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Anatomy - Block 2 > L5 - Peritoneum > Flashcards

L5 - Peritoneum Flashcards

1
Q

Peritoneum

A

is a continuous, glistening, transparent serous membrane

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2
Q

What is the Parietal Peritoneum?

A

internal lining of the abdominopelvic cavity

Anterolateral

mesothelium, fat, connective tissue

(transversalis facia)

Posterior abdominal wall

mesothelium, connective tissue

(endoabdominal facia), muscles

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3
Q

Visceral peritoneum

A
  • invests the organs

3 types of visceral peritoneum

  • mesenteries
  • omenta
  • ligaments

(all consist of double layer of peritoneum)

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4
Q

What do the layers form?

A

they form the peritoneal sac that encloses the peritoneal cavity

  • the viscera lie outside of the peritoneal cavity
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5
Q

Both the parietal and the visceral peritoneum consist of:

A
  • mesothelium, a simple squamous epithelium
  • small amount of underlying connective tissue

Visceral peritoneum = “serosa”

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6
Q

What is the blood supply and innervation of the Parietal Peritoneum?

A

has the same blood supply

and

same innervation as the body wall

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7
Q

What is the blood supply and innervation of the Visceral Peritoneum?

A

has the same blood supply and innervation as the organs it invests

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8
Q

True or False

Because the visceral peritoneum is thin and very vascular, drugs can be injected intraperitoneally (IP) for rapid delivery

A

True

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9
Q

The mesenteries, omenta, and ligaments are formed by:

A

Visceral Peritoneum

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10
Q

Superior part of abdominopelvic cavity

Upper boundary –

Lower boundary –

A

Upper boundary – thoracic diaphragm

Lower boundary – superior pelvic aperture or pelvic inlet

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11
Q

The abdominal cavity extends to which intercostal space?

What are the contents of the abdominal cavity?

A

Extends to the 4th intercostal space

Peritoneum

Parietal

Lines the cavity

Visceral

Covers viscera

Abdominal viscera

  • Digestive organs
  • Spleen
  • Kidneys
  • Adrenal glands
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12
Q

Peritoneal cavity can be divided into two spaces or sacs, what are they?

A

Greater sac (cavum peritonei)

  • main and larger part of peritoneal cavity

Lesser sac (omental bursa)

  • smaller part of the peritoneal cavity

(posterior to the stomach)

  • allows free movement of the stomach
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13
Q

Lesser sac is also known as

A

Omental Bursa

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14
Q

The greater and lesser sac connect via the

A

Epiploic Foramen

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15
Q

Omental Bursa communicates with Greater sac via

A

Foramen of Winslow

Omental foramen =

Epiploic Foramen =

all three names mean the same thing

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16
Q

An opening situated posterior to the free edge of the lesser omentum forming hepatoduodenal ligament

A

Omental (Epiploic) Foramen

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17
Q

What is the connection between the liver and the stomach?

A

Omental Bursa

(lesser omentum)

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18
Q

What connects the stomach to the transverse colon?

A

Greater Omentum

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19
Q

True or False

The connection of one organ to another in the abdominal cavity is known as the Omentum

A

True

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20
Q

The heptodoudenal ligemnt attaches to

A

Liver and Duodenum

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21
Q

True or False

The lesser omentum is inferior to the greater omentum

A

False

Lesser omentum is Superior to the Greater omentum

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22
Q

Which of these is posterior to the stomach and anterior to the pancreas?

A. Greater Sac

B. Lesser Sac

C. Greater Omentum

D. A and C

A

B. Lesser Sac

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23
Q

What are the two subsections of the lesser omentum?

A

Heptoduodenal Ligament

Heptogastric Ligament

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24
Q

Review

A
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25
Q

Where is the viscera located?

What does the cavity normally contain?

Organs described as peritoneal or intraperitoneal are surrounded or nearly surrounded by

A

Viscera are outside the peritoneal cavity

The cavity normally contains a small amount of serous fluid

visceral peritoneum

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26
Q

What are the retroperitoneal organs covered by?

What happens to the secondary retroperitoneal organs during development as they are pushed against the posterior body wall?

