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Peritoneum and Abdominal Viscera Flashcards

1
Q

What is the histological structure of the peritoneum

A

Mesothelium (simple squamous epithelium)

Secretes some serous fluid to lubricate and avoid friction in movements of viscera

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2
Q

What makes up peritoneal fluid

A

Water, Electrolytes and Solvents from intestinal fluid and plasma from adjacent tissues

Proteins

Desquamated mesothelial cells

Macrophages

Fibroblasts

Lymphocytes

When people decide MFL

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3
Q

What is it called when there is an abnormal collection of free fluid in the peritoneal cavity?

A

Ascites

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4
Q

What is the procedure called for draining fluid in the peritoneal cavity

A

Paracentesis abdominis

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5
Q

What is the blood supply of the different parts of the peritoneum?

A

Parietal:

  • Parietal arteries from Inferior Phrenic
  • Lower 6 Intercostal Arteries
  • Lumbar Arteries
  • Obturator Arteries

Visceral:
Normally from vessels that supply the viscera

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6
Q

What is the nerve supply of the different parts of the peritoneum?

A 
Parietal:
-Phrenic nerve
-Lower 6 intercostal
-Lumbar nerves
-Obturator nerves
(NERVES THAT SUPPLY THE WALL)

Viscera:
Abdomen PNS: Vagus N.
Pelvic PNS: Pelvic Splanchnic N.

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7
Q

What is the difference in the embryological germal development of the Parietal and Visceral peritoneum

A

Parietal:
Somatopleuric layer of lateral plate mesoderm

Visceral:
Splanchnic layer of lateral plate mesoderm

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8
Q

What is the “policeman of the abdomen” and why?

A

Greater omentum. Commonly constantly on the move and may adhere to otter peritoneal surfaces around a focus of infection to seal it off and make it remain locaclised.

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9
Q

Where are large amounts of fat stored within the peritoneum?

A 
Peritoneal ligaments
Peritoneal mesentaries (especially greater omentum)
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10
Q

Order of attachments of abdominal peritoneum

A 
Starts at umbilicus (Falciform lig. of ant. abd. wall)
Liver
Stomach
Transverse colon
Pancreas
Duodenum
Post. Abd. Wall
Snall intestine
Post. Abd. Wall
Sigmoid Colon
Rectum
Uterus (females)
Post. fornix of Vagina (females)
Urinary bladder
Seminal vesicles (males)
Umbilicus

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11
Q

What are the attachments of both the lesser and greater omentum

A

Lesser omentum:
Liver to stomach and (proximal 1/2 of 1st part of) duodenum

Greater omentum:
Stomach to Transverse Colon

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12
Q

What are the peritoneal folds from the sides of the bladder to the rectum and sacrum called in males and females?

A 
Males = Rectovesical / Sacrogenital Fold
Females = Retrouterine Fold
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13
Q

What is the peritoneal fold around the uterine tubes called? What does it attach to?

A

Broad Ligament

Attaches the Uterus to the Lateral Abdominal Wall

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14
Q

Give the SHAPE, ATTACHMENTS and CONTENTS of the Falciform Ligament

A

Shape: Sickle-shaped

Attachments:

  • Liver
  • Diaphragm and Supraumbilical Region (of Ant. Abd. Wall)

Contents:
Ligamentum Teres Hepatis (remnant of umbilical vein)

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15
Q

What are the attachments of the Right and Left Triangular Ligaments?

A

Connect Liver to Diaphragm

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16
Q

What are the attachments of the Superior and Inferior Layers of Coronary Ligaments?

A

Both Connect Liver to Diaphragm

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17
Q

What are the attachments of the Gastrophrenic Ligament?

A

Connect the stomach to the diaphragm

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18
Q

What are the attachments of the Splenorenal Ligament? What is it also called?

A

Attaches to Spleen to the Left Kidney.
Also called Lineorenal.
There is only one of them.

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19
Q

What are the attachments of the Gastrosplenic Ligament?

A

Attaches the Stomach to the Spleen

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20
Q

What is the Greater Omentum also called?

A

Gastrocolic Ligament

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21
Q

What is the Lesser Omentum also called?

A

Hepatogastric and Hepatoduodenal Ligament

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22
Q

What are the attachments of the Hepatocolic Ligament?

A

Attaches the Liver to the Right Colic Flexure of the Transverse Colon

23
Q

Where is the Porta Triad located and what are its contents?

A

On the right free edge of the Lesser Omentum

Contents:

  • Portal vein posteriorly
  • Common bile duct (ant. and to rt. of Portal Vein)
  • Hepatic A. (ant. and to lt. of Portal Vein)
24
Q

What are the contents of the Lesser Omentum?

