Peritoneum and Abdominal Contents Flashcards
Boundaries of the peritoneum.
Superior: Diaphragm
Posterior: Muscles of deep back
Lateral: Abdominal muscles
Inferior: Pelvic floor muscles
Two layers of peritoneum.
Parietal - Highly sensitive peritoneal cavity, serous fluid
Visceral - insensitive to touch, temperature, pressure, pain - lacerations
Three main divisions of the peritoneum.
Greater Omentum - the thicker of the 3, significantly more so than mesenteric
Lesser Omentum
Mesenteric - cover all the blood vessels around the superior and inferior mesenteric
Intraperitoneal organs
stomach, liver, gallbladder, most of the small intestine and a portion of the colon (transverse and sigmoid colon); all inside visceral
Retroperitoneal structures.
aorta, inferior vena cava, duodenum, pancreas, adrenal glands, ascending and descending colon, kidneys, ureters, multiple sensory nerves to the abdominal walls (extending to the groin and upper legs), and nerves that regulate bowel control and sexual function
The greater omentum is primarily composed of _______ tissue.
adipose
Ligaments associated with the greater omentum.
Gastro-phrenic ligament, Gastro-splenic ligament, Gastro-colic ligament
Ligaments associated with the lesser omentum.
Hepato-gastric ligament, Hapato-duodenal ligament
Abdominal Ascites
accumulation of fluid in the peritoneal cavity
Boundaries of the omental foramen.
Anteriorly: Hp Duodenal Lig. with portal triad
Posteriorly: IVC, Rt. Crus
Superiorly: liver
Inferiorly: duodenum
Mesentery
double layer of peritoneum, holds organs in place, sites of fat storage, provides a route for circulatory vessels and nerves
Esophageal Constrictions
Cervical
Thoracic (Broncho-aortic: compound)
Diaphragmatic
Cervical constriction.
(15 cm) cricopharyngeus muscle, oblique arytenoid muscles create the first constriction towards the esophagus
Thoracic constriction.
(22cm; 27.5) aorta is deviated to the left side, with a portion that deviates to the midline, creating an aortic compression of the left side of the esophagus, right side and midline compression is from the carina or bronchi
Diaphragmatic constriction.
(40cm) widest and lowest constriction, created as the esophagus penetrates the hiatus and enters the stomach
Valsalva breathing.
allows the diaphragm to move down/inferiorly
Sthenic
average, stomach is somewhat from the epigastric region, deviated into the periumbilical regions, tends to be somewhat long
Hyperasthenic
“heavy bones,” have the shortest gut organs
Asthenic
very slender, tendency to be tall, stomach tends to be elongated
Hyposthenic
slender but not tall, stomach elongated
Four layers of the stomach.
Serosa (outer layer)
Muscularis externa
Submucosa - contains connective tissue
Rugae (ridges) - gastric secretory glands, epithelial lining
Three layers of muscularis externa.
Longitudinal Muscle Layer, Circular Muscle Layer, Oblique Muscle Layer
Stomach irrigation from the celiac trunk.
left gastric, splenic, common hepatic
Left gastric artery.
esophageal branches, branches to the left part of the lesser curvature of the stomach
Splenic artery.
pancreatic branches, short gastric, left gastroepiploic, splenic branches
Common hepatic artery.
Gastroduodenal (superior pancreatic duodenal, right gastroepiploic) Proper hepatic (right gastric, left hepatic, right hepatic - cystic)
This artery supplies the gallbladder.
cystic artery
This area of the stomach is largely responsible for size changes (larger or smaller).
fundus
Sympathetics to the stomach.
Greater Splanchnic N (T5-9) - supplies the stomach, vasoconstriction of vessels and contraction of the stomach, decreasing motility, closing pylorus
Lesser, Least Splanchnic N
Vagus nerve to the stomach.
highest percentage of sensory information of stomach (80% sensory, 20% motor), anterior (left vagus) and posterior (right vagus), vagoplexus form the net of nerves around the esophagus, motor for increasing motility, opening pylorus, initiating secretions