Organization of Abdominopelvic Cavity Flashcards
The fusion of thier visceral peritoneum and mesenteries with the parietal peritoneum of the posterior abdominal wall is called ___________.
Fusion fascia
NOTE: This is a relatively avascular plane that can be easily cleft during surgical procedures.
Peritoneum can extend from the body wall to an organ to another organ. This extension is called ___________.
Peritoneal reflection
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Function of peritoneal reflections
- Support organs and conduct vessels and nerve to organs
_____________ retroperitoneal organs begin embryonic development behind the parietal peritoneum.
Primary
_____________ retroperitoneal organs begin development in an “intraperitoneal” condition, but they later become retroperitoneal.
Secondary
True or false. Intraperitoneal organs are not within the peritoneal cavity.
True
Which organs are secondarily retoperitoneal?
Duodenum, pancreas, ascending and descending colons
NOTE: After the interstines return to the abdominal cavity, some portions press against the posterior abdominal wall and their mesenteries fuse with the parietal peritoneum
The dorsal mesentery of the stomach becomes the _____.
Greater omentum
Hanging from the greater curvature of the stomach, the greater omentum overlies the _________ and _______.
Transverse colon; small intestine
What are the subdivisions of the greater omentum and what organs does each division span between?
-
Gastrophrenic ligament
- Stomach to diaphragm
-
Gastrosplenic ligament
- Stomach to spleen
-
Splenorenal ligament
- Spleen to left kidney
-
Gastrocolic ligament
- Stomach to transverse colon
-
Gastrohepatic *
- Stomach to liver
-
Omental apron
- Freely hands from the transverse colon
The ______ is the portion of the greater omentum that freely hangs from the transverse colon.
Omental apron
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Mesenteries of digestive organs
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Derivatives of the ventral mesentery of foregut
-
Lesser omentum
- Hepatoduodenal ligament
- Hepatogastric ligament
- Falciform ligament
- Visceral peritoneum of the liver
Label
The _________ is a double-layered membrane that gives rise to the falciform ligament, connecting liver to anterior abdominal wall, the visceral peritoneum of the liver, and the lesser omentum.
Ventral mesentary
NOTE: The ventral mesentary is also known as the ventral mesograstrium
Components of the hepatoduodenal ligament
- Hepatic arteries
- Portal vein
- Common bile duct
- Cystic duct
- Hepatic duct
_________________ is the passage of communication between the greater sac and the lesser sac.
Omental forman (a.k.a epiploic foramen)
What are the boundaries of the epiploic foramen?
- Anteriorly- right, free edge of lesser omentum (hepatoduodenal ligament)
- Posteriorly- Inferior vena cava
- Superiorly- Caudate lobe of liver
- Inferiorly- First part of the duodenum
Label
Label
Label 1, 2 and 3
Label
The _________________ are spaces between the colon and the abdominal wall.
Paracolic gutters
Why are the paracolic gutters clinically important?
Allow a passage for infectious fluids from different compartments of the abdomen
The hepatorenal recess is also called the ____________
Pouch of Morison (or Morison’s pouch)
True or false. The hepatorenal recess is filled with fluid in normal conditions.
False
NOTE: The hepatorenal recess is not filled with fluid under normal conditions. However, fluid can collect in this space in circumstances where the abdomen fills with fluid, such as hemoperitoneum
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Digestive glands found in the abdominopervic cavity
Spleen
Liver
Gallbladder
Pancrease
Components of the foregut
Oral cavity- 2nd part of duodenum
Components of the midgut
2nd part of the duodenum- left colic flexure
Components of the hindgut
Left colic flexure- rectum
Branches of the celiac trunk
- left gastric a.
- splenic a.
- short gastric arteries (6)
- splenic arteries (6)
- left gastroepiploic a.
- pancreatic arteries
- common hepatic a.
- right gastric a.
- gastroduodenal a.
- right gastroepiploic a.
- superior pancreaticoduodenal a.
- right hepatic a.
- left hepatic a.
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Major branches of the abdominal aorta
- Celiac trunk
- Superior mesenteric arteries
- Inferior Mesenteric arteries
Branches of the superior mesenteric arteries
- inferior pancreaticoduodenal a.
- jejunal and ileal arteries
- middle colic a.
- right colic a.
- ileocolic a
- anterior cecal a.
- posterior cecal a. – appendicular a.
- ileal a.
- Appendicular artery
Branches of the inferior mesenteric arteries
- left colic a.
- sigmoid arteries (2 or 3)
- superior rectal a.
