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SF4 Exam I > Peritoneal Relations > Flashcards

Peritoneal Relations Flashcards

1
Q

what are the layers of the anterior abdominal wall?

A
  1. Skin
  2. Superficial Fascia
    2a. Fatty Layer (Camper’s Fascia)
    2b. Membranous Layer (Scarpa’s Fascia)
  3. Deep (investing) fascia covering muscles
    External Oblique
    Internal Oblique
    Transversus Abdominis
  4. Transversus Fascia
  5. Extraperitoneal Fascia
  6. Parietal Peritoneum
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2
Q

what is the peritoneum?

A

innermost serous membrane that lines the abdominopelvic cavity
encloses the viscera
consists of two continuous layers: visceral and parietal

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3
Q

what layer of peritoneum lines the internal surface of abdominal wall

A

parietal peritoneum

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4
Q

what layer of peritoneum encloses the organs

A

visceral peritoneum

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5
Q

what is the peritoneal cavity? (what is it filled with)

A

potential space b/w parietal and visceral layers

filled only with fluid

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6
Q

difference b/w peritoneal cavity in males and females

A

in males: it is completely closed

in females: opening of uterine tubes creates communication with the outside

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7
Q

what are the subdivisions of the peritoneal cavity

A 
greater sac
lesser sac (omental bursa)
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8
Q

greater sac (what is it, boundaries)

A

main and larger part of peritoneal cavity
begins at diaphragm and continues inferiorly to pelvic cavity
supracolic compartment and infracolic compartment

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9
Q

what is entered when the parietal peritoneum is penetrated (what part of the cavity)

A

greater sac

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10
Q 
lesser sac (omental bursa)
(where is it, boundaries)
A

lies posterior to stomach and adjoining structures

has superior and inferior boundaries called recesses

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11
Q

Superior Recess of Lesser Sac (limits)

A

limited superiorly by the diaphragm and coronary ligament of the liver

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12
Q

Inferior Recess of Lesser Sac (where is it)

A

b/w superior part of the layers of the greater omentum

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13
Q

the greater and lesser sac communicate through what? (aka the site of continuity b/w the compartment)

A

epiploic foramen (omental foramen, foramen of Winslow)

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14
Q 
intraperitoneal organs
(what does this mean)
A

structures that are completely encased in peritoneum
suspended from abdominal wall by the mesenteries
invaginate into the peritoneal cavity

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15
Q 
retroperitoneal organs
(what does this mean)
A

structures that lie outside the peritoneal cavity
only covered by peritoneum on one surface
not suspended in the abdominal cavity
found b/w abdominal wall and parietal peritoneum
two different types: primarily and secondarily

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16
Q

primarily retroperitoneal organs

what does this mean

A

develop and remain between peritoneum and body wall

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17
Q

secondarily retroperitoneal organs (what does this mean)

A

develop within peritoneum but later fuse to body wall

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18
Q

intraperitoneal organs (name them)

A 
stomach
dodenum (1st and 4th parts)
jejunum and ileum
cecum
appendix
transverse colon
sigmoid colon
spleen
liver (except bare area)
gall bladder
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19
Q

primarily retroperitoneal organs (name them)

A 
kidneys
adrenal glands
aorta
inferior vena cava
testes
bladder and ureters
uterus
rectum
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20
Q

secondarily retroperitoneal organs (name them)

A

duodenum (middle)
pancreas
ascending colon
descending colon

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21
Q

what structure forms the median umbilical fold

A

obliterated urachus

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22
Q

what structure forms the medial umbilical folds (both of them)

A

obliterated umbilical arteries

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23
Q

what structure forms the lateral umbilical folds (both of them)

A

inferior epigastric vessels

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24
Q

mesentery (what is it)

A

double layer of peritoneum that suspends viscera from the posterior and part of the anterior body wall
constitute a continuity of visceral and parietal peritoneum
provide mobility for associated viscera

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25
Q

nerves and blood vessels traveling in the mesenteries allows for what?

A

communication between the organ and body wall

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26
Q

Dorsal Mesentery (where does it attach, where is it)

A

attaches viscera to posterior abdominal wall

found in foregut, midgut, and most of hindgut

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27
Q

what are the named parts of the dorsal mesentery

A

greater omentum
“the mesentery” proper
mesocolons

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28
Q

“the mesentery” proper

what is it

A

term used to describe the mystery of jejunum and ileum
large fan-shaped mesentery that attaches the ~20ft of small intestine to a root that spans 15-20cm on posterior abdominal wall

29
Q

mesocolons (what are they, name them)

A 
named mesenteries of different parts of the large intestine
they are:
mesoappendix
transverse mesocolon
sigmoid mesocolon
30
Q

ventral mesentery (what is it, what does it develop in association with, what structures is it limited to)

A 
attaches viscera to anterior abdominal wall
develops in association with the liver
limited to:
terminal esophagus
stomach
and proximal duodenum
31
Q

what forms the peritoneal covering of the liver?

A

ventral mesentery

32
Q

ventral mesentery (named parts)

A

Lesser omentum
Falciform ligament
Coronary ligament
Left and right triangular ligament

33
Q

ligamentum teres is formed from what?

