Peritoneum and Abdominal Cavity Flashcards
3 embryonic divisions of the gut
foregut, midgut, hindgut
adult organs in foregut
esophagus, stomach
liver, gallbladder
pancreas
duodenum (proximal part)
adult organs in midgut
dueodenum (middle and distal parts)
small intestine
cecum, appendix
colon (ascending/proximal transverse)
adult organs in hindgut
transverse colon (distal third)
descending, sigmoid colon
rectum
visceral peritoneum
covers most of abdomincopelvic organs (all of the intraperitoneal organs)
continuous with the parietal peritoneum at the liver’s falciform ligament
innervation of the parietal peritoneum
parietal-same innvervation of abdominal wall (dermatomes), same sensitivities as skin. same somatic afferents. somatic afferents in the dorsal root ganglion.
what is located in the peritoneal cavity
potential space between peritoneal layers. thin film of fluid
what is a mesentery… function?
double folds of peritoneum (not visceral or parietal) that anchor organs in place and provide pathways for neurovascular supply
primary retroperitoneal organs
adrenal glands
kidneys
aorta/IVC
anteriorly covered by peritoneum
intraperitoneal? what organs? are they covered by visceral peritoneum?
organs completely surrounded by visceral peritoneum/
location of greater omentum and function
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)
function and location of lesser omentum
thin connection of the lesser curvature of the stomach and the proximal duodenum to the liver. suspends this from the liver
2 ligaments of the lesser omentum
hepatoduodenal ligament–thickened free edge, containing portal triad
hepatogastricligament–middle, fan like edge.. almost see through
which ligament contains portal triad
hepatoduodenal ligament
what is the portal triad?
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.
what do the coronary ligaments span between? how do they relate to triangular ligaments?
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
embryological origin of the ligamentum teres hepatic? (round ligament of the liver)
obliterated left umbilical vein. forms free border of falciform ligament
what part of the gut does the mesentery proper support?
anchors jejunum and ileum to posterior abdominal wall. highly vascular and contains all nutrients absorbed
what is the difference between greater sac and omental bursa? where are the continuous?
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
what are 2 potential sources of infection or fluid exudate into omental bursa?
perforation of the posterior wall of the stomach. inflamed or injured pancreas–pancreatic-pseudo cyst.
what is the subphrenic recess? what are potential sources of infection is this recess?
superior part of greater sac above the liver and inferior to diaphragm
what are the paracolic gutters? infection can track from peritoneal cavity into what anatomical location via these gutters?
gutters are defined by ascending and descending colons. and split based on the mesentery proper. right illiac fossa or pelvis
innervations of visceral peritoneum
visceral- same innervation of organs, follow sympathetic pathways, less sensitive, usually stretch and chemical irritation)
secondary retroperitoneal organs
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
mnemonic for retroperitoneal space
SAD PUCKER Supradrenal glands (adrenal) Aorta/IVC Duodenum Pancreas Ureters Colon (ascending/descending) Kidneys Esophagus Rectum
mnemonic for secondary retroperitoneal organs
Pancreas, Ascending colon, Descending colon, Duodenum
PADD
three ligaments of the greater omentum and attachments sites
gastrophrenic ligament–stomach to underside of diaphragm
gastrosplenic ligament- greater curvature of stomach to spleen
gastrocolic ligament–stomach to transverse colon
bare area of liver
bounded by the anterior and posterior portions of the liver, large part without peritoneum. allows infection from liver to right pleural cavity.
falciform ligament
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)
mesenteries of the colon
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
Phrenicocolic ligament
flexor of transverse colon= transverse mesocolon
anchor of the transverse colon=phrenicololic ligament (anchor do diaphragm)
omental bursa
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.
two ligaments of spleen that bound the omentum bursa
gastrosplenic ligament
splenorenal ligament
what are the supra colic and infracolic compartments
greater sac is divided into the supra colic and infracolic compartments by the transverse colon.
communication between supracolic and infracolic compartments
communicate more readily ont he right due to partial block of left by phrenicocolic ligament. pass along the paracolic gutters.
what happens if cystic artery is severed during surgery? what structure controls bleeding?
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.
