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GIGU Exam 1 > Mesenteries And Abdominal Foregut > Flashcards

Mesenteries And Abdominal Foregut Flashcards

1
Q

What is the parietal peritoneum?

A

Lines the inner surface of the abdominal wall

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2
Q

What is the visceral peritoneum?

A

Covers many of the abdominal organs

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3
Q

True or false: the parietal and visceral peritoneum are continuous with one another

A

True

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4
Q

What are the functions of the peritoneum?

A

Produce peritoneal fluid which lubricates the peritoneum
Minimize friction between abdominal organs
Resists infection by producing Abs, mobilizing leukocytes nad localizing infection

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5
Q

What is a mesentery?

A

A double layered peritoneal membrane that attaches intraperitoneal organs to the abdominal wall
Contains arteries, veins, nerves and lymph supplying these organs
Contains a variable amount of fat

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6
Q

What is a peritoneal ligament?

A

Regional mesenteries connecting one organ with another or connecting an organ to the abdominal wall
Most are named but he organs they connect

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7
Q

What are the peritoneal ligaments?

A

Gastrophrenic, gastrosplenic, gastrohepatic (hepatogastric), hepatoduodenal, gastrocolic, transverse mesocolic, phrenocolic, splenorenal

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8
Q

What is the lesser omentum?

A

Peritoneal ligament connecting the liver to the stomach and 1st part of duodenum
Consists of two parts: hepatoduodenal and hepatogastric ligament

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9
Q

What is the greater omentum?

A

Peritoneal ligament attached to greater curvature of the stomach, 1st part of duodenum and to the transverse colon
Includes the gastrocolic, gastrophrenic and gastrosplenic ligaments
Elongated so it drapes over the anterior surface of the intestines

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10
Q

What is the epiploic foramen?

A

Opening connecting the greater and lesser sac

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11
Q

What is the anterior boundary of the epiploic foramen?

A

Hepatoduodenal ligament

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12
Q

What is the inferior boundary of the epiploic foramen?

A

1st part of duodenum

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13
Q

What is the superior boundary of the epiploic of foramen?

A

peritoneal reflection from liver to IVC

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14
Q

What is the posterior boundary of the epiploic foramen?

A

Peritoneum covering inferior vena cava

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15
Q

Where is the stomach located?

A

Right and left upper quadrants
Left end fixed at level of T10-11
Right end fixed at the level of L1

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16
Q

What are the 4 parts of the stomach?

A

Cardiac, fundus, body, pylorus, including pyloric sphincter

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17
Q

What is the greater curvature of the stomach?

A

Inferior border and site of greater omentum attachment

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18
Q

What is the lesser curvature of the stomach?

A

Superior border and where the lesser omentum attaches

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19
Q

Where is the esophageal hiatus of the stomach located?

A

At the level of T10

Esophagus enters the stomach at the cardiac orifice at level of T11

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20
Q

What separates the esophagus from the fundus of the stomach?

A

Cardiac/cardial notch

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21
Q

What is a hiatal hernia?

A

Protrusion of part of the stomach into the mediastinum through the esophageal hiatus of the diaphragm

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22
Q

What is a para-esophageal hiatal hernia?

A

Less common
Cardia in normal position
Fundus through esophageal hiatus
No regurgitation (cardia in normal position)

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23
Q

What is a sliding hiatal hernia?

A

More common
Cardia and part of fundus through esophageal hiatus
Some regurgitation (cardia superior to diaphragm)

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24
Q

Where is the spleen located?

A

LUQ or left hypochondriac region lying parallel to left ribs 9-11 along the mid axillary line between stomach and diaphragm

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25
Q

Describe the spleen

A

Intraperitoneal organ

Attached to both the gastrosplenic and splenorenal ligaments

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26
Q

Describe the duodenum

A

Begins at pylorus and ends at duodenojejunal junction (level of L2)
Consists of 4 parts

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27
Q

Describe the 1st part of the duodenum

A

Superior duodenum
Intraperitoneal
Travels superior and to the right
Associated with the hepatoduodenal ligament

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28
Q

Describe the 2nd part of the duodenum

A

Descending
Retroperitoneal organ
Openings of the hepatopancreatic duct (bile duct and pancreatic duct) - major and minor duodenal papilla

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29
Q

Describe the 3rd part of the duodenum

A

Horizontal part
Retroperitoneal
Crossed by superior mesenteric artery and vein

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30
Q

Describe the 4th part of the duodenum

A

Ascending part
Retroperitoneal
Joins with jejunum
Suspensory ligament at the duodenojejunal junction (ligament of Treitz)

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31
Q

Describe the sympathetic innervating the foregut

A

Sympathetics from T5-9
From greater splanchnic nerves entering from thorax
Synapse in celiac ganglia and then distributed via vessels

32
Q

Describe the parasympathetics innervating the foregut

A

From anterior and posterior vagal trunks - pierces diaphragm at T10 (CN 10)
Branches directly to organs with others entering celiac plexus and distributed via vessels

33
Q

Where is the liver located?

A

URQ or epigastric and right hypochondriac regions

Left lobe located in left upper quadrant

34
Q

What is the diaphragmatic surface of the liver?

A

Conforms to concavity of the diaphragm
Covered by peritoneum except where it is in direct contact with the diaphragm
IVC in direct contact with this surface

35
Q

What is the visceral surface of the liver?

