Gross anatomy of the digestive tract - Escobar Flashcards
Peritoneum
Large continuous sheet of serous membrane that stretches around the abdominal cavity, made of mesothelial tissue
Parietal Peritoneum
Outer layer of peritoneum covering walls
Visceral Peritoneum
Parietal peritoneum extends over organs forming this. (Surrounds organs)
Mesentery Peritoneum
Between posterior wall and organ, any double layer connecting to posterior wall is this.
transports vessels / nerves
Ligaments and folds
Double layer of peritoneum between organs
Omentum
2 or more ligaments continuous together. We have 2 omentums, greater and lesser omentum.
Part of peritoneal sac, it is an apron like fold of it. has 4 layers.
Greater Omentum attaches to…
structure:
ligament it forms:
Attaches to stomach and transverse colon, 4 layers (2 coming down from stomach, 2 from transverse colon). Droops down apron-like forming Gastrocolic ligament
Gastrosplenic ligament : part of omentum going between stomach and spleen (left)
Gastrophrenic ligament : part of omentum going between stomach and diaphragm (top)
theres also a splenorenal ligament, spleen to kidneys
Lesser Omentum attaches to…
made of 2 parts…
*
Attaches to stomach, duodenum, and liver
2 Parts - Hepatoduodenal ligament: part of lesser omentum that goes between Liver and duodenum. Houses portal triad (hepatic artery to left, bile duct to right, portal vein to back)
Hepatogastric ligament: part of lesser omentum that goes between liver and stomach
Ligament where we don’t know to put it:
Phrenicocolic ligament. Near spleen. Ligament connects left colic flexure and diaphragm.
Peritoneal cavity
space between parietal and all the rest of peritoneal
Retroperitoneal structures
*
SAD PUCKER
S: Suprarenal gland (adrenal gland)
A: Aorta and IVC
D: Duodenum (except 1st segment, the 2,3,4 parts)
P: Pancreas
U: Ureters
C: Colon (ascending & Descending)
K: Kidneys
E: Esophagus
R: Rectum
Retro means behind.
Intraperitoneal organs
*
Liver
Stomach
First part of duodenum
Jejunum / Ileum
Cecum / Appendix
Transverse colon
Sigmoid colon
Spleen
FT JICA SSS
Secondarily retroperitoneal *
Retroperitoneal Proper *
ADPR
Ascending / Descending colon, Duodenum (except first part), Pancreas, Upper part of rectum.
SAK
Suprarenal Glands, Abdominal aorta / IVC , Kidneys
Esophageal hiatus, where it is located and contents
*
Located in Right crus of diaphragm. Larger, wraps around esophagus. Located at level of T10.
Contents: Esophagus, Vagal trunks, Esophageal vessels.
Esophagus enters at:
Stomach starts at:
esophagus enters at T10
Stomach starts at T11, known as cardia.
Where is pylorus during supine and standing positions?
Supine: L1
Standing: L2-L4
Rugae:
Mucosa folds forming longitudinal ridges directed to the pyloric region
Posterior stomach relationships
Diaphragm, spleen, left kidney / adrenal gland, pancreas, transverse colon & mesocolon, splenic vessels, superior mesenteric vessels
Peritoneal cavity has 2 subdivisions…
A and B. Where are they located, and how they communicate
Greater and Lesser Sac. Lesser sac is behind liver and stomach, and is AKA omental bursa.
Communicate via epiploic foramen of winslow. deep to portal triad
Hepatoduodenal ligament
Vessel where portal triad is.
Boundaries of Omental Foramen (epiploic foramen of winslow)
Anterior: Hepatoduodenal ligament (contains portal triad)
Posterior: IVC
Superior: liver
Inferior: duodenum (first part)
Duodenum: Clinical Correlation:
Duodenal ulcers mostly in posterior wall of first part of duodenum.
Gastroduodenal artery behind first part of duodenum.
Gallstones may ulcerate and erode gallbladder wall, then perforate the anterior wall of first part of duodenum.
Where does the jejunum begin?
Where does ileum end?
At L2, at duodenojejunal junction
Ileum ends at the ileocecal (ileocolic) junction (right sacroiliac joint)
How do jejunum and ileum attach to abdominal wall
Jejunum and ileum held /attached to posterior of abdominal wall via root of mesentery
