Peritoneum Flashcards

1
Q

Describe embryologic development of peritoneal cavity

A

intermediate mesoderm –> somatic (parietal)+ splanchnic (visceral) mesoderm

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2
Q

what is the space enclosed by the somatic and splanchnic mesoderm?

A

coelom

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3
Q

What passes through the inguinal canal?

A

vaginal process, spermatic cord, round ligament; external pudendal vessels, genital nerve

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4
Q

What passes through vascular lacunae

A

femoral artery and vein, lymphatics, saphenous nerve

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5
Q

What passes thorugh paired slit-like openings dorsal to diaphragm and ventral to psoas muscles?

A

sypmathetic trunck and splanchnic nerves

also air, chlye, peritoneal fluid, other dz processes

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6
Q

What is the Cullen sign?

A

ring of SQ hemorrhage around umbilicus –> from hemoperitoneum or peritonitis

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7
Q

What is a mesentery?

A

wide serous folds by which vessels and nerves reach the organs

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8
Q

Name 3 portions of greater omentum

A

bursal
splenic
veil

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9
Q

What are the boundaries of the epiploic foramen? what part of the greater omentum is it found?

A

dorsal: caudal VC
ventral: portal vein//hepatic artery
Cranial: liver
Caudal: mesoduodenum/celiac artery
Bursal portion

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10
Q

Which of the following is true?
A. The veil portion forms the gastrosplenic ligament
B. Milky spots are a sign of diseased omentum
C. Parts of the lesser omentum –> hepatoduodenal ligament and hepatogastric ligament
D. Normal peritoneal protein concentration is > 3d/dL < 15 g/dL and the colloid osmotic pressure is about 35 mm Hg

A

A. The veil portion contains the left limb of the pancreas (dorsal leaf); splenic portion –> gastrosplenic ligament
B. Milky spots = source of WBC and important for defense
C true
D. < 3 d/dL; 28 mm Hg

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11
Q

What size particles can drain through peritoneal lymphatics?

A

<10 um

bacteria = 0.5-2 um and RBC 7-8 um

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12
Q

What rate of fluid can be absorbed per hour?

A

3-8% of body weight/hr

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13
Q

What is the normal intraabdominal pressure?

A

2-7.5 cm H2O or mean 4.5 cm H2O

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14
Q

Which of the following is true?
A. Renal failure can be caused by intra-abdominal pressures > 20 mm Hg
B. Dogs with MODS have a mortality rate of 70% versus 25% without the syndrome
C. Sclerosing encapsulating peritonitis is an acute reaction to a gossipyboma
D. Alpha-hemolysin is produced by streptococcal organisms and increases patient mortality

A

B true
A. 24 mm Hg or 32.6 cm H2O –> renal failure
C. Chronic response with a “coccoon” layering; humans peritoneal dialysis complications, infectious, chylous
D. a-Hemolysin from E.coli or Baceroides fragilis = toxic to many mammalian cells

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15
Q

What are known adjuvants in peritonitis?

A

gastric mucin
bile salts
hemoglobin
barium

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16
Q

Name causes aseptic periotonitis

A

chemical(abx), peritoneal FB/mechanical, starch granulomatous, sclerosing encapsulating
urine or bile(usually)

17
Q

What volume of fluid can be detected on PE by ballottement?

A

10 ml/kg Body weight