Lecture 3 - Peritoneum & Upper Abdomen

Question 1

Thin, translucent, serous membrane

consists of two continuous layers

Answer 1

The peritoneum consists of two continuous layers: Parietal peritoneum and visceral peritoneum.

Question 2

tend to travel between the peritoneal layers

Answer 2

vessels

Question 3

spleen and stomach : completely covered by visceral peritoneum

Answer 3

Intraperitoneal

Question 4

Organs behind the peritoneum are retroperitoneal

some examples are

Answer 4

kidney, inferior vena cava, aorta

Question 5

all visceral & parietal peritoneal membranes create a

Answer 5

peritoneal sac

Question 6

a potential space within sac
contains only a small amount of serous fluid
allow organs to move freely without friction

Answer 6

peritoneal cavity

Question 7

cavity is within the abdominal cavity and continues into the pelvic cavity. It is a potential space of capillary thinness.

Answer 7

peritoneal cavity

Question 8

attaches to greater curvature of stomach and transverse colon
Drapes over small intestines like an ‘apron’
‘Apron’ = gastrocolic ligament
4 layers of peritoneum

Answer 8

greater omentum

Question 9

functionally it can wall off infections & inflammation sites
results in formation of adhesions

Answer 9

great omentum

Question 10

greater omentum is a derivative from the

Answer 10

dorsal mesentery

Question 11

___= gastrocolic ligament (largest portion) + gastrosplenic ligament and gastrophrenic ligament (to diaphragm)

Answer 11

greater omentum

Question 12

attaches to lesser curvature of stomach and duodenum

2 portions connect these structures to the liver

Answer 12

lesser omentum

-hepatogastric ligament and hepatoduodenal ligament

Question 13

part of lesser omentum,

connects liver to stomach

Answer 13

Hepatogastric ligament

Question 14

part of lesser omentum, connects liver to duodenum

Contains the portal triad

Answer 14

Hepatoduodenal ligament

Question 15

Portal Triad =

Answer 15

hepatic a., portal v., & bile duct

Question 16

Deep to the Lesser Omentum is the __(cavity)

Answer 16

Omental bursa

Question 17

less omentum is a derivatives from the

Answer 17

ventral mesenteries.

Question 18

Anchors most of the small intestine to posterior abd. wall
Runs diagonally from duodenojejunal jxn. to ileocecal jxn.
a distance = 15 to 20 cm in adults

Answer 18

Mesentery Proper

Question 19

Fibromuscular ligament descends from the R. crus of diaphragm; holds distal duodenum in place
Prevents duodenojejunal jxn. from sagging

Answer 19

Suspensory ligament of duodenum (of Treitz)

Question 20

Anchors portions of the colon to the posterior abdominal wall
Ascendingand Descending colon have no mesentery
(attached directly to the posterior wall)
Transverse Colon anchored by____

Answer 20

Double Layered Peritoneum: Mesocolon

transverse mesocolon

Question 21

Transvers mesocolon divides the abdominal cavity into 2 compartments:
_____ – contains stomach, liver and spleen
_______ – contains small intestine and ascending & descending colon.

Answer 21

Supracolic compartment

Infracolic compartment

Question 22

Divides liver into R and L lobes

Anchors liver to diaphragm & anterior body wall

Answer 22

Falciform Ligament

Question 23

border contains the obliterated umbilical vein

Answer 23

round ligament of the liver located at inferior border of liver

Question 24

The left umbilical vein is obliterated after birth and becomes the

Answer 24

ligamentum teres hepatis = round ligament of liver

This then becomes the inferior margin of the falciform ligament.

Question 25

Reflections of peritoneum around the bare area of the liver | Attach liver to inferior surface of diaphragm

Answer 25

Coronary Ligament

Question 26

upper posterior liver

Answer 26

bare area, no peritoneal

Question 27

Potential peritoneal spaces in standing patients Becomes actual spaces in recumbent patients Pathological fluids can accumulate in these recesses

Answer 27

Hepatorenal pouch | Rectovesical or rectouterine pouch

Question 28

the lowest point of the abdominopelvic cavity

Answer 28

hepatorenal recess

Question 29

Bounded by liver, R kidney, colon and duodenum lowest part of peritoneal cavity when recumbent fluids may move down to rectovesical/rectouterine pouch – when in reclining position or sitting up

Answer 29

Hepatorenal Pouch (Pouch of Morrison)

Question 30

Between rectum and bladder (male) another low point of peritoneal cavity when recumbent fluids here may move up to hepatorenal pouch – when in Trendelenburg position

Answer 30

Rectovesical (lowest pouch in male)

