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anatomy of the abdomen adn pelvis > gut and peritoneal cavity > Flashcards

gut and peritoneal cavity Flashcards

1
Q

what is the peritoneum

A

lines the abdominal cavity
single continuous membrane of squamous epithelium - mesothelium
capillary thin layer - full of fluid - allow organs to slide over each other

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2
Q

what is the abdominal cavity

A

the whole of the abdomen

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3
Q

what is the peritoneal cavity

A

potential space within layer of peritoneum

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4
Q

intraperitoneal structures

A

most of SI

suspended from the abdominal wall by mesenteries

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5
Q

retroperitoneal structures

A 
kidney
ureters
adrenal glands 
lumbar plexus 
sympathetic trunk 
oesophagus 
duodenum - except 1st part 
pancreas except tail 
colon - not transverse 
great vessel
lie between parietal peritoneum and abdominal wall
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6
Q

which of the retroperitoneal organs are secondary

A

duodenum
pancreas
colon

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7
Q

formation of the lesser sac

A

as liver grows it moves to the R and dorsal mesentery and spleen move to the L
original R side of the upper peritoneal cavity is now posterior - this is the lesser sac
lesser sac only in foregut region
it is behind the liver and stomach
behind the lesser omentum`

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8
Q

lesser and greater sac

A

2 regions of the peritoneal cavity

in communication with each other via foramen

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9
Q

peritoneal compartments

A

supracolic compartment - above transverse colon

infracolic compartment - below the transverse colon

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10
Q

gutters in the peritoneal cavity`

A

R and L paracolic gutter

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11
Q

where will absess and inflammatory exudate in the R supracolic cavity travel

A

down R paracolic gutter
then to pelvic area
not to left side because pf falciform ligament `

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12
Q

direction of movement of peritoneal fluid

A

move up to underside of the diaphragm
via gutters
cancer moves up too

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13
Q

great vessels

A

inferior vena cava lies to the R of the abdominal aorta
great veins develop in a plane anterior to the arteries - L renal vein crosses anterior of aorta, R renal artery posterior to IVC

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14
Q

primary retroperitoneal structures

A 
abdominal aorta and branches
IVC 
kidneys and ureters
adrenal glands 
nerves  - lumber plexus from spinal cord and sympathetic trunk
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15
Q

what does primary retroperitoneal mean

A

developed outside the parietal peritoneum

never had a mesentery

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16
Q

greater omentum

A

large peritoneal fold that attaches to greater curvature of the stomach and first part of the duodenum
drapes over transverse colon and jejenum and ileum
posteriorly ascends to adhere to peritoneum on superior surface of te transverse colon and anterior layer of transverse mesocolon before arriving at posterior abdominal wall
contains an accumulation of fat
2 arteries and accompanying veins - R and L gastro-omental vessels between double layer of apron - inferior to greater curvature 0f stomach

from lower part of the dorsal foregut mesentery
double fold
anterior to the intestine

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17
Q

transverse colon mesentery

A

transverse colon is intraperitoneal
mesentery is the transverse mesocolon
it is attached to inferior surface of greater omentum

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18
Q

sigmoid colon mesentery

A

sigmoid mesocolon

at the brim of the pelvis

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19
Q

mesentery of the liver

A

convex surface of liver attached t0 diaphragm and anterior abdominal wall by fold of mesentery - falciform (sickle shaped) ligament

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20
Q

ligamentum teres

A

remains of the umbilical veins

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21
Q

lesser omentum

A

sheet of mesentery that connects inferior surface of liver to lesser curvature of stomach
free edge contains hepatic artery, HPV and bile duct
free edge passes through epiploic foramen to enter a pocket of peritoneal cavity posterior to the stomach
this is the lesser sac of the peritoneal cavity

from the ventral foregut mesentery
contains the portal vein, hepatic artery and bile duct - run between posterior abdominal wall and the lesser omentum
ventral mesentery ends at start of midgut so there is a free edge.

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22
Q

foregut development

A

stomach and beginning of duodenum

develops suspended by dorsal and ventral mesentery

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23
Q

liver development

A

in the ventral mesentery

dividing it into a sheet between liver and gut - the lesser omentum

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24
Q

spleen development

A

develops in proximal part of dorsal foregut mesentery
dividing it into a part between the stomach ang the spleen - the gastrosplenic ligament
and a part between the spleen and posterior abdominal wall - the lieno-renal ligamen

25
Q

what are mesenteries

A

peritoneal reflections where the components of the GI tract are stored
attach viscera to the abdominal wall
conduit for vessels, nerves and lymphatics

26
Q

visceral peritoneum

A

surrounds the suspended organs

27
Q

parietal peritoneum

A

lines the abdominal wall

28
Q

dorsal and ventral mesenteries

A

entire gut tube supported by dorsal mesentery

foregut has a ventral mesentery

29
Q

ventral mesentery

A

contains the liver
split into:
falciform ligament - anterior to the liver
lesser omentum - posterior to the liver