Digestion in the stomach
- Holds ingested food
- Degrades this food both physically and chemically
- Delivers chyme to the small intestine
- Enzymatically digests proteins with pepsin
- Secretes intristic factor required for absorption of vitaman B12
Innervation and blood supply of the stomach
Innervation: Sympathetic and parasympathetic fibers of the autonomic nervous system
Blood supply: Celiac trunk and corresponding veins
Upper GI Disorders
Parts of the Duodenum
- Superior part
- Descending part
- Inferior part
- Ascending part
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Pyloric stenosis
A narrowing of the opening from the stomach to the first part of the small intestine (the pylorus)
NOTE: Pyloric stenosis is uncommon, but is a cause for “projectile” vomiting in an infant about 3 to 6 weeks of age. Males are affected more than females
Blood supply to the jejunum and ileum
Vasa recta
Arterial arcades
Colic flexures
Right colic flexure (hepatic flexure)
- sharp bend between the ascending colon and the transverse colon
- Receives blood supply from the superior mesenteric artery.
Left colic flexure (splenic flexure)
- sharp bend between the transverse colon and the descending colon.
- watershed region as it receives dual blood supply from the terminal branches of the superior mesenteric artery and the inferior mesenteric artery
- thus making it prone to ischemic damage in cases of low blood pressure because it does not have its own primary source of blood.
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Meckel’s Diverticulum
- Most common congenital abnormality of the same intestine
- Caused by an incomplete obliteration of the vitelline duct
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What is another name for the vitelline duct?
Omphalomesenteric duct
The peritoneam of the liver is a derivative of the ___________.
Ventral mesentary of foregut
What are the components of the peritoneum of the liver?
- Falciform ligament
- Cortonary ligament
- Superior leaf
- Inferior leaf
- Hepatorenal ligament
- Right triangular ligament
- Left triangular ligament
- Lesser Omentum
- Hepatogastric ligament
- Hepatoduodenal ligament
Liver formation
- As the hepatic diverticulum branches into ventral mesentery to form the biliary tree, it extends cranially into the septum transversum
- A layer of tissue between the heart and the midgut that forms part of the diaphragm
- The caudal part of the septum transversum is invaded by the hepatic diverticulum, which divides within it to form the liver and this gives rise to the ventral mesentary of the foregut
REMEMBER: The ventral mesentery is precursor to the lesser omentum, the visceral peritoneum of the liver and the falciform ligament
The connective tissuem or stroma, of the liver develops from the _____________.
Septum transversum
Portacaval anastomoses
- Esophageal
- Paraumbilical
- Retroperitoneal
- Rectal
Label
Veins of abdomical cavity
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Portosystemic anastomoses
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Lower oesophagus
- Portal: Oesophageal branches of left gastric veins
- Systemic: Azygos veins
-
Upper anal canal
- Portal: Superior rectal vein
- Systemic: Middle/ inferior rectal veins
-
Umbilical
- Portal: Veins of ligamentum teres
- Systemic: Superior/ Inferior epigastric veins
-
Bare area of liver
- Portal: Hepatic/portal veins
- Systemic: Infeior phrenic veins
-
Patent ductus venosus
- Portal: Left branch of portal vein
- Systemic: Inferior vena cava
-
Retroperitoneal
- Portal: Colonic veins
- Systemic: Body wall of veins
Caput medusa veins
A cutaneous manifestation of increased portal venous pressure that is a sign of severe portal hypertension
How can caput medusa be treated?
Managing the underlying medical condition, which is most likey cirrhosis or liver cancer
How are caput medusa veins formed?
- Due to shunting of blood from liver circulation to the systemic circulation via the veins surrounding the umbilicus
- Increased liver pressures force the blood to drain through a new route via the paraumbilical veins
- The paraumbilical veins are not naturally equipped to receive such high volumes of blood so they become distended and engorged forming a sunburst pattern of vessels radiating around the umbilicus
Visceral pain, mediated by ___________, results from increased intraluminal pressure and distention caused sudden calculous obstruction of cystic or common duct.
Splanchnic nerve
Exocrine function of the kidneys
- Secretes pancreatic juice which breaks down all categories of foodstuff
- Acini (clusters of secretory cells) contain zymogen granules with digestive enzymes
Endocrine function of the pancreas
Release of insulin and glucagon
Role of the spleen
- Synthesizes antibodies in its white pulp
- Removes antibody-coated bacteria along with antibody-coated blood cells by way of blood and lymph node circulation
- Removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock
- Recycles iron
NOTE: The spleen is a secondary lymphoid organ, but does not have lymph nodes, just nodules
What are the components of the peritoneum of the spleen?
- Gastrosplenic ligament
- Lienorenal (splenorenal) ligament
- Phrenicocolic ligament
NOTE: The spleen develops within the dorsal mesentery of foregut, so it is embedded within the greater omentum, and its adult derivative.