Abdominal Viscera 1 Flashcards
Peritoneum
-Serous membrane around abdominal viscera
-Lines the walls of abdominal and pelvic cavities and covers many organs
-Forms a sac that encloses the peritoneal cavity
Peritoneum- Parietal and Visceral
2 main types of peritoneum:
- Parietal= “of walls”
-Lines inferior surface of diaphragm, abdominal and pelvic walls, roof over pelvic viscera - Visceral= “of organs”
-Covers organs
Peritoneal Cavity
Greater sac:
-Diaphragm -> pelvis
Lesser sac:
-Behind the stomach
Can extend:
Upward -> diaphragm
Downward -> b/t layers of greater omentum
Left -> spleen
Right -> epiploic foramen of Winslow
Epiploic Foramen of Winslow
Only natural communication/opening b/t greater sac and lesser sac
Borders:
Anterior= free border of lesser omentum
Posterior= IVC
Superior= liver (caudate lobe)
Inferior= 1st part of duodenum
Peritoneum- Intraperitoneal (5 Organs)
Completely covered by peritoneum
-Liver, stomach, spleen, jejunum, iliem
Peritoneal- Retroperitoneal
Anterior surface covered, along posterior wall
-SAD PUCKER
Suprarenal/adrenal glands
Abdominal aorta and IVC
Duodenum (parts 2-4)
Pancreas
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum (proximal 1/3)
Peritoneum Innervation (Intra vs. Retro)
Parietal- Retroperitoneal
-Segmental nerves: overlying skin and muscles (T6-L1)
-Phrenic nerves
-Pain is well localized
Visceral- Intraperitoneal
-Visceral afferents
-Pain is poorly localized (b/c of visceral afferent nerves= less localized nerves)
Peritoneum- Double Peritoneal Folds (4)
- Mesentary (in b/t mesentary lies arteries and veins)
- Lesser omentum (lesser curvature)
- Greater omentum (greater curvature)
- Ligaments
Gut Tube (3 Components)
- Foregut
- Midgut
- Hindgut
Foregut (8 Components)
-Abdominal esophagus to proximal 1/2 of duodenum
-Structures: esophagus, stomach, liver, gallbladder, bile ducts, pancreas, proximal duodenum
-Celiac trunk
*DIGESTION
Midgut (8 Components)
-Distal 1/2 duodenum to proximal 2/3 of transverse colon
-Structures: distal duodenum, jejunum, ilium, cecum, appendix, ascending colon, proximal 2/3 transverse colon
-Superior mesenteric artery (SMA)
*ABSORPTION
Hindgut (5 Components)
-Distal 1/3 of transverse colon to proximal anal canal
-Structures: distal 1/3 transverse colon, descending colon, sigmoid colon, upper anal canal
-Inferior mesenteric artery (IMA)
*REMOVAL
Foregut: Celiac trunk branching
- Common hepatic artery
- Left gastric artery
- Splenic artery
Midgut: SMA branching
- Inferior pancreaticoduodenal artery
- Middle colic artery
- Right colic artery
- Ileocolic artery
- Jejunal arteries
- Ileal arteries
Hindgut: IMA branching
- Left colic artery
- Sigmoidal arteries
- Superior rectal artery
Abdominal Esophagus (Foregut)
-Mechanical digestion and transfer of bolus to stomach
-Passing through diaphragm-> esophageal hiatus (T10) and lower esophageal sphincter (LES)
-Blood supply= esophageal branch of left gastric artery
“I ate (T8) 10 Eggs (T10) At 12 (T12)”
-IVC at T8, Esophagus at T10, Aorta at T12
Stomach Components (9)
- Esophagus
- Cardia
- Fundus
- Body
- Pyloric antrum
- Pyloric canal
- Duodenum
Inside:
8. Rugae (increase surface area, allow for expansion and contraction)
9. Pyloric sphincter
Stomach Blood Supply
Greater curvature:
-Right and left gastro-omental arteries (R. off gastroduodenal artery, L. off splenic artery)
Lesser curvature:
-Right and left gastric arteries (off hepatic artery proper)
Fundus:
-Short gastric arteries (off splenic artery)
Small Intestine
-Breaking down proteins, lipids, carbohydrates and absorption
-Specialization of surface area
Pyloric orifice -> ileocecal junction
Duodenum
-20-25cm
-1st part of the small intestine
-C-shaped
-Mostly retroperitoneal
Duodenum (4 Parts)
1st Part:
-Superior portion
-Contains duodenal cap
-INTRAPERITONEAL
2nd Part:
-Descending portion
-Contains minor and major papilla, hepatopancreatic Ampulla of Vater
-RETROPERITONEAL
3rd Part:
-Inferior/horizontal portion, inferior to the SMA
-RETROPERITONEAL
4th Part:
-Ascending portion
-Suspensory ligament of the duodenum (holds it up), contains duodenojejunal flexure
-RETROPERITONEAL
Duodenum Blood Supply
1st and 2nd part: foregut (proximal duodenum) = anterior and posterior SUPERIOR pancreaticoduodenal arteries
3rd and 4th part: midgut (distal duodenum) = anterior and posterior INFERIOR pancreaticduodenal arteries
Jejunum and Ileum
Jejunum:
-L. upper quadrant
-Begins at the duodenojejunal flexure
-Contains plicae circularis
Ileum:
-R. lower quadrant
-Ends at the ileocecal junction
-Contains Peyer’s Patch
*Both contain mesentary proper in between (blood supply is found within)
Jejunum and Ileum- Blood Supply
Superior Mesenteric Artery
Jejunal arteries -> arterial arcades -> vasa recta
Ileal arteries -> arterial arcades -> vasa recta
*Ileum more arcades and vasa recta (vasa recta shorter)
*Jujunum less arcades and vasa recta (vasa recta longer)
“I Love Arcades” -> Ileum more
