Peritoneal and Vascular Anatomy

Question 1

connections for parietal peritoneum

Answer 1

supplied by ab wall blood vessels, innervated by general sensory (painful), drained by ab wall lymphatics

Question 2

connections for visceral peritoneum

Answer 2

vessels of viscera, innervated by visceral (not painful), visceral lymphatics

often called serosa or mesothelium

Question 3

9 main intraperitoneal organs

Answer 3

stomach, 1st part of duodenum, liver, pancreas tail, spleen, jejunum, ileum, transverse colon, sigmoid

Question 4

retroperitoneal structures- 3 types

Answer 4

urinary: kidneys and adrenals, ureters, bladder
circulatory: aorta, IVC

GI: esophagus, remaining duodenum, pancreas head neck and body, ascending colon, descending colon, rectum

Question 5

fn of greater omentum

Answer 5

covers abdominal viscera, pathway for neurovascular structures and can wrap around inflamed organs to prevent peritonitis

Question 6

major pathway and ligaments of lesser omentum

Answer 6

pathway for portal triad (proper hepatic artery, portal vein, common bile duct)

composed of hepatogastric and hepatoduodenal ligaments (connecting to structure in name)

Question 7

define greater sac, two main compartments

Answer 7

most of peritoneal cavity, from diaphragm to lower ab cavity

supracolic and infracolic compartments

Question 8

3 recesses found in greater sac

Answer 8

subphrenic (suprahepatic)

subhepatic (morrisons pouch)

paracolic recesses (gutters)

Question 9

where is lesser sac

Answer 9

aka omental bursa

behind liver, lesser omentum, stomach

Question 10

omental foramen

Answer 10

opening b/w lesser sac and greater sac, aka foramen of winslow

Question 11

portal triad is w/i…

Answer 11

hepatoduodenal ligament

Question 12

describe mesentery structure

Answer 12

dbl layers of peritoneum, reflect off body wall and enclose viscera, contain blood vessels

Question 13

define peritoneal ligaments

Answer 13

mesentery b/w organs

Question 14

spinal location of gut vasculature

Answer 14

celiac trunk- T12

SMA- L1

IMA- L3

Question 15

3 branches of celiac trunk

Answer 15

common hepatic, splenic, left gastric

Question 16

3 branches of common hepatic

Answer 16

runs along upper border of pancreas, branches near duodenum

proper hepatic, right gastric, gastroduodenal

Question 17

supply targets of common hepatic

Answer 17

liver, gallbladder, stomach, pancreas, part of duodenum

Question 18

describe splenic artery course, branches

Answer 18

tortuous winding course along pancreas to spleen

two branches: short gastric, left gastroepiploic

supplies pancreas, spleen, greater curvature of stomach

Question 19

left gastric course

Answer 19

along lesser curvature, supplies distal esophagus and lesser curvature

Question 20

4 major branches of SMA

Answer 20

middle colic (transverse), right colic (ascending), intestinal arcade, ileocolic (ileum and cecum)

Question 21

3 branches of IMA

Answer 21

left colic (descending), sigmoid, superior rectal

Question 22

3 precursors to portal vein

Answer 22

splenic vein, SMA, IMA

bring nutrients from gut to lliver

Question 23

define porto-caval anastomoses, 3 examples

Answer 23

obstructions in liver or portal vein cause rerouting of blood to systemic

1. left gastric to esophageal and azygos veins
2. paraumbilical to superficial abdominal veins
3. superior rectal to middle and inferior rectal veins

Question 24

cirrhosis connection to porto caval anastamosis

Answer 24

this causes rerouting to caval system, can cause esophageal varices (left gastric), caput medusae (paraumbilical), and hemorrhoids (superior rectal)