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GI - A > Dry Room 1 > Flashcards

Dry Room 1 Flashcards

1
Q

What is the peritoneum?

A

The peritoneum is a transparent serous membrane that covers body wall and organs.

Although it is one continuous layer, it is often described differently, depending on whether it lines the body wall or covers the organs.

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2
Q

What are the two layers of the peritoneum called?

A 
Parietal = covers the wall
Visceral = covers viscera
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3
Q

What structures does the peritoneum form?

A

It forms folds such as mesenteries and omenta

It also forms ligaments which may be vascular or avascular

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4
Q

Define the term peritoneal cavity

A

The peritoneal cavity is the potential space between the parietal and visceral peritoneum

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5
Q

Two major divisions of the peritoneal cavity are termed sacs.
Which are these?

A 
Greater sac
Lesser sac (omental bursa)
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6
Q

Through which passage do the two sacs of the peritoneum communicate?

A

Omental foramen

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7
Q

Describe where the omental foramen is located and its relations

A

Posterior to the free edge of the lesser momentum forming the hepatoduodenal ligament

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8
Q

How are organs described depending on how they are peritonised?

A

Intraperitoneal = organs completely surrounded by visceral peritoneum

Retroperitoneal = organs only covered on their anterior surface and therefore firmly attached to the posterior wall

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9
Q

List the intraperitoneal organs

A

SALTD SPRSS

S=Stomach
A=Appendix
L=Liver
T=Transverse colon
D=Duodenum (only first part)
S=Small intestine
P=Pancreas (only the tail)
R=Rectum (upper 3rd)
S=Sigmoid colon
S=Spleen
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10
Q

List the retroperitoneal organs

A

SADPUCKER

S=Suprarenal glands
A=Aorta and IVC
D=Duodenum (except first part)
P=Pancreas
U=Ureter and Bladder
C=Colon (asending and descending)
K=Kidneys
E=Esophagus
R=Rectum (lower two thirds)
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11
Q

What is present inside the peritoneal cavity?

A

Peritoneal fluid. There are no organs

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12
Q

What term is used to describe structures in the abdominopelvic cavity which are not covered in peritoneum

A

Extraperitoneal

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13
Q

Which layer of the peritoneum is more sensitive to pressure, pain, heat and cold?

A

Parietal layer

You don’t want the visceral layer to feel lots of eating food would cause you pain.

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14
Q

What are the attachments of the greater and lesser omentum?

A

Greater Omentum: Greater curvature of the stomach to proximal part of the duodenum

Lesser Omentum: Lesser curvature of the stomach and proximal part of the duodenum to the liver

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15
Q

What parts of the greater omentum are free?

A

The lower margin and the left and right margins.

It moves about the abdominal cavity in response to peristaltic movements.

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16
Q

Why do surgeons refer to the greater omentum as the abdominal policeman?

A

In infection, especially appendicitis, inflammatory exudate causes the momentum to adhere to the site of infection, and wrap itself around the infected organ.
This localises the infection to a small area of the cavity, protecting against serious diffuse peritonitis.

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17
Q

Describe the innervation of the parietal peritoneum

A

Innervated by the lower 6 thoracic nerves and L1, the pain here is somatic and can be easily localised.

It is extremely sensitive to stretching and this is made use of in clinical diagnosis (rebound tenderness)

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18
Q

Describe the innervation of the visceral peritoneum

A

Innervated by automatic nerves. Pain is often referred, and is dull and poorly localised.

Because the GI tract is a midline structure receiving bilateral nerve supply, pain is often referred to the midline.

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19
Q

What are the 3 major openings in the diaphragm and at what vertebral level are they found?

A

Caval Opening T8
Oesophageal Opening T10
Aortic Hiatus T12

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20
Q

What are the 3 main branches of the abdominal aorta which supplies blood to the gut tube within the abdominopelvic cavity

A

Celiac Trunk
Superior Mesenteric Artery
Inferior Mesenteric Artery

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21
Q

At what vertebral level does the abdominal aorta divide into 2 common iliac arteries?

A

L4

22
Q

How is the inferior vena cava (IVC) formed in the abdomen?

A

Formed from the left common iliac and right common iliac veins.

23
Q

What vertebral level do the celiac trunk, superior mesenteric and inferior mesenteric arise from the aorta?

