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Anatomy > Peritoneal Cavity, Stomach, And Spleen > Flashcards

Peritoneal Cavity, Stomach, And Spleen Flashcards

1
Q

Abdominopelvic cavity

A

. Abdominal cavity plus pelvic cavity
. Entire space bounded by muscular abdominal wall, diaphragm, and pelvic diaphragm
. Extraperitoneal fat, all abdominal and pelvic viscera, peritoneum, and peritoneal cavity inside it

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2
Q

Peritoneal cavity

A

. Space btw parietal and visceral peritoneum ( thin film watery liquid inside it)
. Space inside peritoneal sac

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3
Q

Parietal peritoneum

A

. Strong, bonded to body wall
. Includes Diaphragmatic peritoneum on inf. Side of diaphragm
. somatic innervation from ventral rami

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4
Q

Visceral peritoneum

A

. Less strong
. Bonded to various viscera (tunica serosa)
. Not sensitive to somatic sensations

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5
Q

Peritoneal cavity allows intraperitoneal viscera to ____

A

Move, change shape and volume freely

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6
Q

As cites

A

. Abnormal accumulation of serous fluid in peritoneal cavity
. Occurs in heart, kidney, and liver failure

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7
Q

Peritonitis

A

. Causes by bacterial infection of peritoneal cavity

. Results in adhesions that cause tanking and necrosis of intestines

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8
Q

Mesentery

A

. Sheet of tissue that suspends structures
. Double layer of peritoneum that begins as extension of visceral peritoneum
. Connects organ to body wall
. Conveys vessels, nerves, and lymph
. Fatty CT btw double layers
. Allows movement of viscera w/o tangling or blocked blood supply
. Include peritoneal ligaments and omenta

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9
Q

Intraperitoneal viscera

A

. Have mesentery
. Not enclosed in mesentery, visceral peritoneal covering is not part of mesentery but is continuous w/ mesenteric peritoneal layers

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10
Q

Extraperitoneal structures

A

. Organ external to peritoneum from viewpoint inside peritoneal cavity

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11
Q

Secondarily retroperitoneal structures

A

. had mesentery at one time but lost it by fusing to abdominal wall and having peritoneum degenerate
. Tunica serosa stuck to paternal peritoneum then both disappeared leaving bare area
. One layer of mesenteric peritoneum stuck to parietal peritoneum and both disappeared leaving single layer of mesenteric peritoneum

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12
Q

Secondarily retroperitoneal viscera

A

. Duodenum (except 1st part)
. Pancreas
. Cecum
. Ascending and descending colon

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13
Q

Primarily retroperitoneal structures

A

. Never had mesentery
. External to parietal peritoneum
. Kidney, ureters, suprarenal glands, abdominal aorta, IVC, urinary bladder, prostate, vagina, rectum

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14
Q

Greater omentum

A

. Gastrophrenic ligament: stomach to diaphragm
. Gastrosplenic (gastro-lienal) ligament: stomach to spleen
. Gastrocolic ligament: stomach to transverse colon
. Omental apron: free flap drooping inf. To transverse colon, often considered part of gastrocolic ligament

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15
Q

Lesser omentum

A

. From liver to lesser curvature of stomach and 1st part of duodenum
. Hepatogastric ligaments
. Hepatoduodenal ligament: contains portal triad

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16
Q

Splenorenal (lieno-renal) ligament

A

. Stomach ligament

. Spleen to parietal peritoneum over left kidney

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17
Q

Subdivisions of peritoneal cavity

A

. Lesser peritoneal sac
. Greater peritoneal sac
. Omental foramen

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18
Q

Lesser peritoneal sac (omental bursa)

A

. Bounded ant. By lesser omentum, stomach, and greater omentum

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19
Q

Greater peritoneal ac

A

. Rest of peritonal cavity

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20
Q

Omental (epiploic) foramen

A

. Also called foramen of Winslow
. Only communication btw greater and lesser sacs
. Bounded by heptoduodenal ligament ant., IVC covered by parietal peritoneum post., liver sup., first part of duodenum inf.

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21
Q

Celiac artery/trunk

A

. Supplies embryological abdominal foregut (spleen, stomach, duodenum, liver, gall bladder and pancreas)
. From abdominal aorta at T12/L1
. Retroperitoneal
. 1-2 cm long
. Passes sup. To upper margin of pancreas

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22
Q

Branches of celiac a.

A

. Common hepatic a.
. Splenic a.
. Left gastric a.

23
Q

Common hepatic a. Branches

A

. Proper and gastroduodenal aa.
. Proper branches into R gastric a. And R and L hepatic aa. (Cystic a. Branches from R hepatic a.)
. Gastroduodenal branches into R gastroepiploic, sup. Pancreaticoduodenal, and superduodenal aa.

24
Q

Splenic a. Branches

A

Pancreatic aa.
Short gastric aa.
Left gastroepiploic a.

25
Q

Left gastric a. Branch

A

Esophageal a.

26
Q

T/F there is a celiac v.

A

F, all drainage to hepatic portal vein then go to liver, hepatic vv., to IVC

27
Q

Branches of hepatic portal v.

A

. Sup. And inf. Mesenteric vv.

. Splenic v.