A

Retroperitoneal organs are only covered by peritoneum on their anterior surfaces

Secondary retroperitoneal organs lose their mesenteries during development as they are pushed against the posterior body wall

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27
Q

Identify the Intraperitoneal Organs

A
  • Spleen
  • Duodenum: Superior Part
  • Liver
  • Stomach
  • Transverse Colon
  • Small Intestine

completely covered with visceral peritoneum

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28
Q

Idetify the Primary Retroperitoneal Organs

A

Kidneys

Suprarenal (Adrenal) Glands

peritoneum only on their anterior surface

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29
Q

Identify the secondary Retroperitoneal Organs

A
  • Pancreas
  • Ascending Colon
  • Descending Colon
  • Duodenum

(Descending, Horizontal & Ascending Part)

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30
Q

The esophagus enters at and when it gets to the stomach, the the cardiac orifice enters at

A

T10

T11

31
Q

Which of these are NOT secondarily retroperitoneal?

A. Pancreas

B. Descending Colon

C. Ascending Colon

D. Kidneys

E. Duodenum (Descending, Transverse and Ascending Parts)

A

D. Kidneys

Kidneys are Primary retroperitoneal

(never had mesentery)

32
Q

What is the Cradiac Orfice?

What is the pyloric sphincter?

What is the Gastric rugae?

A

where the esophagus enters the stomach

connects the stomach to the duodenum

allow to expend gastric volume (stomach to expand and move)

33
Q

Foregut

Midgut

Hindgut

A

Foregut

liver, stomach, esophagus

Midgut

small intestines and some of large intestine

Hindgut

large intestine, sigmoid, etc

34
Q

What arteries directly come off the Celiac Trunk?

A

Left Gastric Artery

Splenic Artery

Common Hepatic Artery

35
Q

What branches off of the Splenic Artery?

A

Splenic Artery → Left Gastroepiploic Artery

36
Q

What branches off of the Common hepatic artery?

A

Common Hepatic Artery

→ Gastroduodenal Artery

→ Anterior & Posterior Superior Pancreaticoduodenal Artery

Gastroduodenal Artery turns into the Right Gastroepiploic Artery

37
Q

The Proper hepatic artery comes off of the

A

Common Hepatic artery

Common hepatic artery turns into Proper hepatic artery

38
Q

What comes off of the Proper Hepatic Artery?

A

Proper Hepatic Artery → Right Gastric Artery

Proper Hepatic Artery → Left & Right Hepatic Artery

39
Q

What comes off of the Right Hepatic Artery?

A

Right Hepatic Artery → Cystic Artery

40
Q

Celiac Trunk

Left Gastric Artery (comes off celiac trunk)

Splenic Artery → Left Gastroepiploic Artery

Common Hepatic Artery → Gastroduodenal Artery → Anterior & Posterior Superior Pancreaticoduodenal Artery & Right Gastroepiploic Artery

Proper Hepatic Artery → Right Gastric Artery

Proper Hepatic Artery → Left & Right Hepatic Artery

Right Hepatic Artery → Cystic Artery

A
41
Q

Left & Right Gastric Arteries, as well as Left & Right Gastroepiploic Arteries, form , respectively

A

an anastomosis (cross/connect)

42
Q

True or False

Right Gastro-Omental = Right Gastroepiploic

A

True

43
Q

Splenic artery off the celiac trunk gives off which branch?

A. Gastroduodenal Artery

B. Right Gastric Artery

C. Left Gastroepiploic Artery

D. Left Gastric Artery

A

Left Gastroepiploic Artery

44
Q

Where is the spleen found?

A

Located on left side within the greater sac

It lies against the 9th - 11th ribs

Trauma to the ribs can rupture the spleen causing profuse internal bleeding

45
Q

What type of circulation does the spleen have?

A

Spleen: open and closed circulation

RBC have to make it back quickly to the spleen in order to go back to the heat

(RBC has to be fast and quick)

46
Q

The spleen is an organ

What’s its job?

A

Immune organ

Highly vascular – filters blood

47
Q

Pancreas

-Secondarily Retroperitoneal organ

A

It s an exocrine organ

(within ducts)

  • secretes enzymes in a large volume of fluid into duodenum

and

endocrine organ

(within bloodstream)

  • secretes hormones insulin and glucagon into the blood
48
Q

The head of the pancreas is hugged by what structure?