30
Q

mesenteries in relation to stomach, liver and spleen

A

falciform ligament - connects upper surface of liver to the anterior abdominal wall
lesser omentum, separated into gastrohepatic ligament and hepatoduodenal ligament, attach liver to stomach
gastrosplenic ligament - stomach to spleen
splenorenal ligament - spleen to kidneys

31
Q

liver mesenteries

A

liver develops in ventral foregut mesentery

32
Q

pyloric sphincter

A

ring of muscle - prevent food entering duodenum

can palpate it

33
Q

internal structure of stomach

A

rugae - fixed longitudinal folds in mucosa

34
Q

how is the gut tube attached to the abdomen

A

suspended from the posterior abdominal wall

by peritoneal fold - dorsal mesentery

35
Q

first part of the duodenum

A

duodenal cap - most ulcers are here
horizontal R-L from pylorus of stomach to position anterior to R hilum of kidney
5cm long
L1 level

36
Q

2nd part

A

contains entrance for the common bile duct - major duodenal papilla, and pancreatic ducts
descending
7-10cm R of L1-3
root of transverse mesocolon crosses it

37
Q

3rd part of the duodenum

A 
run L 
inferior 
6-8cm 
cross L3 
crossed anteriorly by superior mesenteric artery and vein
38
Q

4th part of duodenum

A

ascending
become continuous with jejunum
5cm
L2

39
Q

relations between the duodenum and pancreas

A

duodenum is G shaped - curled around origen of superior mesenteric artery
head of pancreas lies in curve of duodenum
uncinate process hooks around superior mesenteric artery
neck and body run towards ileorenal ligament
tail of panc reaches hilum of spleen

40
Q

position of duodenum and pancreas in abdomen

A

duodeno-pancreatic block lies anterior to vasculo-renal plane

41
Q

first 2cm of duodenum

A

intraperitoneal

anterior to bile duct, portal vein and gastroduodenal artery

42
Q

arteries and veins that supply the midgut

A

arteries: jejunal or iliac branches of mesenteric artery

jejunal and ileal veins - from the superior mesenteric vein which joins portal vein via the liver

43
Q

nerves

A

sympathetic
afferent and efferent
from lower thoracic spinal nerves via splanchnic nerves and superior mesenteric ganglia

44
Q

lymphatics

A

vessels drain the superior mesenteric lymph nodes

45
Q

jejunum

A 
proximal 2/5 
larger in diameter than ilium 
upper L quadrant of abdomen 
less prominent arterial arcades 
longer vasa recta
46
Q

ileum

A 
distal 3/5 
smaller in diameter
lower R quad of abdomen 
prominent arterial arcades
shorter vasa recta
47
Q

large intestine

A 
cecum - start
ascending colon 
transverse colon 
descending colon 
sigmoid colon 
tenia coli - muscular layer 
glands locate at epiploicae
48
Q

blood supply

A

blood supplies arise form anterior aorta
unpaired arteries
coeliac trunk - foregut, panc, liver, spleen
superior mesenteric artery - midgut
inferior mesenteric artery - hindgut - large

49
Q

branches of the coeliac trunk

A

L gastric artery
splenic artery
common hepatic artery

50
Q

branches of superior mesenteric artery

A 
middle colic artery 
R colic artery 
ileocolic artery
ileal artery 
jejunal arteries
51
Q

branches of the inferior mesenteric artery

A

L colic artery
superior rectal artery
ssigmoid arteries

52
Q

where is the change from superior mesenteric artery to inferior mesenteric artery supply

A

left flexure of colon ie change from mid to hind gut

53
Q

venous drainage

A

drain into the portal vein
superior mesenteric v drain everything supplied by superior mesenteric artery
descending, splenic colon and rectum - inferior mesenteric vein
inferior mesenteric vein drain into splenic vein
spenic vein drains stomach

54
Q

porto-systemic anastomosis

A

systemic vein and portal vein may anastomose when there is a blockahge/high pressure in the portal system - haemorrhoids
severe venous haemorrhage from oesophagus and rectum

55
Q

lymphatics

A

lymphatic drainage follow arterial supply not venous drainage
all lymph drain into cisterna chyli
cysterna chyli - elongated lymphatic sac located in front of L1 and L2 bodies
thoracic duct commences from the cisternae chyli

56
Q

innervation

A

viscera - supplied by autonomic nervous system
sensory fibres important
PNS sensory rate of contraction, peristalsis and secretion of glands- vagus nerves, pelvic splanchnic nerves - S2 S3
sympathetic sensory - pain in duct region, closure of sphincter: thoracic splanchnic T5-12
lumbar splanchnic L1 and 2
would work without oine

57
Q

thoracic splanchnic nerves

A

greater splanchnic nerves - T5-9
lesser 10-11
least 12

58
Q

flexures of the colon

A

the R and l are in contact with lower pole of kidney

root of transverse mesocolon runs across 2nd part of duodenum and along pancreas

anatomy of the abdomen adn pelvis (8 decks)

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