Anatomy - Peritoneum Flashcards

1
Q

What is the peritoneum?

A
  • A single continuous membrane lining the abdominal membrane

- Made of simple squamous epithelium (mesothelium)

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2
Q

What is the difference between the abdominal and peritoneal cavity?

A
  • The abdominal cavity is everything inside the abdominal wall
  • The peritoneal cavity is inside the peritoneum. It is a potential space between the visceral and parietal layers of the peritoneum
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3
Q

What are mesentries?

A

Modified peritoneal reflections, from which abdominal organs are suspended from the abdominal wall.

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4
Q

What is the purpose of mesentries?

A

Acts as a condiut for vessels, nerves and lymphatics

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5
Q

What is the difference between intraperitoneal and retroperitoneal cavities?

A
  • Intraperitoneal are structures suspended form the abdominal wall by mesentries
  • Retreoperitoneal structures lie between the parietal peritoneum and abdominal wall
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6
Q

List the retroperitoneal structures.

A
  • Kidneys and ureters
  • Supradrenal glands
  • Aorta/IVC
  • Nerves (lumbar plexus and sympathetic trunk)
  • Oesophagus
  • Rectum

Secondary:

  • Duodenum (except the start)
  • Pancreas
  • Colon (ascending and descending)
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7
Q

What is the difference between primary and secondarily retroperitoneal organs?

A

Secondary retroperitoneal organs origionally had a mesentry, then became secondarily retroperitoneal when the mesentry fused with the body wall

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8
Q

Where is the foregut?

A

Distal 3rd of oesophagus to 2nd part of the duodenum at the entrance of the bile duct

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9
Q

Where is the midgut?

A

2nd part of duodenum to two thirds along the transverse colon

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10
Q

Where is the hindgut?

A

Distal 3rd of the transverse colon to the rectum

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11
Q

Where are the dorsal and ventral mesentry?

A
  • Whole gut tube suspended from the dorsal mesentry, which attaches to the greater curve of the stomach
  • Foregut has a ventral mesentry as well (encloses the liver and pancreas), which attaches to the lesser curve of the stomach
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12
Q

What are the subdivisions of the gut?

A
  • Lesser sac (ommental bursa), which forms when the liver rotates while growing, forming a sac inbetween the liver and the stomach posterior. Ventral foregut mesentry
  • Greater sac/omentum covers the abdomen like a sheet. This is the dorsal foregut mesentry
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13
Q

What is the epiploic foramen?

A

Where the ommental bursa is continuous with the greater sac.

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14
Q

What structures are on the right free edge of the ommental bursa?

A
  • Portal vein
  • Hepatic artery
  • Bile duct
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15
Q

What are the peritoneal compartments?

A
  • Supracolic compartment (above the mesentry of the transverse colon)
  • Infracolic compartment (below the mesentry of the transverse colon)
  • Paracolic gutter (right/left of the abdomen)
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16
Q

What is the falciform ligament?

A

Attaches the liver to the diaphragm

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17
Q

Describe the direction of peritoneal fluid and inflammatory exudate.

A
  • Peritoneal fluid goes towards the diaphragm where it is reabsorbed
  • Inflammatory exudate flows downwards, towards the pelvis
18
Q

Compare the functions between the outer muscularis layer of the abdomen and the inner mucosa muscularis

A
  • Muscularis layer causes peristalisis and segmentation

- Mucosa muscularis causes small movements to prevent food getting stuck to serosa

19
Q

What is the first part of the duodenum?

A

Duodenal cap

20
Q

Name the entrance for the common bile duct in the duodenum, and describe its location

A
  • Major duodenal papilla

- In the second part of the duodenum

21
Q

How can the jejunum and illeum be distinguished?

A
  • Jejunum has less prominant arterial arcades, and longer vasa recta
  • Illeum has more prominant arterial arcades and short vasa rects
  • Jejunum has a larger diameter
22
Q

List the parts of the large intestine

A
  • Caecum
  • Ascending colon
  • Transverse colon
  • Descending colon
  • Sigmoid colon
23
Q

How can the large intestine and small intestine be distinguished?

