Peritoneum and Pleura

Question 1

List the order of the GI tract

Answer 1

1. Stomach
2. Piloric sphincter
3. Duodenum
4. Jejunum
5. Ilium
6. Cecum
7. Ascending colon
8. Transverse colon
9. Tecending colon
10. Sigmoid colon
11. Rectum

(N:261)

Question 2

Where is the appendix?

Answer 2

(N:263)

Located at the junction between the ilium and the cecum

Question 3

Falciform Ligament

Answer 3

In between the liver and the diaphragm

(N:261)

It attaches the liver to the anterior body wall

It is sickle shaped (ie falciform)

Question 4

Ligamentum teres hepatis/round ligament

Answer 4

Degenerative string of tissue that exists in the free edge of the falciform ligament of the liver

Divides the left part of the liver into medial and lateral sections

Question 5

Greater Omentum and Lesser Omentum

Answer 5

Omentum=post natal derivative of mesentery

Greater: Covers the greater curvature of the stomach

Lesser: covers the lesser curvature of the stomach

(N:265)

Question 6

Gastroduodenal Ligament ????? ASK

Answer 6

ASK

Question 7

Medial Umbilical Ligament (?? GO BACK)

Answer 7

Obliterated remnants of the umbilical arteries that returned blood to the placenta in fetal life

Question 8

Median Umbilical Ligament (??ADD)

Answer 8

????

Question 9

Omental Bursa

Answer 9

The omental bursa is the lesser sac which is the cavity in the abdomin that is formed by the lesser and greater omentum

Question 10

Epiploic foramen (In later interval)

Answer 10

Connects the omental bursa to the greater sac

Question 11

Parietal Peritoneum

Answer 11

Serous/friction reducing membrane that forms the lining of the abdopelvic wall

Question 12

Visceral Peritoneum

Answer 12

Serous/friction reducing membrane that surrounds gastrointestinal viscera

Question 13

Transverse Thoracis

Answer 13

Aids in expiration (?). Found on the innermost surface of the thoracic cage originating from the sternum and inserting upon ribs 2-6

Question 14

Innermost Intercostals

Answer 14

Function not known

Question 15

Anterior Intercostal Nerves

Answer 15

Innervates the costal (thoracic wall/rib) parietal pleura

Question 16

Phrenic Nerve

Answer 16

C3,4,5

Innervates diaphragm, mirrored so if you ruin one, have off-sided diaphgram contracted

Question 17

Vagus Nerve

Answer 17

Cranial nerves that wander all the way through the thorax and most of the abdomin to provide a major source of parasympathetic innervation (innervates heart, lungs, and most of GI tract)

Question 18

Internal Thoracic Artery and Vein

Answer 18

Is the medial source of blood to the breast

Extends down to become the superior epigastric artery

Question 19

Anterior intercostal arteries and veins ???

Answer 19

?

Question 20

Aorta-ascending, arch, descending???

Answer 20

???

Question 21

Brachiocephalic veins ????

Answer 21

Union of juglar vein and subclavian vein. Returns blood to SVC

Question 22

Superior Vena Cava

Answer 22

Vein that carries deoxy blood into right atrium. Formed by left and right brachiocephalic veins

Question 23

Arch of azygos vein ??

Answer 23

The azygos vein drains the chest wall and receives intercostal drainagage, depositing it into the SVC

Question 24

Describe the separations of the gut and their blood supplies

Answer 24

Foregut: esophagous, stomach, liver, bili apparatus, pancreas to the entrance of the bile duct in the second part of the duodenum

Blood Supply: Celiac artery

Midgut: Last 2/3 of duodenum, jejunum, ilium, cecum, the ascending colon to the distal 2/3 of transverse colon

Blood Supply: Superior mesenteric artery

Hindgut: Last 1/3 of the transverse colon, the descending colon, the sigmoid colon and the rectum

Blood Supply: Inferior mesenteric artery

Question 25

Left Lung Lobes

Answer 25

The left lung is made of 2 lobes the upper and lower and they are separated by the oblique fissure

Question 26

What is the order of the structures within the root of the left lung?

