L17 - Abdomical Viscera I Flashcards
What is peritoneum?
- peri = “around” + teino = “to stretch” = stretching around abdominal viscera
- serous membrane that lines the walls of thre abdomucal and pelvic cavities, and covers many organs
- forms a sac that encloses the peritoneal cavity
- has a parietal layer and visceral layer
2 main types of perioneum
- parietal
- visceral
parietal peritoneum
“of walls”
lines:
- inferior surface of diaphragm
- abdomical and pelvic walls
- roof over pelvic viscera
visceral peritoneum
- “of organs”
- covers organs
peritoneal cavity: greater sac
diaphragm -> pelvis
peritoneal cavity: lesser sac
- behind the stomach
- can extend:
- upward: diaphragm
- downward: between layers of greater omentum
- left: spleen
- right: epipoic foramen of Winslow
Epiploic foramen of Winslow
- only natural communication between the greater sac and lesser sac
Epiploic foramen of Winslow: borders
- anterior: free border of Lesser Omentum
- posterior: Infeiror Vena Cava
- superior: Liver (Caudate Lobe)
- inferior: 1st part of Duodenum
Peritoneum - intraperitoneal
- completely covered by peritoneum
- liver, stomach, spleen, jejunum, ileum
Peritoneum - retroperitoneal
- anterior surface covered
- SAD PUCKER
SAD PUCKER
- Suprarenal/adrenal glands
- Abdominal Aorta and Inferior Vena Caca
- Duodenum (parts 2-4)
- Pancreas
- Ureters
- Colon (ascending and descending)
- Kidneys
- Esophagus
- Rectum (proximal 1/3)
Peritoneum innervation - visceral (intraperitoneal)
- visceral afferents
- pain is poorly localized
Peritoneum innervation - parietal (retroperitoneal)
- segmental nerves: overlying skin and muscles (T6-L1)
- phrenic nerves
- pain is well localized
Gut Tube: sections
- foregut: abdominal esophagus to proximal 1/2 of duodenum
- midgut: distal 1/2 of duodenum to proximal 2/3 of transvers Colon
- hindgut: distal 1/3 of transverse colon to proximal anal canal
Foregut structures
- esophagus
- stomach
- liver
- gallbladder
- bile ducts
- pancreas
- proximal duodenum
- celiac trunk
Foregut function
digestion
midgut structures
- distal duodenum
- jejunum
- ileum
- cecum
- appendix
- ascending colon
- proximal 2/3 transverse colon
- superior mesenteric artery (SMA)
midgut function
absorption
hingut structures
- distal 1/3 transverse colon
- descending colon
- sigmoid colon
- upper anal canal
- inferior mesenteric artery (IMA)
hindgut function
removal
Foregut - which arteries come off of hte celiac trunk? (3)
- common hepatic artery
- left gastric artery
- splenic artery
(branch off of the celeiac trunk at the celiac axis)
Midgut - which arteries come off of the superior mesenteric artery (SMA)? (6)
- inferior pancreaticoduodenal artery
- jejunal arteries
- ileal arteries
- middle colic artery
- right colic artery
- ileocolic artery
Hindgut - which arteries come off of the inferior mesenteric artery (1MA)? (3)
- left colic artery
- sigmoidal arteries
- superior rectal artery
Abdomical esophagus - foregut
- mechanical digestion and transfer of bolus to the stomach
- passing through diaphragm (esophageal hiatus (T10), lower esophageal sphincter (LES))
- blood supply: esophageal branch of left gastric artery
What sentence can help you remember where the strctures are on the vertebral column?
“I ate (8) 10 Eggs At 12”
I = inferior vena cava
E = esophagus
A = aorta
Stomach - greater curvature: blood supply
- right and left gastromental arteries
Stomach - lesser curvature: blood supply
- right and left gastric arteries
Stomach - fundus: blood supply
- short gastric arteries
(celiac trunck -> splenic artery -> short gastric artery)
Small intestine: functions
- braking down proteins, lipids, and carbohydrates
- absorption
small intestine
- specialization fo surface area
- pyloric orifice -> ileocecal junction
small intestine - duodenum
- 20-25cm
- 1st part of small intestine
- C-shaped
- mostly retroperitoneal
small intestine - duodenum: parts
- 1: superior (intraperitoneal)
- 2: descending (retroperitoneal)
- 3: inferior/horizontal (retroperitoneal, inferior to the SMA)
- 4: ascending (retroperitoneal)
1st and second part of duodenum are part of the ___ while the 3rd and 4th are part of the _____
- foregut (proximal duodenum)
- midgut (distal duodenum)
blood supply for 1st and second part of duodenum are from the ____ ____ ____ while the 3rd and 4th are from the ____ ____ ____
- superior pancreaticoduodenal arteries
- inferior pancreaticoduodenal arteries
Small intestine: jejunum
- left upper quadrant
- begins at the duodenojejunal flexure
Small intestine: ileum
- right lower quadrant
- ends at the ilececal junction
the blood supply for the jejunum an dileum is found within the ____ ____
mesentery proper
blood supply jejunum and illeum
- superior mesenteric artery –> jejunal arteries and ileal arteries –> arterial arcades –> vasa recta
