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Anatomy - Abdomen and Pelvis > Chapter 3 - Abdominal Cavity and Peritoneum > Flashcards

Chapter 3 - Abdominal Cavity and Peritoneum Flashcards

1
Q

9 regions of abdomen

A
  1. Right hypochondrium
  2. Left hypochondrium
  3. Epigastric
  4. Right lumbar
  5. Left lumbar
  6. Umbilical
  7. Right iliac fossa
  8. Left iliac fossa
  9. Hypogastric
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2
Q

Transpyloric plane

A
  • horizontal plane
  • passes midway b/w suprasternal notch and pubic symphysis
  • anteriorly, passes through tip of 9th coastal cartilage
  • posteriorly, through body of L1 vertebra
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3
Q

Transtubercular plane

A
  • horizontal plane

- through tubercles of iliac crest and body of L5

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4
Q

Lateral planes

A
  • correspond to midclavicular lines

- pass through midinguinal point

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5
Q

Histological composition of peritoneum

A
  • outer layer of fibrous tissue - gives strength

- inner layer of mesothelial cells - secrete serous fluid to lubricate viscera

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6
Q

Parietal peritoneum

A
  1. Lines inner surface of abdomen and pelvic walls and lower surface of diaphragm
  2. Derived from somatopleuric layer of lateral plate mesoderm
  3. Pain sensitive due to somatic innervation
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7
Q

Visceral peritoneum

A
  1. Firmly adherent to outer surface of viscera
  2. Derived from splanchnopleuric layer of lateral plate mesoderm
  3. Evokes pain when viscera is stretched, ischemic or distended
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8
Q

Folds of peritoneum

A
  1. Degree and direction of mobility of organ governed by size and direction of folds
  2. Provide pathway for passage of vessels, nerves and lymphatics
  3. Form ligaments to connect organs to abdominal wall or to each other
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9
Q

Peritoneal cavity

A
  • potential space b/w adjacent layers of peritoneum
  • thin film of serous fluid present secreted by mesothelial cells
  • fluid helps in lubrication and free movement
  • divided into greater sac and lesser sac which communicate through epiploic foramen
  • recesses separated from main cavity are present
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10
Q

Functions of peritoneum

A
  1. Provides slippery surface for movements of viscera
  2. Contains phagocytic cells for both cellular and humoral immunity
  3. Greater omentum can move towards area of infection to prevent spread
  4. Mesothelium acts as semipermeable membrane to allow passage of solutes and water
  5. Mesothelial cells can transform into fibroblasts for healing of wounds
  6. Capable of storing large amounts of fat
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11
Q

Causes of ascites

A

Collection of free fluid in peritoneal cavity

  1. Liver cirrhosis
  2. Tubercular peritonitis
  3. Congestive heart failure
  4. Malignant infiltration of peritoneum
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12
Q

Inflammation of peritoneum

A

Peritonitis

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13
Q

Presence of air in peritoneal cavity

A

Pneumoperitoneum

May occur after perforation of stomach or intestines

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14
Q

Artery of foregut, midgut and hindgut

A

Foregut: Coeliac
Midgut: Superior mesentric
Hindgut: Inferior mesenteric

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15
Q

Foregut forms

A

Oesophagus
Stomach
Upper part of duodenum

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16
Q

Midgut forms

A 
Duodenum, jejunum, ileum
Appendix
Caecum
Ascending colon
2/3 transverse colon
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17
Q

Hindgut forms

A

1/3 transverse colon
Descending colon
Sigmoid colon
Proximal rectum

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18
Q

Ventral mesogastrium

A
  1. Ventral mesentery that suspends abdominal part of foregut
  2. Divided by liver into dorsal and ventral
    Ventral part
    - falciform ligament
    - right and left triangular ligaments
    - coronary ligament
    Dorsal part
    - lesser omentum
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19
Q

Dorsal mesogastrium

A
  1. Caudal part forms greater omentum
  2. Cranial gets divided into ventral and dorsal by spleen
    Ventral: gastrosplenic ligament
    Dorsal: lienorenal ligament
  3. Cranialmost part forms gastrophrenic ligament
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20
Q

Greater omentum define

A
  • Large fold of fperitoneum that hangs down from greater curvature of stomach
  • Made of 4 fused layers of peritoneum
21
Q

Greater omentum attachments

A
  • Ant. 2 layers descend from greater curvature of stomach and fold upon themselves
  • Post. 2 layers ascend to anterior surface of body of pancreas
  • 4th layer is partially fused to ant. surface of transverse colon and transverse mesocolon
22
Q

Contents of Greater omentum

A
  1. Right and left gastroepiploic vessels

2. Fat

23
Q

Functions of Greater omentum

A
  1. Stores fat
  2. Protects cavity from infection (milky spots of macrophages)
  3. Limits infection
  4. Forms partition b/w supra and infracolic compartments
24
Q

Lesser omentum define

A
  • extends from lesser curvature of stomach and duodenum to liver
    Hepatogastric ligament: portion b/w stomach and liver
    Hepatoduodenal lig.: b/w duodenum and liver
  • has a free right margin in front of epiploic foramen
25
Q