A

Celiac Trunk = T12
Superior Mesenteric = L1
Inferior Mesenteric = L3

24
Q

List the foregut structures

A

Abdominal part of the oesophagus

Stomach

25
Q

List the midgut structures

A

Small intestine

Ascending colon and 2/3rds transverse colon

26
Q

List the hindgut structures

A

Descending colon

Rectum

27
Q

Name the additional foregut and midgut structures not associated with the gut tube

A

Foregut: Liver, Biliary apparatus, Pancreas, Spleen
Midgut: Appendix

28
Q

How does blood from the abdominopelvic gastrointestinal tract drain blood to the liver?

A

Via the hepatic-portal system

29
Q

The portal vein is formed by the union of which two major veins of the abdominal cavity?

A

Superior Mesenteric vein

Inferior Mesenteric vein

30
Q

How does blood from the gut tube superior to the diaphragm and inferior to the pelvic floor drain?

A

Via the systemic venous system

This means that an anastomosis is present at these watersheds: porto-systemic (portocaval) anastomoses

31
Q

List the 4 sites of portocaval anastomoses in the body

A

In the distal oesophagus
In the rectal veins
Para-umbilical (anterior abdominal wall)
In the colic veins

32
Q

What is the clinical significance of portocaval anastomoses?

A

Cirrhosis of the liver causes portal hypertension.
At sites of anastomoses between portal an systemic veins, portal hypertension produces varicose veins.
These may rupture (haemorrhage).
Bleeding from oesophageal varies at the distal oesophagus is severe and possibly fatal.

33
Q

How does the sympathetic nervous system supply the abdominal viscera?

A

Abdominopelvic splanchnic nerves (greater, lesser and least)
Prevertebral sympathetic ganglia
Abdominal aortic plexuses

34
Q

How does the parasympathetic nervous system supply the abdominal viscera?

A

Anterior and posterior vagal trunks (vagus nerve)

Pelvic splanchnic nerves (S2, S3 and S4)

35
Q

How does parasympathetic innervation affect the GI tract?

A

Increased GI secretion
Increased GI motility or peristalsis
Vasodilation of blood vessels

36
Q

How does the sympathetic innervation affect the GI tract?

A

Decreased GI secretion
Decreased GI motility or peristalsis
Vasoconstriction of blood vessels

37
Q

What is a vagotomy and what effect does it have on gastric secretion?

A

Eliminates the parasympathetic supply from the stomach to the left side of the transverse colon.
Used to treat peptic ulcer disease.
It decreases the production of acid

38
Q

What is the functional difference between the greater, lesser and least splanchnic nerves and the pelvic splanchnic nerves?

A

ask scott

39
Q

What is the chief difference in the arrangement of ganglia in the sympathetic and parasympathetic nervous system?

A

Sympathetic ganglia lie outside the target organ

Parasympathetic ganglia lie within the target organ

40
Q

What is the position of the kidneys?

A

The kidneys lie on the posterior abdominal wall at the level of T12-L3 vertebrae

41
Q

The right kidney lies slightly lower than the left kidney. Why is this?

A

Presence of the liver

42
Q

What is the anterior to posterior arrangement of the structures entering and leaving the hilum of the kidney?

A

Renal vein, Renal artery and then renal pelvis

43
Q

How are the kidneys peritonised?

A

Reteroperitoneum

44
Q

What is the anatomical location of the suprarenal gland, and what type of gland is it?

A

Between the supermodel aspects of the kidneys and the diaphragmatic crura. These are adrenal glands

45
Q

What are the ureters?

A

Muscular ducts carry urine from the kidneys to the urinary bladder

46
Q

What is the term used to describe the expanded upper part of the ureter?

A

The renal pelvis

47
Q

In which three locations is the ureter normally constricted during its course from the kidneys to the urinary bladder?

A

At the junction of the ureters and renal pelvis (pelviuretic junction)

Where the ureters cross the brain of the pelvic inlet

During passage through the wall of the urinary bladder

48
Q

Coeliac trunk gives what branches?

A

Left gastric artery
Splenic artery
Common hepatic artery

49
Q

Common hepatic artery gives what branches?

A

Hepatic artery
Right gastric artery
Gastroduodenal artery

50
Q

Gastroduodenal artery gives what branches?

A

Superior pancreatoduodenal artery

Right gastro-epiploic artery

51
Q

The splenic artery gives which branches?

A

Short gastric arteries
Splenic branches
Left gastro-epiploic artery

GI - A (8 decks)

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