Question 31

Between rectum and uterus (♀) another low point of peritoneal cavity when recumbent fluids here may move up to hepatorenal pouch – when in Trendelenburg position

Answer 31

Rectouterine pouch (lowest pouch in female)

Question 32

detoxifies chemical products & produces bile

Answer 32

liver

Question 33

stores bile for emulsification of fats

Answer 33

gallbladder

Question 34

produces enzymes for digestion

Answer 34

pancreas

Question 35

produces lymphocytes & filters blood

Answer 35

spleen

Question 36

how many lobes does the liver have

Answer 36

4

Question 37

Attached to inferior surface of liver Fundus, body, & neck Contacts duodenum, colon & anterior abdominal wall Receives bile produced by liver via bile ducts Bile then drains into duodenum thru these ducts

Answer 37

gallbladder

Question 38

Receives, concentrates and stores bile from the liver

Answer 38

gallbladder

Question 39

The arterial supply is the cystic artery from the right hepatic artery (a branch of the hepatic artery proper.

Answer 39

gallbladder

Question 40

receives bile from R & L lobes of liver

Answer 40

R & L hepatic ducts | of gallbladder

Question 41

receives R & L hepatic ducts

Answer 41

common hepatic duct

Question 42

duct connected to gall bladder

Answer 42

cystic duct

Question 43

receives cystic & common hepatic ducts

Answer 43

common bile duct

Question 44

joins with the pancreatic duct & drains into the descending part of the duodenum at the major duodenal papilla

Answer 44

the common bile duct

Question 45

Common bile duct joins main pancreatic duct Both empty into

Answer 45

major duodenal papilla | in descending part of duodenum

Question 46

Consists of a head, neck, body, tail and uncinate process Retroperitoneal & transverse across posterior abdominal wall Surrounded by C-shaped duodenum on R & spleen on L

Answer 46

pancreas

Question 47

_____ drain from pancreas via 1 or 2 ducts ___enters duodenum with bile duct at major duodenal papilla ____may enter duodenum as well ~ 2 cm superior to major papilla

Answer 47

enzymes Main pancreatic duct Accessory pancreatic duct

Question 48

Pattern of pancreatic drainage is ___

Answer 48

variable

Question 49

contacts diaphragm along ribs 9-11, also contacts stomach, L kidney, pancreas & colon

Answer 49

Diaphragmatic surface of spleen

Question 50

The spleen is connected to the greater curvature of the stomach by the _____ which contains the short gastric and gastro-omental vessels

Answer 50

gastrosplenic ligament

Question 51

the spleen is connected to left kidney by the _____ which contains the splenic vessels. Both these ligaments are parts of the greater omentum.

Answer 51

splenorenal igament

Question 52

The spleen is surrounded by visceral peritoneum except in the area of the ___ on them medial surface of the spleen.

Answer 52

hilum

Question 53

The splenic hilum is the entry point for the ___ and occasionally the tail of the pancreas reaches this area.

Answer 53

splenic vessels

Question 54

The arterial supply of the spleen is the splenic artery from the

Answer 54

celiac trunk.

Question 55

1st major br. of Abd aorta Supplies liver, gb, esophagus, stomach, pancreas & spleen

Answer 55

celiac trunk

Question 56

3 main branches of the celiac trunk

Answer 56

common hepatic a. - L. gastric a.-(supplies lessser curve of stomach) splenic a.-(spleen)

Question 57

``` Right br. of celiac trunk Runs toward liver & gallbladder 2 terminal branches Proper hepatic a. Gastroduodenal a. ```

Answer 57

common hepatic a.

Question 58

Superior br. of common hepatic a. Runs toward liver & medial to bile duct R Gastric a. Splits into R & L hepatic aa

Answer 58

proper hepatic a.

Question 59

Inferior br. of common hepatic a. Runs toward junction of stomach & duodenum sends Supr. pancreaticoduodenal aa. to pancreas/duodenum sends R gastroepiploic a. (R gastro-omental a.) to greater curvature of stomach

Answer 59

gastroduodenal a.

Question 60

branch of gastroduodenal a., and supplies greater curve of stomach

Answer 60

right gastroepiploic a.

Question 61

Superior br. of celiac trunk Runs L toward lesser curvature of stomach supplies stomach & esophagus (via esophageal brs.)

Answer 61

L Gastric A.

Question 62

Left br. of celiac trunk Runs toward spleen supplies pancreas & spleen Sends short gastric aa. & L gastroepiploic a. (L gastro-omental a.) supply greater curvature of stomach

Answer 62

splenic a.