Exam 3: Peritoneum Flashcards
Peritoneum
Smooth membrane that lines abdominal cavity
2 types of peritoneum
Parietal and visceral
Parietal peritoneum
Lines abdominal walls
Visceral peritoneum
Covers abdominal organs
Peritoneal cavity
Potential space between parietal and visceral peritoneum
Peritoneal cavity in male
Completely closed sac
What connects parietal to visceral peritoneum
Mesentery
In female, peritoneal cavity communicates w/ exterior through
Uterine tubes
Test for patency of uterine tubes
Dye in uterus, should enter uterine tubes and then peritoneal cavity; if not, obstruction
Functions of peritoneum
Minimize friction
Resist infection
Fat storage
Retroperitoneal organs
Posterior to peritoneum
Duodenum and pancreas are mostly
Retroperitoneal
Innervation of peritoneum
Phrenic Intercostal Subcostal Iliohypogastric Ilioinguinal
Phrenic nerve refers pain to
Shoulder, causes hiccups in peritonitis
Peritoneum that is very sensitive to pain
Parietal
Peritoneum that is insensitive to pain
Visceral
Omenta mean
Apron
Omentum
Broad, apronlike reflection of peritoneum
2 omenta within abdominal cavity
Greater and lesser
Greater omentum connects to
Greater curvature of stomach
Greater omentum reflects posteriorly to attach to
Transverse colon and transverse mesocolon
3 parts of greater omentum
Gastrophrenic lig
Gastrosplenic lig
Gastrocolic lig
Gastrophrenic connects
Greater curvature and diaphragm
Gastrosplenic lig connects
Greater curvature and spleen
Gastrocolic lig connects
Greater curvature and transverse colon
Greater omentum is ____ and adheres to ____
Very mobile; areas of inflammation
Greater omentum adhering to areas of inflammation restricts
Spread of infection
Greater omentum often referred to as
Abdominal policeman
Lesser omentum extends from _____ to ______
Porta hepatis to lesser curvature of stomach
2 parts of lesser omentum
Hepatogastric lig
Hepatoduodenal lig
Hepatogastric lig connects
Liver and lesser curvature
Hepatoduodenal lig connects
Liver and duodenum
“General” definition of mesentery
Any double layer of peritoneum which connects portion of intestine to body wall
“Mesentery proper”
Double layer of peritoneum connects jejunum and ileum to body wall
Mesentery of jejunum and ileum
Suspends jejunum and ileum from posterior body wall
Transmits nerve and vessels
Transverse mesocolon
Connects transverse colon to posterior wall
Sigmoid mesocolon
Connects sigmoid colon to pelvic wall
Mesoappendix
Connects appendix to mesentery of ileum
Phrenicocolic ligament
Attach left colic flexure to diaphragm
Suspends L colic flexure in more superior position that R
Subdivisions peritoneal cavity
Omental bursa (lesser sac) Greater sac
Omental bursa location
Posterior to liver, lesser omentum, and stomach
Omental sac is a closed sac except for
Omental foramen — opening into greater sac
Greater sac extends from
Diaphragm to pelvic floor
Subdivisions of greater sac
Right subphrenic space Left subphrenic space Subhepatic space Right paracolic gutter Left paracolic gutter
Right subphrenic space location
Below diaphragm, above liver, right of falciform lig
Left subphrenic space
Below diaphragm, above stomach, left of falciform lig
Subhepatic space location
Between liver and transverse colon
Recess within subhepatic space
Hepatorenal recess
Hepatorenal recess location
Posterosuperior extension of subhepatic space
Between liver and R kidney
Right paracolic gutter location
Lateral to ascending colon
Left paracolic gutter
Lateral to descending colon
Omental foramen
Opening between omental bursa and greater sac
Structures which pass through porta hepatis
Bile duct (R) Hepatic artery proper (L) Portal vein (behind)
3 independent parts of GI tract embryologically
Foregut
Midgut
Hindgut
Foregut forms
Distal esophagus
Stomach
Part of duodenum
Foregut ends within
2nd part of duodenum (entrance of bile duct)
Midgut begins and ends at
Entrance of bile duct to right 2/3 of transverse colon
Hindgut begins and ends with
Left 1/3 of transverse colon to upper part of anal canal
Foregut blood supply
Branches of celiac trunk
Midgut blood supply
Branches of superior mesenteric artery
Hindgut blood supply
Branches of inferior mesenteric artery
Foregut sympathetic innervation
Greater splanchnic (T5-9) Lesser splanchnic (T10-11)
Midgut sympathetic innervation
Greater splanchnic (T5-9) Lesser splanchnic (T10-11)
Hindgut sympathetic innervation
Lumbar splanchnic nerves (L1-2)
Foregut para sympathetic innervation
Vagus nerve
Midgut parasympathetic innervation
Vagus nerve
Hindgut parasympathetic innervation
Pelvic splanchnic nerves (S2-4)
Sympathetic activation effect on GI tract
Decreases motility and tone
Contracts sphincters
Parasympathetic activation effect on GI tract
Increases motility and tone
Relaxes sphincters
4 major layers of gut wall
Mucosa
Submucosa
Muscularis externa
Serosa/adventitia
Mucosa
Mucous membrane
Innermost layer
Contains muscularis mucosae
Muscularis mucosae
Thin layer of smooth muscle
Submucosa
Loose CT layer
Contains blood vessels and lymphatics
Muscularis externa
Thick layer of smooth muscle
Muscularis externa is responsible for
Peristalsis
2 layers of muscularis externa
Inner circular layer
Outer longitidunal layer
Reverse peristalsis results in
Puking
Serosa
Visceral peritoneum
Adventitia
Covers retroperitoneal organs
Enteric nervous system
Nerves specific to gut
ENS if semi-independent of
CNS
2 parts of ENS
Submucosal plexus
Myenteric plexus
Submucosal plexus location
Within submucosa
Submucosal plexus supplies
Muscularis mucosae and mucus secreting glands
Myenteric plexus location
Between circular and longitudinal layers of muscularis externa
Myenteric plexus supplies
Smooth muscle layers
Myenteric plexus stimulates
Peristalsis