A

obliterated umbilical veins

34
Q

gutters (what are they0

A

channels created by fusion of GI tract to the posterior abdominal wall

35
Q

what provides a pathway for the flow of ascitic fluid and the spread of intraperitoneal infection

A

paracolic gutters

36
Q

Peritoneal Gutters (name them)

A

right lateral (paracolic)
left lateral (paracolic)
right of the mesentery (infracolic)
left of the mesentery (infracolic)

37
Q

Pouches or Recesses (what are they)

A

fossae of peritoneum formed by peritoneal reflections (folds)

38
Q

what determine the extent and direction of the spread of pathological fluids that enter the peritoneal cavity

A

peritoneal recesses

39
Q

Subphrenic Recess

what is it

A

space in the greater sac b.w the diaphragm and liver on either side of the falciform ligament

40
Q 
Hepatorenal Recess (of Morison)
(what is it)
A

part of the greater sac b/w liver (anteriorly) and right kidney and diaphragm (posteriorly)

41
Q

what is the lowest part of the adominopelvic cavity when the patient is laying down

A

hepatorenal recess (of Morison)

42
Q

infection of the pleural cavity is a common associated complication of what and why?

A

Infection of Hepatorenal Recess (of Morison)
infection can be absorbed by diaphragmatic lymphatics in this recess and then the infection can spread via systemic circulation

43
Q

Peritoneal Ligament (what are they)

A

double layer of peritoneum that connects and organ with another organ or the abdominal wall

44
Q

Omenta (what are they)

A

specific peritoneal ligaments of the stomach

pass from stomach and proximal duodenum to adjacent viscera in abdominal cavity or abdominal wall

45
Q

Omenta (name them and what they are derived from)

A

Greater Omentum- dorsal mesentery

Lesser Omentum- ventral mesentery

46
Q

Lesser Omentum (what does it connect)

A

lesser curvature of the stomach and proximal duodenum to the liver

47
Q

Lesser Omentum (named parts and contents)

A

Hepatogastric ligament
Hepatoduodenal Ligament
Contains- portal triad

48
Q

falciform ligament (what does it connect, what does it contain, what is it derived from)

A

connection b/w liver and anterior abdominal wall
from ventral mesentery
free interior margin contains legamentum teres (obliterated umbilical vein)

49
Q

Coronary ligament (what is it derived from, what does it connect)

A

liver to diaphragm

50
Q

Left and right triangular ligaments (what are they derived from, what do they connect)

A

ventral mesentery

liver to diaphragm

51
Q

Greater Omentum (what is it path and connections)

A

dorsal mesentery
fused 4 layer sheet
hangs down like an apron from the greater curvature of the stomach and proximal duodenum
descends and then folds back to attach to the anterior part of the transverse colon and its mesentery

52
Q

Grater Omentum (named parts)

A

Gastrophrenic ligament
Gastrosplenic Ligament
Gastrocolic Ligament

53
Q

Splenorenal ligament (derived from what, what does it connect)

A

dorsal mesentery

spleen to left kidney

54
Q

Phrenicocolic ligament (derived from what and connects what

A

dorsal mesentery

extends from left colic flexure to diaphragm

55
Q

what is the portal triad

A

hepatic artery, bile duct, portal vein

56
Q

Peritonitis (what is it, what causes it)

A

inflammation of peritoneum that occurs form injury or infection
peritoneum secretes fluid and cells in response to trauma, leading to excess fluid accumulation in the peritoneal cavity (ascites)

57
Q

ascites

A

when excess fluid accumulates in peritoneal cavity

58
Q

Peritoneal Adhesions (what are they, what causes them)

A

fibrous bands of scar tissue that form between abdominal organs and walls, joining them together abnormally
caused by inflammation, injury, infection, and most commonly surgery
most do not cause clinical problems, can be associated w/ intestinal obstruction

59
Q

Intra-abdominal infections usually stay where?

A

stay below the diaphragm and do not enter other body cavities

60
Q

the large surface area of the abdomen allows for what (in terms of infection and malignant cells)

A

they can spread easily and rapidly throughout the abdomen

61
Q

anterior boundary of epiploic foramen

A

portal triade in heptoduodenal ligament

62
Q

posterior boundary of epiploic foramen

A

inferior vena cava and right crus of diaphragm

63
Q

superior boundary of epiploic foramen

A

caudate lobe of liver

64
Q

inferior boundary of epiploic foramen

A

first part of duodenum

65
Q

depression lateral to the lateral umbilical fold?

A

lateral inguinal fossa

66
Q

lateral inguinal fossa is the site of?

A

deep lingual ring

indirect hernia

67
Q

why are women at particular risk of infection of the hepatorenal recess?

A

because of open communication b/w fallopian tubes and peritoneal cavity

68
Q

where is the opening of the epiploic foramen

A

lateral edge of hepatoduodenal ligament of the lesser momentum

69
Q

what must be cut for surgical access to lesser sac

A

gastrocolic ligament

SF4 Exam I (16 decks)

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