Mesenteries and Foregut

Question 1

What is the difference between parietal and visceral peritoneum?

Answer 1

Parietal lines the inner surface of the wall and visceral covers the organs. They are continuous

Question 2

What is a mesentary?

Answer 2

Double layered peritoneal membrane that attahes intraperitoneal organs to the abdominal wall. Within the mesentary are arteries veins nerves and lymphatics

Question 3

What is lesser omentum?

Answer 3

Made of the hepatoduodenal and hepatogastric ligament. It connects liver to stomach and duodenum

Question 4

What is greater omentum?

Answer 4

Made of Gastrocolic Gastrophrenic and Gastrosplenic ligament. It is a peritoneal ligament attached to the greater curvature of the stomach first part of duodenum and transverse colon

It is elongated so it drapes over anteriro surface of intestines

Question 5

What is the Epiploic Foramen?

Answer 5

Opening connecting the greater and lesser sacs

• Anterior boundary is hepatoduodenal lig
• Inf is 1st part of duodenum
• Superior boundary is peritoneal reflection from liver to IVC
• Posterior is peritoneum covering IVC

Question 6

Where is the stomach located and what are the parts?

Answer 6

Located in RUQ and LUQ

Cardiac fundus body and pylorus greater curvature(inferior border) and Lesser curvature (superior border)

Question 7

What is esophageal hiatus?

Answer 7

Esophageal hiatus is the opening in the diaphragm where esophagus enters stomach at T10

Question 8

Hiatal hernia and subtypes?

Answer 8

• Protrusion of part of stoamch into mediastinum through esophageal hiatus of diaphragm
  
  • Para esophageal less common cardia in normal position fundus though the esophageal hiatus and no regurgitation
  • Sliding is more common cardia nad part of fundus through esophgeal hiatus and some regurgitation

Question 9

Where is spleen located

Answer 9

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

Attaches to gastrosplenic and splenorenal ligaments

Question 10

Describe parts of duodenum

Answer 10

• 1st part: Intraperitoneal, travels superior to right associated with hepatoduodenal ligament
• 2nd: descending, retroperitoneal, openings of hepatopancreatic duct, minor and major duodenal papilla
• 3rd: horizontal, retroperitoneal crossed by superior mesenteric artery and vein
• 4th: ascending, retroperiotneal joins wit hjejunum, suspensory ligement at duodenojejunal junction

Question 11

What innervates the Foregut?

Answer 11

• Sympathetics from T5-9 from the greater splanchnic nerves entering from thorax synapsing in celica ganglia
• Parasympathetic from anterior and posterior vagal trunks, piercing diaphragm at T10
  
  • LARP

Question 12

Describe surfaces of liver

Answer 12

• Diaphragmatic surface: conforms to concavity of diaphragm covered by peritoneum except where there is direct contact with diaphragm, IVC in direct contact
• Visceral surface: covered with periotneum except where gallbladder and porta hepatis are located, transmits porta hepatis
  
  • Porta hepatis is the transverse fisssure on visceral surface containing the hepatic portal cein artery and nerve plexus, hepatic bile ducts and lymph vessels

Question 13

Lobes of liver?

Answer 13

• Right lobe: larger than the left
  
  • Caudate lobe btw IVC and falciform (more posterior)
  • Quadrate lobe btw gallbladder and falciform (more anterior)
• Left lobe: smaller than right and separated from it by falciform ligament

Question 14

What part of the liver is in direct contact with the diaphragm?

Answer 14

Bare area of the liver

Question 15

What are the coronary ligaments?

Answer 15

Reflection of visceral peritoneum from liver to respiratory diaphrgm surrounding bare area of liver

Question 16

What is falciform ligament?

Answer 16

Fold of peritoneum caused by ligamentum teres hepatis/round ligament of liver

Question 17

What is the dual blood supply to the liver>?

Answer 17

• Hepatic artery carrying blood from common hepatic artery to the liver
• Hepatic portal vein carrying blood from stoamch intestines spleen and gall bladder

Question 18

What makes up the portal triad?

Answer 18

Hepatic artery portal vein and common bile duct

Question 19

Describe the relationship between the pancreas and the stomach, duodenum (part2) and spleen?

Answer 19

• anterior
• Right
• Left

Question 20

Relationship btw pancreas and Aorta IVC common bile duct, left kidneyand supierior mesenteric a/v?

Answer 20

Posterior

Question 21

What are the hepatic ducts, common hepatic ducts, bile ducts, and cystic ducts?

Answer 21

• Hepatic ducts from left and r ight hepatic lobes
• Common are combined hepatic ducts
• Cystic is connecting gallbladder to common hepatic duct
• Bile duct is combined cystic and common hepatic duct

Question 22

What is the hepatopancreatic ampulla and where does it open?

Answer 22

Formed by the union of commob bile duct and main pancreatic duct, it is associated with the sphincter of oddi and major duodenal papilla. It opens into the duodenum

Question 23

What are the branches off of the common hepatic artery?

Answer 23

• Gastroduodenal artery
  
  • Gastroepiploic
  • Superior pancreaticoduodenal artery
  • Supraduoudenal artery
• Right gastric
• Hepatic artery proper
  
  • right and left hepatic arteries
  • Cystic artery

Question 24

What are the first second and third branches off of the celiac trunk?

Answer 24

1. Common hepatic
2. Splenic (very tortuous)
3. Left gastric

Question 25

What are the branches off of the splenic artery?

Answer 25

• Short gastric artery
• Gastroepiploic artery
• Pancreatic branches

Question 26

What is the cystic hepatic triangle of Calot?

Answer 26

Cystic artery arises within it and its borders are Cystic duct common hepatic duct visceral surface of the liver