28
Q

Spleen

A

. Largest lymph organ
. Soft and purplish
. Sharp ant. And sup. Notched borders w/ rounded inf. And post. Borders
. Hilus for entrance and exit of blood

29
Q

Spleen functions

A

. Blood filtration and storage
. Hematopoiesis during fetal development
. Lymphopoiesis

30
Q

Anatomical relations of spleen

A 
. Ant: stomach
. Post: L kidney ad part of diaphragm 
. Inf: L colic flexure and phrenicocolic ligament 
. Lat: diaphragm 
. Med: tail of pancreas and L kidney 
. Lies deep to ribs 9-11
. Doesn’t extend below costal margin
31
Q

Ligaments of spleen

A

. Gastrosplenic (gastrolienal)
. Splenorenal
. Arteries found in these

32
Q

Spleen innervation

A

. Post-ganglionic sympathetic nn. From celiac plexus to blood vessels
. Vasomotor

33
Q

Spleen blood supply

A

Splenic a.

34
Q

Spleen rupture

A

. Easy w/ blow to left upper quadrant because of thin capsule
. May need to be removed
. Remember close relationship to pancreas tail to spleen hilus during removal

35
Q

Accessory spleens

A

. In 10% of people
. 1 cm in diameter
. In hilus, tail of pancreas, gastrosplenic ligment
. Need to look for them is removing spleen because of splenic anemia

36
Q

Esophagus

A

. 23-25 cm long (1.5-2.5 cm in abdominal cavity
. Enters stomach through diaphragmatic opening (esophageal hiatus) that has physiological sphincter
. Enters stomach in cardiac region at cardiac orifice
. Lower esophageal sphincter surrounds cardiac orifice (damage can cause GERD)

37
Q

Stomach curvatures

A

. Lesser: right side, concave, blends w/ esophagus, attachment to lesser omentum
. Greater: left side, convex, junction w/ esophagus via cardiac notch, 4-5x longer than lesser, atttached to ant. Layer of greater omentum

38
Q

Stomach areas

A

. Cardia: around cardiac orifice
. Fundus: bulge sup. To horizontal line drawn to left from cardiac notch, rests against left dome of diaphragm, filled w/ gas on X-ray
. Body (corpus): largest area, below cardia and fundus to vertical line dropped from angular incisure
. Pyloric: below angular incisure line, pyloric antrum (wider area next to body), canal (narrower region leading to pyloric sphincter)

39
Q

. Pyloric sphincter

A

. Junctionof stomach and duodenum
. Anatomical: actual thickening of muscle inf ut wall
. Controls rate of stomach emptying
. Constantly in tonic contraction unless emitting stomach contents

40
Q

Rugae

A

Gross folds of mucosa in stomach

41
Q

Shape of stomach varies according to __

A

. Stature
. State of digestion (lower when full)
. Body position (higher supine, 1-16 cm lower when upright)

42
Q

Stomach functions

A

. Distension, holds 2-3 L, blender and reservoir
. Food enters as bolus, mixes w/ enzymes to form chyme
. Gastric peristalsis moves chyme to intestine
. Empties 2-3 hrs after eating

43
Q

Hiatal hernia

A

. Herniation of fundus of stomach trough esophageal hiatus into thorax

44
Q

Stomach anatomical relations

A

. Ant: diaphragm, liver, ant. Abdominal wall
. Post: stomach bed(diaphragm, spleen, kidney, adrenal, pancreas, transverse mesocyclone)
. Cardiac orifice post. To 7th left costal cartilage 2-4 cm from midline
. Highest point in fundus post. To 5th left rib in midclavicular line
. Pyloric at level of transpyloric line through lower L1 body (L1-3 when supine, L2-4 when erect)

45
Q

Stomach sympathetic preganglionic innervation

A

. From T5-9, coalesces to form greater splanchnic n.

. Synapse in celiac ganglion

46
Q

Stomach sympathetic postganglionic innervation

A

. Fibers carried on branches of celiac a.

. Dec. motility and secretion, vasoconstriction, stimulates pyloric sphincter to stay closed

47
Q

Stomach sympathetic sensory afferent

A

. Carried back to CNS in greater splanchnic n.
. Senses pain and violent contraction
. Referred to epigastric region

48
Q

Stomach parasympathetic innervation

A

. Preganglionic: L/R vagus nn., enters as ant. And post. Vagal trunks tat synapse on wall of stomach in myenteric or submucosal ganglia
. Postganglionic: shooter w/in stomach wall, inc. motility, secretion, vasodilator, inhibits tonic contraction of pyloric sphincter

49
Q

Stomach blood supply to lesser curvature

A

. R gastric a. 9branch of proper hepatic a.)

. L gastric a. (Branch of celiac a.)

50
Q

Stomach blood supply to greater curvature

A

. R gastroepiploic a. (Branch of gastroduodenal)
. L gastroepiploic a. (Branch of splenic a.)
. Short gastric aa. (Branches of splenic a.)

51
Q

Stomach venous drainage

A

. L/R gastric vv. Drain lesser curvature which go into hepatic portal v.
. Prepyloric v. Ascends over pyloric to R gastric v.
. Short gastric, L/R gastroepiploic vv. Drain greater curvature
. R gastroepiploic v. Drains to sup. Mesenteric v.
. L gastroepiploic and short gastric vv. Drain into splenic v.

52
Q

Stomach lymph drainage

A

. Follows arterial pattern

. Abundant along greater and lesser curvatures

53
Q

Vein of Mayo

A

. Area of pyloric sphincter

. Surgical landmark

54
Q

Congenital hypertrophic pyloric stenosis

A

. Enlargement of pyloric sphincter in infants

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