Attachments of lesser omentum

A

Inferiorly: lesser curvature of stomach and upper border of duodenum
Superiorly: liver

26
Q

Contents of lesser omentum

A
  1. Proper hepatic A
  2. Portal V
  3. Bile duct
  4. Lymph nodes
  5. Hepatic plexus of N
  6. Right and left gastric vessels
  7. Gastric lymph nodes
  8. Gastric nerves
27
Q

Define mesentery

A
  • broad, fan-shaped fold of peritoneum

- suspends coils of jejunum and ileum

28
Q

Borders of mesentery

A
  • attached border extends from duodenojejunal flexure to right sacroiliac joint
  • it crosses:
    Abdominal aorta
    Inferior vena cava
    Right ureter
    Right psoas major
  • free border is in pleats forming visceral peritoneum of gut
29
Q

Contents of mesentery

A
  1. Jejunal and ileal branches of superior mesenteric A
  2. Accompanying V
  3. Autonomic nerve plexuses
  4. Lacteals
  5. 100-200 lymph nodes
  6. Fat
30
Q

Mesoappendix

A
  • small triangular fold of peritoneum
  • suspends vermiform appendix
  • reaches tip of appendix
  • contains vessels, nerves, lymph nodes and lymphatics
31
Q

Features of transverse mesocolon

A
  • broad fold of peritoneum

- suspends transverse colon from upper part of posterior abdominal wall

32
Q

Attachments of transverse mesocolon

A
  • root attached to anterior surface of head and anterior body of pancreas
33
Q

Contents of transverse mesocolon

A
  1. Middle colic vessels
  2. Nerves
  3. Lymph nodes
  4. Lymphatics
34
Q

Features of sigmoid mesocolon

A
  • triangular fold of peritoneum

- suspends sigmoid colon from pelvic wall

35
Q

Attachments of sigmoid mesocolon

A
  • V shaped root
  • apex lies over left ureter
  • left limb attached along upper half of left external iliac A
  • right limb to posterior pelvic wall
36
Q

Contents of sigmoid mesocolon

A
  1. Sigmoid vessels

2. Superior rectal vessels, N, lymph nodes, lymphatics

37
Q

Describe epiploic foramen

A
  • vertical slit like opening through which lesser sac communicates with greater sac
  • situated behind right free margin of lesser omentum
  • level of T12 vertebra
38
Q

Boundaries of epiploic foramen

A

A: Right free margin of lesser omentum containing portal V, proper hepatic A, bile duct
P: IVC, T12, right adrenal gland
S: Caudate process of liver
I: Duodenum, hepatic A

39
Q

Features of lesser sac

A
  • recess of peritoneal cavity behind stomach, lesser omentum and liver
  • closed except in upper part of right border for epiploic foramen
40
Q

Anterior boundaries of lesser sac

A
  1. Peritoneum of liver
  2. Posterior layer of lesser omentum
  3. Peritoneum covering posterior surface of stomach
  4. 2nd layer of greater omentum
41
Q

Posterior boundaries of lesser sac

A
  1. 3rd layer of greater omentum
  2. Peritoneum covering transverse colon
  3. Upper layer of transverse mesocolon
  4. Peritoneum covering pancreas, left adrenal, left kidney, splenic vssels, diaphragm
42
Q

Other boundaries of lesser sac

A

Upper: reflection of peritoneum of diaphragm
Lower: Right margin og greater omentum
Right: Epiploic foramen
Left: Left margin of greater omentum

43
Q

Intraperitoneal spaces of supracolic compartment

A
  1. left anterior
  2. left posterior
  3. right anterior
  4. right posterior
44
Q

Extraperitoneal spaces of supracolic compartment

A
  1. right extraperitoneal
  2. left extraperitoneal
  3. middle extraperitoneal
45
Q

Left anterior and posterior spaces

A 
LAS
- b/w left lobe of liver and diaphragm
- extends to front of lesser omentum
- reaches spleen towards left
LPS = Lesser sac
46
Q

Right anterior and posterior spaces

A 
RAS
- b/w right lobe of liver and diaphragm
- in front of coronary and right triangular ligament
RPS
- hepatorenal pouch of Morrison
47
Q

Right, left and middle extraperitoneal spaces

A

RES
- around upper pole of right kidney
LES
- around left suprarenal gland and upper pole of left kidney
MES
- b/w bare area of liver and diaphragm
- bounded by superior and inferior layers of coronary ligament

48
Q

Boundaries of hepatorenal pouch of Morrison

A 
A: 
1. inferior surface of liver
2. Gall bladder
P:
1. Right adrenal
2. Right kidney
3. 2nd part of duodenum
4. Hepatic flexure of colon
5. Transverse mesocolon
6. Head of pancreas
S: inferior layer of coronary ligament
I: peritoneal cavity
RIGHT: Diaphragm
LEFT: Omental bursa
49
Q

Right and left infracolic compartments

A 
RIC
- b/w ascending colon and mesentery
- triangular with apex downwards
LIC
- b/w descending colon and mesentery
- triangular with apex directed upwards

Anatomy - Abdomen and Pelvis (8 decks)

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