Midterm 2: Abdomen Flashcards

1
Q

What is the peritoneum? What are the two layers of peritoneum? What do the 2 layers create?

A

Peritoneum is a serous membrane that lines the abdominal cavity comprised of a supportive layer of connective tissue. The two layers are VISCERAL peritoneum and PARIETAL peritoneum. Visceral peritoneum envelops the organs while the parietal peritoneum lines the interior abdominal cavity. The two layers create the peritoneal cavity lined with mesothelium and contain small amount of fluid called peritoneal fluid.

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2
Q

Peritoneal structures that connect organs to the abdominal wall

A

Peritoneal formations

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3
Q

What is mesentery? Are the organs suspended mobile or immobile? What are the different types of mesentary?

A
  • Extensions of peritoneum from the abdominal wall to certain abdominal organs.
  • Organs suspended by a mesentery are mobile
  • Conveys vasculature and nerves to/from peritoneal organs within abdomen.
  • The different types include mesentery proper, lesser and greater omenta, mesocolon, and peritoneal ligaments.
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4
Q

Function of mesentery proper

A

suspends majority of distal small intestine from posterior abdominal wall

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5
Q

What connects intraperitoneal organs to one another? What are the types? What are their functions?

A

Omenta connects intraperitoneal organs to one another. The two types are the greater and lesser omentum. GREATER omentum connects the greater curvature of the stomach and duodenum to the transverse colon. LESSER omentum connects the liver to the duodenum and lesser curvature of the stomach.

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6
Q

What is the function of the mesocolon?

A

attaches colon to posterior abdominal wall

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7
Q

What are the functions of peritoneal ligaments? What are two peritoneal ligaments and what do they attach to?

A

Peritoneal ligaments attach an intraperitoneal organ to another organ, the abdominal wall, or diaphragm.

Coronary ligament anchors liver to diaphragm
Falciform ligament anchors liver to anterior abdominal wall

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8
Q

What are the 3 abdominal regions going from superior to inferior?

A

Foregut
Midgut
Hindgut

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9
Q

What is the foregut also called? What is it comprised of?

A

Also called the celiac trunk. Comprised of accessory organs of the GI tract like the Liver, Gallbladder, Stomach, Spleen, and Pancreas.

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10
Q

What artery supplies the organs in the midgut with blood? What are the organs in this region?

A

The superior mesenteric artery provides the Small intestine, Appendix, Ascending colon, and Proximal transverse colon with blood in the midgut.

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11
Q

What artery supplies the organs in the hindgut with blood? What are the organs in this region?

A

The inferior mesenteric artery provides the rectum, distal transverse colon, descending colon, and sigmoid part of the colon with blood in the hindgut.

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12
Q

Describe the blood supply in the foregut. Also name the smallest and largest arteries in this area.

A

The left gastric artery is the SMALLEST blood vessel in the foregut and supplies mainly the stomach directly anterior.

The splenic artery is the LARGEST and supplies mainly the spleen, then tail of the pancreas, and left side of stomach.

The common hepatic artery supplies liver, gallbladder, head of pancreas, and right side of stomach. It branches off into the right gastric artery, hepatic proper artery, and gastroduodenal artery.

Right gastric- supplies the lesser curvature region of the stomach.
Hepatic proper artery- supplies the liver and gallbladder.
Gastroduodenal- Supplies stomach, greater curvature region and duodenum nearest the pyloric sphincter and terminates as hepatic proper artery.

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13
Q

What are the 2 venous return systems in the abdominal region?

A

1st System: Renal, pelvis, and lower limbs all drain into the inferior vena cava.

2nd System: Gastrointestinal organs and spleen all drain into the liver which then drains into hepatic portal vein then the inferior vena cava. (portal circulation)

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14
Q

What is portal circulation?

A

Portal circulation is the process of GI organs and the spleen emptying their blood into the portal veins of the liver which then drains into the inferior vena cava.

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15
Q

What organs are found in the 1st venous return system? (6)

A
  • Urinary organs
  • Genital organs
  • Suprarenal glands
  • Abdominal walls
  • Pelvis
  • Lower Limbs
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16
Q

What kind of organs are found in the 2nd venous return system?

A

There are hollow and solid organs found in the 2nd venous return.

The hallow organs consist of the stomach, small intestine, large intestine.

The slid organs consist of the pancreas, liver, gallbladder, and spleen.

17
Q

Boundaries of the abdomen (superior, lateral/anterior walls, posterior wall, inferior)

A

Superior: Diaphragm
Lateral / Anterior walls: Abdominal muscles
Posterior wall: Thoracic and lumbar spine and musculature of abdomen and back
Inferior: Communication with pelvic cavity

18
Q

Describe intraperitoneal organs.

A
  • Outer surface or organs comprised of visceral peritoneum (serosa).
  • Organs suspended by mesentery allowing them to move fairly freely within peritoneal cavity
19
Q

Describe Retroperitoneal (extraperitoneal) organs. Also, Explain secondary retroperitoneal organs.

A
  • Organs and structures not suspended by mesentery.
  • Lie within the area of the abdominal cavity located between the posterior parietal peritoneum and posterior/posterolateral abdominal wall.
  • Organs not as mobile compared to peritoneal organs (because these organs are not suspended by mesentery)
  • “Secondary retroperitoneal” organs are those that were within the peritoneal cavity and had associated mesentery during fetal development, but moved posterior and “lost” their mesentery as it fused to the posterior parietal peritoneum/posterior abdominal wall; these organs are less mobile as a result compared to peritoneal organs
20
Q

Where are Subperitoneal (extraperitoneal) organs found?

