Gross anatomy of the digestive tract - Escobar

Question 1

Peritoneum

Answer 1

Large continuous sheet of serous membrane that stretches around the abdominal cavity, made of mesothelial tissue

Question 2

Parietal Peritoneum

Answer 2

Outer layer of peritoneum covering walls

Question 3

Visceral Peritoneum

Answer 3

Parietal peritoneum extends over organs forming this. (Surrounds organs)

Question 4

Mesentery Peritoneum

Answer 4

Between posterior wall and organ, any double layer connecting to posterior wall is this.

transports vessels / nerves

Question 5

Ligaments and folds

Answer 5

Double layer of peritoneum between organs

Question 6

Omentum

Answer 6

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.

Question 7

Greater Omentum attaches to…

structure:

ligament it forms:

Answer 7

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

Question 8

Lesser Omentum attaches to…

made of 2 parts…

*

Answer 8

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

Question 9

Ligament where we don’t know to put it:

Answer 9

Phrenicocolic ligament. Near spleen. Ligament connects left colic flexure and diaphragm.

Question 10

Peritoneal cavity

Answer 10

space between parietal and all the rest of peritoneal

Question 11

Retroperitoneal structures

*

Answer 11

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.

Question 12

Intraperitoneal organs

*

Answer 12

Liver
Stomach
First part of duodenum
Jejunum / Ileum
Cecum / Appendix
Transverse colon
Sigmoid colon
Spleen

FT JICA SSS

Question 13

Secondarily retroperitoneal *

Retroperitoneal Proper *

Answer 13

ADPR
Ascending / Descending colon, Duodenum (except first part), Pancreas, Upper part of rectum.

SAK
Suprarenal Glands, Abdominal aorta / IVC , Kidneys

Question 14

Esophageal hiatus, where it is located and contents

*

Answer 14

Located in Right crus of diaphragm. Larger, wraps around esophagus. Located at level of T10.

Contents: Esophagus, Vagal trunks, Esophageal vessels.

Question 15

Esophagus enters at:
Stomach starts at:

Answer 15

esophagus enters at T10
Stomach starts at T11, known as cardia.

Question 16

Where is pylorus during supine and standing positions?

Answer 16

Supine: L1
Standing: L2-L4

Question 17

Rugae:

Answer 17

Mucosa folds forming longitudinal ridges directed to the pyloric region

Question 18

Posterior stomach relationships

Answer 18

Diaphragm, spleen, left kidney / adrenal gland, pancreas, transverse colon & mesocolon, splenic vessels, superior mesenteric vessels

Question 19

Peritoneal cavity has 2 subdivisions…

A and B. Where are they located, and how they communicate

Answer 19

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

Question 20

Hepatoduodenal ligament

Answer 20

Vessel where portal triad is.

Question 21

Boundaries of Omental Foramen (epiploic foramen of winslow)

Answer 21

Anterior: Hepatoduodenal ligament (contains portal triad)
Posterior: IVC
Superior: liver
Inferior: duodenum (first part)

Question 22

Duodenum: Clinical Correlation:

Answer 22

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.

Question 23

Where does the jejunum begin?

Where does ileum end?

Answer 23

At L2, at duodenojejunal junction

Ileum ends at the ileocecal (ileocolic) junction (right sacroiliac joint)

Question 24

How do jejunum and ileum attach to abdominal wall

Answer 24

Jejunum and ileum held /attached to posterior of abdominal wall via root of mesentery

Question 25

Where does large intestine begin? Order of structures from start to end.

Answer 25

Starts at right sacroiliac joint -> cecum -> ascending colon -> right colic flexure -> transverse colon -> left colic flexure -> Descending colon -> Sigmoid colon -> rectum

Question 26

3 characteristics of Large intestine:

Answer 26

Taeniae coli: Longitudinal fibers of muscles that groups in 3 bands of large intestine

Haustra of colon: puckers

Omental appendices: fat