Abdominopelvic & Peritoneal Cavities, Stomach, Duodenum, Celiac Trunk Flashcards
Intraperitoneal vs retroperitoneal
Intraperitoneal:
- Mesentery present
- Suspended + mobile
Retroperitoneal:
- No mesentery
- Fixed to posterior abdominal wall
Where can ascites develop?
Peritoneal cavity
What is located in the peritoneal cavity?
NO ORGANS (except some fluid)
Name the 9 abdominal regions
- Right hypochondriac
- Epigastric
- Left hypochondriac
- Right lumbar
- Umbilical
- Left lumbar
- Right iliac
- Suprapubic
- Left iliac
Subcostal
At level of last costal cartilages
Transtubercular
Across levels of iliac tubercles
What is the function of the greater omentum?
- Walls off any sort of inflammation that may arise within peritoneum
Where is the greater omentum located?
- Anchors onto the greater curvature of the stomach + to ascending, transverse, and descending colon
- Acts like an apron draped over duodenum + jejunum
+ some of ileum (some loops are exposed)
Mesentery
Double fold of peritoneum that attaches organs to abdominal wall
Abdominal ligament
Double fold of peritoneum that attaches organs together
Secondary retroperitoneal abdominal organs
Ascending colon and descending colon
Hepatic flexure
Colon flexure on the right
Splenic flexure
Colon flexure on the left
Is the rectum intraperitoneal or retroperitoneal?
Retroperitoneal
What are the peritoneal layers attached to the colon called?
Mesocolon
What are the ligaments of the greater omentum?
- Gastrophrenic
- Gastrosplenic
- Gastrocolic
Where will fluid accumulate if a patient with ascites lays supine?
Morrison’s pouch (hepatorenal recess)
What marks the entrance to the omental bursa?
Omental/epiploic foramen (of Winslow)
What are the ligaments of the lesser omentum?
- Hepatoduodenal ligament
- Hepatogastric ligament
- Hepatoesophageal ligament
Where is the omental bursa/lesser sac situated?
In between stomach + pancreas
What part of the duodenum is intraperitoneal?
1st part, rest is retroperitoneal
Is the pancreas intraperitoneal or retroperitoneal?
- Body is secondary retroperitoneal
What is the Pringle maneuver?
Clip off portal triad (hepatoduodenal ligament) to minimize blood loss during liver surgery
What are the 4 parts of the duodenum?
1) Superior
2) Descending
3) Horizontal
4) Ascending
What marks the transition spot between duodenum + jejunum?
Duodenojejunal flexure (ligament of Treitz)
What is in close proximity to the C-shaped loop of the duodenum?
Head of the pancreas
3 main branches off the celiac trunk
1) Left gastric artery (left superiorly)
2) Splenic artery (left inferiorly)
3) Common hepatic artery (right)
What does the left gastric artery supply?
Lesser curvature of the stomach
What branches arise from the common hepatic artery?
Proper hepatic artery
Gastroduodenal artery
What does the right gastric artery supply?
Lesser curvature of the stomach
What branches arise from the splenic artery?
- Left gastro-omental artery
- Short gastric arteries
- Great pancreatic artery
What do the gastro-omental arteries supply?
Greater curvature of the stomach
What branches arise from the proper hepatic artery?
- Right gastric artery
- Right + left hepatic arteries
What branches arise from the gastroduodenal artery?
- Supraduodenal
- Superior pancreaticoduodenal (splits into anterior + posterior)
Where does the celiac trunk arise from the aorta?
- Above the pancreas
- Level of T12/L1
What branches arise from the right hepatic artery?
Cystic artery (to gallbladder)
Where can the cystic artery be found/what area is important to assess during cholecystectomy?
Calot’s triangle
Name the important anastomoses in the abdominal arteries
- Gastro-omental (right + left)
- Gastric (right + left)
- Pancreaticoduodenal (superior + inferior)
What pathology of the duodenum can cause a patient to present with hematemesis?
- Duodenal ulcer that has eaten though the GastroDuodenal Artery (Gosh Darn Artery)
Functions of the spleen
- Destroy old RBCs
- Contains WBCs
Where does the esophagus pass through the diaphragm + enter the abdominal cavity?
T10
Walk through path of the esophagus down the thoracic cavity and into the abdominal cavity
- Descends from superior mediastinum
- Posterior + to right of aortic arch, behind pericardium + left atrium, left main bronchus
- Deviates to left + passes through diaphragm at T10, anterior to aorta
- Vagal trunks travel along anterior + posterior surfaces (left anterior, right posterior)
Lower esophageal sphincter (LES)
Musculatureofthegastroesophagealjunctionthatistonically
activeexceptduringswallowing
Two common pathologies of LES
- Scleroderma
- Achalasia
Scleroderma
- Infiltrative condition that destroys muscle
- Missing normal sphincter tone
- Results in significant acid reflux
Achalasia
- Lacks neural message to dilate
- Empties food poorly into stomach
- Results in dilated esophagus
