta and the left kidney. The splenic artery and vein pass posterior/superior
border of the body of the pancreas.
•Tail–enters the splenorenal ligament to reach the hilum of the spleen.

Question 33

Route of main pancreatic duct

Answer 33

Courses through the pancreas to the head where it joins the common bile duct to form the heptapancreatic ampulla

Question 34

Blood supply to the pancreas

Answer 34

Neck, body, and tail- splenic artery

Head- superior and inferior pancreaticduodenal branches of the gastroduodenal and superior mesenteric arteries

Question 35

Parts of the duodenum/relation to other organs

Answer 35

1st part- intrapreitoneal- anterior to the gastroduodenal artery and common bile duct

2nd part- intraperitoneal- recieve the common bile duct and the main pancreatic duct at the hepatopancreaatic ampulla. Smooth muscle in the wall is known as the sphincter of Oddi

3rd part- horiztonal, retroperitoneal, anterior to the aorta, deep tp tje superior mesenteric artery and vein

4th part- ascending connects to jejunum at the suspernsory ligament of Trietz (has msucle fibers from the right crus of the diaphragm)

Question 36

Duodenum parts– pay attention to what lies anterior and posterior to each part of the duodenum

Answer 36

Question 37

3 trunks of celiac and what do they supply

Answer 37

Left gastri

Splenic

Common Hepatic

Foregut!

Question 38

Where is the left gastric?

What does it give off?

And what does it connect with?

Answer 38

Left Gastric
•lesser curvature of stomach
•short esophageal branches
•connects with right gastric

Question 39

Where does the splenic travel and waht does it give off

Answer 39

Posterior to the stomach

Gives of the left gastro-omental branchs and pancreatic branches

Question 40

What arteries arise from the common hepatic artery

Answer 40

Right gastric

Gastroduodenal– right hastro-omental

Proper hepatic

Question 41

Important Anastomoses Review this card’s materias

Answer 41

Right Gastric (off common hepatic) anastomosis with Left Gastric (off celiac) .
•
Gastrodudoneal Branch (offf common hepatic) – duodenal branches
and superior pancreaticoduodenal branches
(anterior and posterior;
i.e. the pancreas is an endocrine/digestive organ and needs a lot of blood.)
•
Proper Hepatic Branch (off common hepatic) with cystic artery

Question 42

Answer 42