A

Covered with peritoneum except where gallbladder and porta hepatis are located
Transmits porta hepatis

36
Q

What is the porta hepatis?

A

Transverse fissure on visceral surface

Contains hepatic portal vein, hepatic artery proper, nerve plexus, hepatic bile ducts, and lymph vessels

37
Q

What is cirrhosis?

A

Alcoholic cirrhosis is the most common type
Hepatomegaly and hobnail appearance of liver surface
Resulting from fatty changes and fibrosis

38
Q

Describe the right lobe of the liver

A

Larger than left

Includes quadrate and caudate lobes which are separated by the porta hepatis

39
Q

Where is the caudate lobe located?

A

Between IVC and falciform ligament

40
Q

Where is the quadrate lobe located?

A

Between gallbladder and falciform ligament

41
Q

What separates the left lobe of the liver from the right?

A

The falciform ligament

42
Q

What is the bare area of the liver?

A

In direct contact with the diaphragm

43
Q

What are the coronary ligaments of the liver?

A

Reflection of visceral peritoneum from liver to the respiratory diaphragm
Surrounds bare area of liver

44
Q

What is the falciform ligament?

A

Fold of peritoneum caused by ligamentum teres hepatis/round ligament of liver (remnant of left umbilical vein)

45
Q

What are the ligaments of the liver?

A

Coronary, right and left triangular and falciform ligaments

46
Q

What is the dual blood supply of the hepatic portal?

A

Hepatic artery carrying oxygenated blood from common hepatic artery to liver
Hepatic portal vein carrying venous blood from stomach, intestines, spleen and gallbladder

47
Q

What is the portal triad?

A

Hepatic artery, portal vein and bile duct

48
Q

What is the Pringle maneuver?

A

Pinching of the hepatoduodenal ligament containing the hepatic A to cut off blood supply to the gallbladder after its removal

49
Q

At what level is the pancreas located?

A

Level of L1-2

50
Q

What is located anteriorly to the pancreas?

A

Lesser sac (omental bursa) and stomach

51
Q

What is posterior to the pancreas?

A

Aorta, IVC, splenic vein, common bile duct, right crus of diaphragm, left kidney and vessels, left suprarenal gland, superior mesenteric a/v

52
Q

What is located to the right of the pancreas?

A

Duodenum (2nd part)

53
Q

What is located left of the pancreas?

A

The spleen

54
Q

What is inferior to the pancreas?

A

3rd part of duodenum

55
Q

Where is the head of the pancreas located?

A

Lies in curvature of the duodenum

56
Q

Describe the neck of the pancreas

A

Indistinct
Joins head to body
Overlies superior mesenteric artery

57
Q

Where is the tail of the pancreas located?

A

Within the splenorenal ligaments

It’s tip is adjacent to the hilum of the spleen

58
Q

What is the uncinate process of the pancreas?

A

Adjacent to the head

Superior to third part of the duodenum

59
Q

Describe the gallbladder

A

Stores and releases bile
Attached to liver by CT in liver fossa
Three main parts: body, fundus and neck

60
Q

What is the cystic duct?

A

Connects neck of gallbladder to common hepatic duct

61
Q

What is the blood supply and innervation of the gallbladder?

A

Supplied by cystic A (usually off right hepatic A but varies)
Nerves from celiac plexus

62
Q

What are gallstones?

A

Clinical condition known as cholelithiasis
Composed of cholesterol crystals
Can be lodged in several structures such as the cystic duct, hepatic duct, or the hepatopancreatic ampulla
Blockage of the hepatopancreatic ampulla blocks both common bile duct and main pancreatic duct
Results in bile backing up into pancreas causing pancreatitis

63
Q

What are the hepatic ducts?

A

From right and left hepatic lobes

64
Q

What is the common hepatic duct?

A

Combined hepatic ducts

65
Q

What is the bile duct?

A

Combined cystic and common hepatic duct

66
Q

What is the main pancreatic duct?

A

Begins in tail and courses to the head
Usually joined by accessory duct in the head
Contains the sphincter of the main pancreatic duct which prevents bile from entering the pancreas
Joins common bile duct

67
Q

What is the accessory pancreatic duct?

A

May have a separate opening in the duodenum at the minor duodenal papilla

68
Q

What is the hepatopancreatic ampulla of Vater?

A

Formed by union of common bile duct and main pancreatic duct
Associated with sphincter of Oddi (hepatopancreatic sphincter) and major duodenal papilla

69
Q

What are the branches of the celiac trunk?

A

Common hepatic artery, splenic artery and left gastric A

70
Q

What are the branches of the common hepatic artery?

A

Gastroduodenal artery, right gastric and hepatic artery proper

71
Q

What are the branches of the gastroduodenal artery?

A

Right gastro-omental (gastroepiploic) artery
Superior pancreaticoduodenal artery
Supraduodenal artery

72
Q

What are the branches of hepatic artery proper?

A

Right and left hepatic A

Cystic A

73
Q

What are the branches of the splenic A?

A

Short gastric arteries
Left gastro-omental (gastroepiploic) artery
Pancreatic branches: dorsal pancreatic and great pancreatic artery

74
Q

What are the branches of the left gastric A?

A

Esophageal branch

75
Q

What is the cystohepatic triangle of Calot?

A

Cystic artery arises within it

Borders: cystic duct, common hepatic duct and visceral surface of the liver

GIGU Exam 1 (19 decks)

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