A

Area inferior to the peritoneal cavity and within the pelvic cavity

21
Q

Name the 10 intraperitoneal organs. Categorize them by abdominal peritoneal and pelvic peritoneal

A

Abdominal Peritoneal:

  • Stomach
  • Small intestine (jejunum, ileum, portion of superior portion of duodenum)
  • Large intestine (transverse and sigmoid colon)
  • Spleen
  • Liver
  • Gallbladder
  • Cecum with vermiform appendix

Pelvic Peritoneal:

  • Uterus (fungus and body)
  • Suprarenal glands
  • Uterine cervix
22
Q

Name the 14 extraperitoneal organs. Categorize them by retroperitoneal(primarily and secondary) and infraperitoneal/subperitoneal.

A
Retroperitoneal: 
(Primarily): 
-Kidneys and ureters
-Suprarenal glands
-Uterine Cervix

(Secondarily):

  • Duodenum (descending, horizontal, ascending)
  • Ascending and descending colon and cecum
  • Pancreas
  • Upper 2/3 of rectum

Infraperitoneal/ Subperitoneal:

  • Urinary bladder
  • Distal ureters
  • Prostate
  • Seminal vessicles
  • Uterine cervix
  • Vagina
  • Lower 1/3 of rectum
23
Q

What supplies the superior section/cap of the duodenum?

A

From the gastroduodenal and other smaller arteries that all originate from the common hepatic artery

24
Q

List the hallow organs

A

Stomach, Small Intestine, Large Intestine

25
Q

List the solid organs

A

Pancreas, Liver, Gallbladder, Spleen

26
Q

What does the hepatic portal vein directly receive blood from? What organs are associated with each?

A

1) superior mesenteric vein (midgut: small intestine, ascending and proximal ½ of transverse colon)
2) splenic vein (part of foregut: spleen and part of stomach) and gastric vv. (majority of stomach).

27
Q

What does the inferior mesenteric vein get its blood from and what does it drain into? Where does it terminate?

A
  • Hindgut: distal half of transverse and the descending and sigmoid colon; rectum
  • Drains into the splenic vein first prior to its termination soon at the hepatic portal vein
28
Q

Describe the 3 branches of abdominal lymphatics. (Names, where they join and drain to)

A

-right branch, left lumbar branch, and intestinal branch

-Join at cisterna chyli → thoracic duct → left subclavian vein
(left shoulder region; drains into this vein the vast majority of the time)

29
Q

What makes up the lumbar ducts?

A

Gonads, kidneys, hindgut (left lumbar only), bladder and uterus

30
Q

What makes up intestinal ducts?

A

Foregut and midgut organs; spleen

31
Q

Esophagus, Foregut, and Midgut receives parasympathetic innervation via ___________.

A

Vagus (CN X)

32
Q

Describe the celiac plexus, preganglionic lesser splanchnic and what it synapses with

A

Celiac plexus is a branching network of nerves between the two celiac ganglia; the preganglionic lesser splanchnic nerves pass through this network and then synapse inferiorly within the superior mesenteric ganglion with the postganglionic fiber.

33
Q

Where does the sympathetic innervation of the abdominal/ pelvic region pass through?

A

Preganglionic sympathetic to the foregut, midgut, hindgut, urinary and reproductive organs pass through the sympathetic trunk (paravertebral ganglia) and travel to their respective prevertebral ganglia .

(i.e., celiac, superior mesenteric, and inferior mesenteric ganglia – note that these ganglia are proximal to the celiac trunk, superior mesenteric, and inferior mesenteric aa., respectively)

34
Q

Describe the thoracic greater splanchnic nerve. (Autonomic division, sympathetic trunk location, destination ganglion, and what it innervates)

A

Sympathetic
Sympathetic trunk location: Mid-lower thoracic (T5-T9)
Ganglion destination: celiac ganglion
Innervates: Esophagus (gastroesophageal junction) , foregut, midgut (duodenum

35
Q

Describe the thoracic lesser splanchnic nerve. (Autonomic division, sympathetic trunk location, destination ganglion, and what it innervates)

A

Sympathetic
Sympathetic trunk location: Lower thoracic (T10-T11)
Ganglion destination: superior mesenteric ganglion via celiac plexus
Innervates: Midgut

36
Q

Describe the Lumbar splanchnic nerve. (Autonomic division, sympathetic trunk location, destination ganglion, and what it innervates)

A

Sympathetic
Sympathetic trunk location: Upper Lumbar (L1-L2/3)
Ganglion destination: inferior mesenteric ganglion
Innervates: Hindgut

37
Q

Describe the Pelvic splanchnic nerve. (Autonomic division, sympathetic trunk location, destination ganglion, and what it innervates)

A

Parasympathetic
Sympathetic trunk location: Mid-Sacral (S2-S4)
Ganglion destination: Ganglion near organ of innervation
Innervates: Hindgut

38
Q

Major abdominal arterial vasculature

A
  • Abdominal (descending) aorta
  • Parietal and Terminal Branches (typically paired branches)
  • Major visceral branches (ones related to GI tract are UNPAIRED)
    - Celiac trunk
    - Superior mesenteric
    - Inferior mesenteric