A 
Porta Triad
Hepatic plexus of nerves
Gastric vessels (left and right)
Gastric nerves
Lymphatics
Lymph nodes

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25
What is the function of the Epiploic Foramen? What is it's full name?
To enable the Greater Sac to communicate with the Lesser Sac Called Epiploic Foramen of Winslow or Omental Foramen
26
What is the Lesser Sac also called?
Omental Bursa
27
What are the two parts of the Lesser Sac?
Inferior Recess: Potential space usually cut off from main part of bursa. Located between the umbilical and epigastric region Superior Recess: Extends towards diaphragm posteriorlly to caudate lobe of the liver.
28
What are the boundaries of the Epiploic Foramen?
Anterior: Portal Triad Posterior: Inferior Vena Cava Right crus of diaphragm Superior: Caudate lobe of liver ``` Inferior: Superior part of duodenum Portal vein Hepatic artery Bile duct ```
29
What is a hernia going into the omental bursa? How does it normally enter?
Called an internal hernia Normally enters through the Epiploic Foramen
30
What is the collective name of the Greater and Lesser Omentum?
Mesogastrium
31
What does the "mesentary of the small intestine" connect?
Connects jejunum and ileum with the Post. Abd. Wall
32
What does the "transverse mesocolon" connect?
Connects transverse colon to Post. Abd wall
33
What does the "sigmoid mesocolon" do? And what is its shape?
Connects the Sigmoid Colon with the Pelvic Wall It's line of attachment forms a V-shaped curve
34
With which parts of the GIT are the Peritoneal Recesses associated?
Duodenum Caecum Sigmoid colon
35
What are the names of the duodenal recesses and what is the prevalence of hernia in each?
Superior Duodenal Recess (50%) Inferior D. Recess (20%) Duodenojejuneal Recess (20%). Retroduodenal and Mesentericoparietal fold of Waldeyer (10%)
36
What are the Peritoneal recesses associated with the Caecum?
Superior Ileocaecal Inferior Ileocaecal Retrocaecal (appendix frequently herniates here)
37
What are the Peritoneal recesses associated with the Sigmoid Colon
Intersigmoid Fossa This is the inverted V-shaped attachment of the mesosigmoid The Apex is a surgeon's guide to Left Ureter
38
What are the recesses in the supracolic region?
Right and Left Subphrenic Recess: --directly below the diaphragm Right Subhepatic Space (Morrison's pouch): --Most common site of subphrenic abscess and accumulation of fluid or pus Left subhepatic space: --This is the lesser sac or omental bursa Extraperitoneal suphrenic space - -On the right, it corresponds to 'bare area of the liver' - -On the left, it lies around the Lt. suprarenal gland and upper pole of Lt. kidney
39
What are the recesses in the infracolic region? What are their relations?
Paracolic gutters: - -On right, continuous superiorly with Morrison's Pouch and Omental Bursa - -Continuous inferiorly with rectouterine pouch in females and rectovesical pouch in males.
40
What are the boundaries of the Rectouterine Pouch of Douglas?
Anterior - Uterus - Posterior fornix of Vagina Posterior -Rectum Floor -Rectovaginal fold of peritoneum
41
What is found in the Right Hypochondriac Region?
Liver and Gall Bladder Kidney and Suprarenal Gland --RETROPERITONEAL Colon (at hepatic flexure)
42
What is found in the Epigastric Region?
Liver --INTRAPERITONEAL Transverse colon --INTRAPERITONEAL Abdominal Aorta --RETROPERITONEAL Inferior Vena Cava --RETROPERITONEAL Pylorus and Duodenum (1st part) --INTRAPERITONEAL
43
What is found in the Left Hypochondriac Region?
Stomach --INTRAPERITONEAL Spleen --INTRAPERITONEAL Kidney and Suprarenal Gland --RETROPERITONEAL Colon (at splenic flexure)
44
What is found at the Right Lumbar (Right Lateral) region?
Kidney --RETROPERITONEAL Ascending Colon --SEC. RETROPERITONEAL Small Intestine
45
What is found in the Umbilical Region
Transverse colon --INTRAPERITONEAL Duodenum --RETROPERITONEAL Pancreas --RETROPERITONEAL Abdominal Aorta --RETROPERITONEAL Inferior Vena Cava --RETROPERITONEAL Small Intestine --INTRAPERITONEAL Iliac Vessels
46
What is found in the Left Lumbar (Left Lateral)
Kidney Descending colon --SEC. RETROPERITONEAL Pancreas --RETROPERITONEAL Small Intestine (jejunum) --INTRAPERITONEAL
47
What is found in the Right Inguinal (Right Iliac) region?
Caecum --INTRAPERITONEAL Appendix --INTRAPERITONEAL Small Intestine (Ileum) --INTRAPERITONEAL
48
What is found in the Hypogastric Region?
Bladder (full in adults and always in infants) --EXTRAPERITONEAL Uterus (after 12th wk) --INTRAPERITONEAL Small Intestine --INTRAPERITONEAL HERE Iliac vessels Spermatic Cords
49
What is found in the Left Inguinal (Left Iliac) Region?
Sigmoid Colon --INTRAPERITONEAL Small Intestine
50
What are the horizontal planes separating the abdominal regions?
Transpyloric Plane | Intertubercular Plane
51
Which Abdominal Structures are found in the Extraperitoneal Region?
Bare area of liver Rectum (lower 1/3) Bladder (Inferlateral Surface)
52
Which organs are found in the Intraperitoneal Region?
Stomach Proximal 1/2 of first part of duodenum Jejunum Ileum Appendix Ceacum Transverse colon Sigmoid Colon Rectum (upper 1/3) Liver Spleen Body of Uterus, Fallopian tubes, Ovaries
53
What are the Retroperitoneal Organs?
Rest of Duodenum (proximal 1/2 of first part is intraperitoneal) Rectum (lower 2/3) Kidneys Pancreas Suprarenal glands Ureters Renal vessels Gonadal vessels Ascending and Descending colon (secondarily retroperitoneal - initially intraperitoneal) Abdominal Aorta Inferior Vena Cava Bare area of liver Bladder (inferolateral surface)

Abdomen (10 decks)

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