A
  • Large intestine has fatty tags, called appendices epiploicae
  • Large intestine has longitudinal muscle in its walls segregated into three bands, taeniae coli
  • LI has larger diameter
24
Q

What artery supplies the foregut, liver, pancreas and spleen?

A

Coeliac trunk

25
Q

Which artery supplies the midgut?

A

Superior mesenteric artery

26
Q

Which artery supplies the hind gut?

A

Inferior mesenteric artery

27
Q

Where do the arteries supplying the gut arise from?

A

Anterior of the aorta - they are unpaired

28
Q

What are the branches of the celiac trunk, and where do they arise?

A

Upon arising from the abdominal aorta immediately below the diaphragm, the coeliac artery splits into the:

  • Left gastric artery
  • Splenic artery
  • Common hepatic arteries
29
Q

Describe the pathway of the left gastric artery

A
  • Esophageal branches supply the oesophagus
  • Descends along the lesser curvature of the stomach in the lesser omentum, supplying the stomach and anastamosing with the right gastric artery
30
Q

Describe the pathway of the splenic artery

A
  • Moves along the left, the superior border of the pancreas
  • Travels in the splenorenal ligament
  • Branches enter the right hilum of the spleen
  • Short gastric arteries supply the fundus of the stomach
  • Left gastroomental artery runs along the greater curvature of the stomach, and anastamoses with the right gastro-omental artery
31
Q

Describe the pathway of the common hepatic artery

A
  • Hepatic artery proper (forms right and left hepatic arteries)
  • Gastroduodenal artery (right gastro-omental artery and anterior superior pancreaticoduodenal artery)
32
Q

List the branches of the superior mesenteric artery

A
  • Inferior pancreaticoduodenal artery
  • Jejunal and ileal arteries
  • Middle colic artery
  • Right colic artery
  • Ileocolic artery
33
Q

List the branches of the inferior mesenteric artery

A
  • Left colic artery
  • Sigmoid arteries
  • Superior rectal artery
34
Q

List the veins draining the abdomen

A
  • All the veins end up in the portal vein which goes to the liver
  • From superior mesenteric vein, inferior mesenteric vein and splenic vein
  • First inferior mesenteric joins the splenic, then this vein joins the superior mesenteric
35
Q

What are portal systemic anastamoses?

A

Where the veins draining to the portal vein and the IVC communicate

36
Q

Describe the main lymphatics in the gut

A
  • Follows the arterial supply
  • Lymph all drains into cisterna chyli
  • Involves the coelic nodes, superior mesenteric nodes, and inferior mesenteric nodes
37
Q

Describe the innervation of the gut

A
  • Viscera supplied by the autonomic nervous system
  • PNS controls regulate reflex gut function (vagus nerve and pelvic splancnic nerves, S2-4)
  • SNS mediates pain (thoracic splancnic T5-12 and lumbar splanchnic L1 and 2)
38
Q

What nerves does the thoracic splanchnic nerve give rise to?

A
  • Greater splanchnic nerve (T5-9)
  • Lesser splanchnic nerve (T10-11)
  • Least splanchnic nerve (T12)
39
Q

What are the effects of parasympathetic efferents on the gut?

A
  • Increased peristalsis
  • Relax sphincters
  • Increase secretion
40
Q

What are the effects of the sympathetic efferents on the gut?

A
  • Decreased peristalsis
  • Constrict sphincters
  • Decrease blood flow and secretions
41
Q

Describe the blood supply of the stomach

A
  • Greater curvature supplied by left and right gastroepliploic arteries
  • Fundus is supplied by the short gastric artery
  • Lesser curvature is supplied by the right and left gastric arteries
  • The cardiac region is supplied by the left gastric
42
Q

Describe the blood supply of the pancreas

A
  • Head supplied by superior pancreaticoduodenal and superior mesenteric arteries
  • Tail, body and neck supplied by pancreatic branches of the splenic artery