The tail is by the

A

Duodenum

Spleen

49
Q

The pancreas is to the stomach

A

Posterior

50
Q

The pancreas is exocrine and endocrine in function because of what, respectively?

A

Secretes enzymes into the duodenum;

Secretes insulin and glucagon into the bloodstream

51
Q

Hormonal control of exocrine function by what?

A

enteroendocrine cells in duodenum

enteroendocrine cells in the duodenum regulate the secretion of the enzymes from the pancreas

52
Q

The minor papillae is ________to the major papillae

A

Superior

53
Q

Major Papilla

Minor Papilla

A

Major papilla

opening of the main pancreatic duct and common bile duct

Minor papilla

Site of _drainage of the accessory pancreatic duc_t

54
Q

Hepatopancreatic Ampula

A

Regulates flow of bile and pancreatic juice

55
Q

What can Obstructive Jaundice be caused by?

A
  • Pancreatic Carcinoma
  • Obstruction of Common Bile Duct
56
Q

True or False

Liver AND Pancreas are exocrine only in function

A

False

Liver AND Pancreas are

exocrine and endocrine in function

57
Q

Liver

What supplies deoxygenated blood to the liver?

What supplies oxygenated blood to the liver?

A

Portal Vein - 75%

Hepatic Artery - 25%

central vein – travels alone

58
Q

Exocrine & Endocrine Summary

A

Exocrine:

Pancreas

  • Secretory enzymes into the duodenum

Liver

  • Bile production and storage in gallbladder

Endocrine

Pancreas

  • Production of insulin and glucagon and their release into the bloodstream

Liver

  • Production and release of plasma proteins into the bloodstream
59
Q

Which structure flows through the major papilla?

A

Main Pancreatic Duct & Common Bile Duct

60
Q

True or False

The Liver is:

  • Intraperitoneal (Peritoneal) organ
  • The largest glandular tissue in the body (exocrine and endocrine)
A

True

61
Q

What is the Bare area?

A

Bare area

the site where the original relationship with septum transversum is retained

  • The liver is suspended from the diaphragm by the coronary ligament
62
Q

Coronary ligament suspends the liver from ?

A

the diaphragm

63
Q

What separates the left and right lobe of the liver?

A

Falciform Ligament ​

64
Q

Where is the bile produced and stored?

A

Bile is produced in the LIVER

but

stored in the Gallbladder

65
Q

Common Hepatic Duct + Cystic Duct

A

Common Hepatic Duct + Cystic Duct

→ Common Bile Duct

→ Major Papilla

66
Q

All of the venous drainage from the digestive organs and the spleen enter the to be carried to the liver.

A

portal venous system

67
Q

True or False

The liver has a low regenerative capacity

A

False

The liver has a high regenerative capacity

68
Q

The Liver: Vascular System

Interlobular vessels

travel in triads

(blood directed toward the sinusoids)

  • portal vein 75%

(blood from intestine, spleen, pancreas)

  • hepatic artery 25%

(oxygenated blood to the liver)

central vein – travels alone

(receives blood from the sinusoids)

A
69
Q

Vascular system – blood flow:

A

Vascular system – blood flow:

↑

Inferior vena cava

↑

Hepatic veins

↑

Sublobular and collecting veins

↑

Central vein

↑

Sinusoids

↑

Inlet venules

↑

Portal vein and hepatic artery and their branches

70
Q

Liver Cirrhosis

A

Progressive Hepatocyte Destruction →

Scarring →

Loss of Connections →

Fibrocollagenous Tissue →→→ Chronic Liver Failure

71
Q

Gallbladder

A

Peritoneum completely surrounds the fundus of gallbladder

Gallbladder → Stores Bile

Common Hepatic Duct + Cystic Duct

→ Common Bile Duct

→

72
Q

Gallstones

A

Obstructive Jaundice: Obstruction of Common Bile Duct

Cholecystitis: Obstruction of Cystic Duct

73
Q

Gallbladder: obstructive biliary disease (Obstructive jaundice)

A

First 6 months:

A constant drip of bile

After 6 months:

Good regulation

74
Q

Gallstones

A
  • Twice as likely in female than male
  • can cause severe epigastric or right upper quadrant pain
  • Pain can be referred to right shoulder
  • Large gallstones can cause obstructive jaundice

Anatomy - Block 2 (8 decks)

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