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Anatomy Abdomen > Peritoneum and Peritoneal Cavity > Flashcards

Peritoneum and Peritoneal Cavity Flashcards

1
Q

where would you perform a paracentesis

A

RLQ, LLQ
- lateral to rectus sheath to avoid inferior epigastric arteries

or 2 cm below umbillicus

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2
Q

layers you puncture for paracentesis mid clavicular line

A 
Skin
superficial fascia (
external oblique
internal oblique
transversus abdominis
fascia transversalis
extra peritoneal fat 
parietal peritoneum ( STOP)
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3
Q

layers to puncture mid sternally

A 
skin
superficial fascia 
linea alba 
transversals fascia 
extra peritoneal fat
parietal peritoneum (STOP)
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4
Q

greater peritoneal sac

A

extends from diaphragm to pelvic floor

i

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5
Q

lesser peritoneal sac

A

aka omental bursa– lies posterior to stomach and liver

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6
Q

mesentery

A

double layer of peritoneum that encloses an organ and connects it to the abdominal wall (name changes depending on organ involved)

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7
Q

peritoneal ligament

A

double layer of peritoneum that connects an organ to another organ or abdominal wall - contain vessels or remnants of vessels

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8
Q

omentum

A

double layered sheet of peritoneum that attaches the stomach to the abdominal wall or other abdominal organs

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9
Q

lesser omentum *

A

connects the lesser curvature of the stomach to proximal part of the liver
- also referred as hepatogastric ligament (1)
- hepatoduodenal ligament (2)- which has portal triad
-

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10
Q

greater omentum

A

apron
connects stomach with diaphragm spleen and transverse colon
- gastrocolic, gastrosplenic, gastrophrenic

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11
Q

peritoneal recesses

A

blind pouches
retrocecal recess- appendix lies
rectouterine- pouch of douglas

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12
Q

what divides supra and infra colic compartments

A

transverse mesocolon

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13
Q

infra colic compartments creates what, whats the importance**

A

create lateral and medial parabolic gutters ( R and L) separated by the ascending colon ( R) and descending colon (L)

they slope superiorly and posteriorly* so when fluid accumulates the fluid follows the gutters to the superior part of the abdomen when the patient is supine**

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14
Q

communication of greater sac and lesser sac (omental bursa) ***

A

through the omental/ epiploic foramen or the foramen of winslow*
it is posterior to the free edge of the lesser momentum ( hepatoduodenal ligament)

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15
Q

boundaries of the epiploic foramen*

A

anteriorly- the portal triad within the hepatoduodenal ligament
posteriorly - IVC and right crus of diaphragm
superiorly- caudate lobe of liver
inferiorly- superior part of duodenum

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16
Q

contents of portal triad*

A

Portal vein (posteriorly)
proper hepatic artery (left)
common bile duct (right)

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17
Q

peritoneal organs

A

mesentery and enclosed in peritoneum- freey movable

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18
Q

retroperitoneal organs

A

partially covered by peritoneum

immobile

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19
Q

major peritoneal organs *

A 
stomach, liver gallbladder
spleen beginning of duodenum 
tail of pancreas
jejunum, ileum, appendix 
transverse colon
20
Q

major primary retroperitoneal organs *

A

kidneys, adrenals, ureter
aorta, IVC
lower rectum anal canal

21
Q

major secondary retroperitoneal *

A 
most of duodenum
most of pancreas
ascending
descending 
upper rectum
22
Q

foregut* area

A 
ends at second portion of duodenum at sphincter of oddi 
makes:
 esophagus 
stomach 
liver 
gallbladder 
biliary passages
1-2 parts of duodenum 
pancreas
23
Q

midgut* area

A

from second portion of duodenum to proximal 2/3 of transverse colon ( L colic flexure)

Duodenum 2 3 4
jejunum
ileum 
cecum
appendix
transverse colon (proximal 2/3)
24
Q

Hindgut* area

A

distal 1/3 of transverse colon to upper part of anal canal

transverse (distal 1/3)
descending colon
sigmoid colon 
rectum
anal canal
25
Q

Para, symp, and blood supply of foregut*

A

Parasympathethic: Vagus
Sympathetic: Greater Splanchnic T5-T9
blood supply: celiac trunk

26
Q

Para, symp, and blood supply of midgut*

A

parasympathetic: vagus
sympathetic: lesser splanchnic nerve T10-t11
blood supply: SMA (superior mesenteric artery)

27
Q

Para, symp, and blood supply of hindgut*

A

parasympathetic: pelvic splanchnic nerve (s2 s3 s4)
sympathetic: lumbar splanchnic (L1 L2)
blood supply: IMA (inferior mesenteric artery)

28
Q

where does the esophagus enter the stomach*

A

at the cardiac orifice
posterior to the 7th costal cartilage

right border is continuous with lesser curvature of stomach (concave)

left border is separated from the fundus by the cardiac notch (convex)

29
Q

where is the cardiac part of the stomach located*

A

posterior to 7th left cartilage 2-4 cm from medial plane at the level of T11

30
Q

where is the fundus of the stomach located*

A

lies posterior to the 5th rib in the mid clavicular plane

31
Q

location of pyloric sphincter supine *

A

9th CC at level of L1 1.25 cm right of the midline

32
Q

location of pyloric sphincter in erect position*

A

from L2-L4

33
Q

branches of the celiac trunk?*

A

L gastric artery
Common hepatic artery
Splenic artery

34
Q

branches of splenic

A
  • pancreatic branches
  • L gastroomental– greater curvature of stomach
  • short gastric– fundus of stomach
  • splenic - spleen
35
Q

branches of common hepatic

A
  • hepatic proper
  • gastroduodenal a
  • R gastric a
36
Q

R and L gastric veins drain into

A

portal system

37
Q

right gastro omental vein drains into

A

superior mesenteric vein

38
Q

L gastro Omental vein and short gastric veins drains into

A

splenic vein – eventually into portal vein

39
Q

1st part of duodenum* A/ P

A

superior
Anteriorly- liver and gallbladder
posteriorly- bile duct and portal vein

40
Q

2nd part of duodenum

A

descending
lies anterior to renal vessels
the posterior wall receives the main pancreatic duct and common bile duct into the hepatopancreatiic ampulla (ampulla of vader) controlled by hepatopancreatic sphincter (sphincter of oddi)

41
Q

3rd part of duodenum*

A

Horizontal lies anterior to IVC aorta right ureter right gonadal artery

42
Q

what is the suspensory ligament of Treitz*?

A

band that extends from upper aspect of ascending part of duodenum (4th part)
to the right crus of the diaphragm and tissue around the celiac trunk

43
Q

Jejunum and ileum

A

jejunum proximal 2/5 of small intestine
ileum distal 3/5 of small intestine-
enters ascending colon at the iliocolic junction

44
Q

Venous supply of jejunum and ileum*

A

Portal vein is made by: SMV and splenic vein- joined in the posterior aspect of the neck of the pancreas

45
Q

difference of blood supply between jejunum and ileum

A

jejunum has few large loops of arcades and NO lymphoid tissue
ileum has small many loops of arcades and lymphoid

Anatomy Abdomen (5 decks)

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