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Abdomen > Peritoneum and Abdominal Viscera > Flashcards

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

Some like starch. Take pancakes during parties so people see real unlikeness. Pace unbelievably speedily university-way.

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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
Q

What is the function of the Epiploic Foramen? What is it’s full name?

A

To enable the Greater Sac to communicate with the Lesser Sac

Called Epiploic Foramen of Winslow
or Omental Foramen

26
Q

What is the Lesser Sac also called?

A

Omental Bursa

27
Q

What are the two parts of the Lesser Sac?

A

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
Q

What are the boundaries of the Epiploic Foramen?

A

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
Q

What is a hernia going into the omental bursa? How does it normally enter?

A

Called an internal hernia

Normally enters through the Epiploic Foramen

30
Q

What is the collective name of the Greater and Lesser Omentum?

A

Mesogastrium

31
Q

What does the “mesentary of the small intestine” connect?

A

Connects jejunum and ileum with the Post. Abd. Wall

32
Q

What does the “transverse mesocolon” connect?

A

Connects transverse colon to Post. Abd wall

33
Q

What does the “sigmoid mesocolon” do? And what is its shape?

A

Connects the Sigmoid Colon with the Pelvic Wall

It’s line of attachment forms a V-shaped curve

34
Q

With which parts of the GIT are the Peritoneal Recesses associated?

A

Duodenum
Caecum
Sigmoid colon

35
Q

What are the names of the duodenal recesses and what is the prevalence of hernia in each?

A

Superior Duodenal Recess (50%)

Inferior D. Recess (20%)

Duodenojejuneal Recess (20%).

Retroduodenal and Mesentericoparietal fold of Waldeyer (10%)

36
Q

What are the Peritoneal recesses associated with the Caecum?

A

Superior Ileocaecal
Inferior Ileocaecal
Retrocaecal (appendix frequently herniates here)

37
Q

What are the Peritoneal recesses associated with the Sigmoid Colon

A

Intersigmoid Fossa

This is the inverted V-shaped attachment of the mesosigmoid

The Apex is a surgeon’s guide to Left Ureter

38
Q

What are the recesses in the supracolic region?

A

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
Q

What are the recesses in the infracolic region? What are their relations?

A

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
Q

What are the boundaries of the Rectouterine Pouch of Douglas?

A

Anterior

  • Uterus
  • Posterior fornix of Vagina

Posterior
-Rectum

Floor
-Rectovaginal fold of peritoneum

41
Q

What is found in the Right Hypochondriac Region?

A

Liver and Gall Bladder

Kidney and Suprarenal Gland –RETROPERITONEAL

Colon (at hepatic flexure)

42
Q

What is found in the Epigastric Region?

A

Liver –INTRAPERITONEAL

Transverse colon –INTRAPERITONEAL

Abdominal Aorta –RETROPERITONEAL

Inferior Vena Cava –RETROPERITONEAL

Pylorus and Duodenum (1st part) –INTRAPERITONEAL

43
Q

What is found in the Left Hypochondriac Region?

A

Stomach –INTRAPERITONEAL

Spleen –INTRAPERITONEAL

Kidney and Suprarenal Gland –RETROPERITONEAL

Colon (at splenic flexure)

44
Q

What is found at the Right Lumbar (Right Lateral) region?

A

Kidney –RETROPERITONEAL

Ascending Colon –SEC. RETROPERITONEAL

Small Intestine

45
Q

What is found in the Umbilical Region

A

Transverse colon –INTRAPERITONEAL

Duodenum –RETROPERITONEAL

Pancreas –RETROPERITONEAL

Abdominal Aorta –RETROPERITONEAL

Inferior Vena Cava –RETROPERITONEAL

Small Intestine –INTRAPERITONEAL

Iliac Vessels

46
Q

What is found in the Left Lumbar (Left Lateral)

A

Kidney

Descending colon –SEC. RETROPERITONEAL

Pancreas –RETROPERITONEAL

Small Intestine (jejunum) –INTRAPERITONEAL

47
Q

What is found in the Right Inguinal (Right Iliac) region?

A

Caecum –INTRAPERITONEAL

Appendix –INTRAPERITONEAL

Small Intestine (Ileum) –INTRAPERITONEAL

48
Q

What is found in the Hypogastric Region?

A

Bladder (full in adults and always in infants) –EXTRAPERITONEAL

Uterus (after 12th wk) –INTRAPERITONEAL

Small Intestine –INTRAPERITONEAL HERE

Iliac vessels

Spermatic Cords

49
Q

What is found in the Left Inguinal (Left Iliac) Region?

A

Sigmoid Colon –INTRAPERITONEAL

Small Intestine

50
Q

What are the horizontal planes separating the abdominal regions?

A

Transpyloric Plane

Intertubercular Plane

51
Q

Which Abdominal Structures are found in the Extraperitoneal Region?

A

Bare area of liver

Rectum (lower 1/3)

Bladder (Inferlateral Surface)

52
Q

Which organs are found in the Intraperitoneal Region?

A

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
Q

What are the Retroperitoneal Organs?

A

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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