Answer 26

RALS! The pulmonary vein is the most inferior. The pulmonary artery is superior to the left primary bronchus

Question 27

Left Main Bronchus

Answer 27

It is the first branch point from the trachea Less vertical than the right main bronchus

Question 28

Hilus (Lung)

Answer 28

The structures in the root enter and exit through the hilus Contains the pulmonary vein, pulmonary artery and the main bronchus

Question 29

Superior and Lower Lobar Bronchus

Answer 29

Bronchus in the upper lobe and lower lobes ??

Question 30

Cardiac Notch (lung)

Answer 30

Notch due to space taken up by the heart

Question 31

Lingula

Answer 31

Tongue-like structure that is like the middle lobe of the right lung, except very small. During inspiration, it extends into the costomedial recess

Question 32

Right Lung Lobes

Answer 32

Upper and middle separated by a horizontal fissure and a lower separated by a oblique fissure

Question 33

What is the order of structures within the root of the RIGHT lung?

Answer 33

RALS - AB: in the right lung, the artery is anterior to the bronchus

Question 34

what is the root of the lung and what structures does it contain?

Answer 34

- the root of the lung connects the lung to the heart and trachea - and structures in the root enter or exit the lung through the hilus - each root (right and left) contains: 1) a main bronchus 2) a pulmonary artery and two pulmonary veins 3) bronchial artiers that supply lung tissue 4) autonomic nerves, sensory nerves, and lymphatic vessels

Question 35

Right Main Bronchus

Answer 35

First branch point of bronchi Shorter, wider and more vertical than the left main bronchus so an aspirated foerign body is more likely to enter right main bronchus and get lodged in middle or inferior right lobes.

Question 36

How many lobes are there in the RIGHT lung? What separates each?

Answer 36

3 lobes: - right upper (or superior) lobe - right middle lobe - right lower (or inferior) lobe - horizontal fissure separates superior and middle lobes - oblique fissure separates superior&middle from inferior lobe

Question 37

Costodiaphragmatic recess

Answer 37

potential space in the pleural vacity at a point where the visceral pleura and underlying lung do not completely fill the pleural caivty during inspiration; specifically the diaphragmatic pleura is in contant with the costal pleura.

Question 38

Pleural Cavity

Answer 38

- potential space between visceral and parietal pleura, e.g. it contains nothing except a small amount of serious fluid. - this permits visceral pleura and underlying lung to glide against the parietal pleura during respiration

Question 39

Visceral Pleura

Answer 39

- pleura covering actual lungs - continuous with parietal pleura at the ROOT of each lung

Question 40

Costal pleura

Answer 40

parietal pleura covering the thoracic wall, e.g. the rib cage

Question 41

diaphragmatic pleura

Answer 41

parietal pleura covering the diaphragm

Question 42

mediastinal pleura

Answer 42

parietal pleura covering the mediastinum

Question 43

cervical parietal pleura

Answer 43

expents into the root of the neck superior to the medial one third of the clavicle and the first rib -also known as the cupola

Question 44

Open Pneumothorax

Answer 44

Due to a penetrating wound of the thoracic wall or neck piercing the costal or cervical pleura respectively Lung collapses During inspiration: heart and other mediastinal structures shift away from the affected side and compress the opposite lung. During expiration: heart etc shift back Shifts reduce venous return to the heart

Question 45

Tension Pneumothorax

Answer 45

Due to a penetrating wound of the pleura Lung collpases Inspiration: get a shift of heart and other mediastinal structures away from the affected side Expiration: flap of pleural tissue closes the wound and prevents the expulsion of air. Intrapleural pressure increases and the shift of structures to the opposite side is augmented. Cardiac output, venous return, and respiratory function are compromised

Question 46

Spontaneous Pneumothorax

Answer 46

Air enters the pleural cavity by passing through the visceral pleura

Question 47

Ligamentum Arteriosum

Answer 47

Remnant of ductus arteriosis. Between left pulmonary artery and decending aorta. In the superior mediastium, the left vagus nerve crosses the arch of the aorta and gives off the left recurrent laryngeal nerve, which hooks under the arch just posterior to the ligamentum arteriosum and courses superiorly to the larynx.