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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
what are mesenteries
peritoneal reflections where the components of the GI tract are stored attach viscera to the abdominal wall conduit for vessels, nerves and lymphatics
26
visceral peritoneum
surrounds the suspended organs
27
parietal peritoneum
lines the abdominal wall
28
dorsal and ventral mesenteries
entire gut tube supported by dorsal mesentery | foregut has a ventral mesentery
29
ventral mesentery
contains the liver split into: falciform ligament - anterior to the liver lesser omentum - posterior to the liver
30
mesenteries in relation to stomach, liver and spleen
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
liver mesenteries
liver develops in ventral foregut mesentery
32
pyloric sphincter
ring of muscle - prevent food entering duodenum | can palpate it
33
internal structure of stomach
rugae - fixed longitudinal folds in mucosa
34
how is the gut tube attached to the abdomen
suspended from the posterior abdominal wall | by peritoneal fold - dorsal mesentery
35
first part of the duodenum
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
2nd part
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
3rd part of the duodenum
``` run L inferior 6-8cm cross L3 crossed anteriorly by superior mesenteric artery and vein ```
38
4th part of duodenum
ascending become continuous with jejunum 5cm L2
39
relations between the duodenum and pancreas
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
position of duodenum and pancreas in abdomen
duodeno-pancreatic block lies anterior to vasculo-renal plane
41
first 2cm of duodenum
intraperitoneal | anterior to bile duct, portal vein and gastroduodenal artery
42
arteries and veins that supply the midgut
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
nerves
sympathetic afferent and efferent from lower thoracic spinal nerves via splanchnic nerves and superior mesenteric ganglia
44
lymphatics
vessels drain the superior mesenteric lymph nodes
45
jejunum
``` proximal 2/5 larger in diameter than ilium upper L quadrant of abdomen less prominent arterial arcades longer vasa recta ```
46
ileum
``` distal 3/5 smaller in diameter lower R quad of abdomen prominent arterial arcades shorter vasa recta ```
47
large intestine
``` cecum - start ascending colon transverse colon descending colon sigmoid colon tenia coli - muscular layer glands locate at epiploicae ```
48
blood supply
blood supplies arise form anterior aorta unpaired arteries coeliac trunk - foregut, panc, liver, spleen superior mesenteric artery - midgut inferior mesenteric artery - hindgut - large
49
branches of the coeliac trunk
L gastric artery splenic artery common hepatic artery
50
branches of superior mesenteric artery
``` middle colic artery R colic artery ileocolic artery ileal artery jejunal arteries ```
51
branches of the inferior mesenteric artery
L colic artery superior rectal artery ssigmoid arteries
52
where is the change from superior mesenteric artery to inferior mesenteric artery supply
left flexure of colon ie change from mid to hind gut
53
venous drainage
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
porto-systemic anastomosis
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
lymphatics
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
innervation
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
thoracic splanchnic nerves
greater splanchnic nerves - T5-9 lesser 10-11 least 12
58
flexures of the colon
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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