Peritoneum and Abdominal Cavity

Question 1

3 embryonic divisions of the gut

Answer 1

foregut, midgut, hindgut

Question 2

adult organs in foregut

Answer 2

esophagus, stomach
liver, gallbladder
pancreas
duodenum (proximal part)

Question 3

adult organs in midgut

Answer 3

dueodenum (middle and distal parts)
small intestine
cecum, appendix
colon (ascending/proximal transverse)

Question 4

adult organs in hindgut

Answer 4

transverse colon (distal third)
descending, sigmoid colon
rectum

Question 5

visceral peritoneum

Answer 5

covers most of abdomincopelvic organs (all of the intraperitoneal organs)
continuous with the parietal peritoneum at the liver’s falciform ligament

Question 6

innervation of the parietal peritoneum

Answer 6

parietal-same innvervation of abdominal wall (dermatomes), same sensitivities as skin. same somatic afferents. somatic afferents in the dorsal root ganglion.

Question 7

what is located in the peritoneal cavity

Answer 7

potential space between peritoneal layers. thin film of fluid

Question 8

what is a mesentery… function?

Answer 8

double folds of peritoneum (not visceral or parietal) that anchor organs in place and provide pathways for neurovascular supply

Question 9

primary retroperitoneal organs

Answer 9

adrenal glands
kidneys
aorta/IVC
anteriorly covered by peritoneum

Question 10

intraperitoneal? what organs? are they covered by visceral peritoneum?

Answer 10

organs completely surrounded by visceral peritoneum/

Question 11

location of greater omentum and function

Answer 11

attaches at 2 points on the greater curvature of the stomach, andthe transverse colon, separates viscera from abdominal wall. adhere and prevent infections. moves with transverse colon.
clinically: can fuse together in adults (becomes 4 layers)

Question 12

function and location of lesser omentum

Answer 12

thin connection of the lesser curvature of the stomach and the proximal duodenum to the liver. suspends this from the liver

Question 13

2 ligaments of the lesser omentum

Answer 13

hepatoduodenal ligament–thickened free edge, containing portal triad
hepatogastricligament–middle, fan like edge.. almost see through

Question 14

which ligament contains portal triad

Answer 14

hepatoduodenal ligament

Question 15

what is the portal triad?

Answer 15

hepatic artery proper
hepatic portal vein
common bile duct
The hepatoduodenal ligament is the portion of the lesser omentum extending between the porta hepatis of the liver and the superior part of the duodenum.

Question 16

what do the coronary ligaments span between? how do they relate to triangular ligaments?

Answer 16

coronary ligament is single layered. suspends liver from diaphragm. span between the right and left triangular ligaments. falciform ligament divides liver into right and left lobes

Question 17

embryological origin of the ligamentum teres hepatic? (round ligament of the liver)

Answer 17

obliterated left umbilical vein. forms free border of falciform ligament

Question 18

what part of the gut does the mesentery proper support?

Answer 18

anchors jejunum and ileum to posterior abdominal wall. highly vascular and contains all nutrients absorbed

Question 19

what is the difference between greater sac and omental bursa? where are the continuous?

Answer 19

continous at the epiploic foramen. greater sac is the remainder of abdominal cavity. it is divided into supra colic and infra colic compartments.
contains the subphrenic recess

Question 20

what are 2 potential sources of infection or fluid exudate into omental bursa?

Answer 20

perforation of the posterior wall of the stomach. inflamed or injured pancreas–pancreatic-pseudo cyst.

Question 21

what is the subphrenic recess? what are potential sources of infection is this recess?

Answer 21

superior part of greater sac above the liver and inferior to diaphragm

Question 22

what are the paracolic gutters? infection can track from peritoneal cavity into what anatomical location via these gutters?

Answer 22

gutters are defined by ascending and descending colons. and split based on the mesentery proper. right illiac fossa or pelvis

Question 23

innervations of visceral peritoneum

Answer 23

visceral- same innervation of organs, follow sympathetic pathways, less sensitive, usually stretch and chemical irritation)

Question 24

secondary retroperitoneal organs

Answer 24

begin development in the peritoneal cavity, migrate to retroperitoneal space during development
pancreas ( head, neck, and body, not the tail)
the duodenum (except for the proximal first segment)
ascending and descending portions of the colon

Question 25

mnemonic for retroperitoneal space

Answer 25

SAD PUCKER
Supradrenal glands (adrenal)
Aorta/IVC
Duodenum
Pancreas 
Ureters
Colon (ascending/descending)
Kidneys
Esophagus
Rectum

Question 26

mnemonic for secondary retroperitoneal organs

Answer 26

Pancreas, Ascending colon, Descending colon, Duodenum

PADD

Question 27

three ligaments of the greater omentum and attachments sites

Answer 27

gastrophrenic ligament–stomach to underside of diaphragm
gastrosplenic ligament- greater curvature of stomach to spleen
gastrocolic ligament–stomach to transverse colon

Question 28

bare area of liver

Answer 28

bounded by the anterior and posterior portions of the liver, large part without peritoneum. allows infection from liver to right pleural cavity.

Question 29

falciform ligament

Answer 29

double layer that anchors liver to anterior wall of abdomen, separates right and left lobes, mesentary, free border formed by ligamentum teres (round ligament of the liver)

Question 30

mesenteries of the colon

Answer 30

ascending and descending are retroperitoneal, mesentery is limited to transverse and sigmoid colon +appendix
transverse mesocolon (free edge)
sigmoid mesocolon (free edge, brief mesentery)
mesoappendix

Question 31

Phrenicocolic ligament

Answer 31

flexor of transverse colon= transverse mesocolon

anchor of the transverse colon=phrenicololic ligament (anchor do diaphragm)

Question 32

omental bursa

Answer 32

small cavity. anterior wall is the lesser momentum, left lateral boundary are ligaments of spleen.right communicates with greater sac via epiploic foramen posterior to the hepatoduodenal ligament.

Question 33

two ligaments of spleen that bound the omentum bursa

Answer 33

gastrosplenic ligament

splenorenal ligament

Question 34

what are the supra colic and infracolic compartments

Answer 34

greater sac is divided into the supra colic and infracolic compartments by the transverse colon.

Question 35

communication between supracolic and infracolic compartments

Answer 35

communicate more readily ont he right due to partial block of left by phrenicocolic ligament. pass along the paracolic gutters.

Question 36

what happens if cystic artery is severed during surgery? what structure controls bleeding?

Answer 36

The cystic artery supplies oxygenated blood to the gallbladder and cystic duct. you can compress the right hepatic artery to control the bleeding, or in the triad, the hepatic artery proper.