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Anatomy Exam 2 > Peritoneum and Upper Abdomen > Flashcards

Peritoneum and Upper Abdomen Flashcards

1
Q

Describe the peritoneum

A
  • Thin, translucent, serous membrane
    • Parietal peritoneum lines inner abd. wall
    • Visceral peritoneum covers organs
  • Organs behind the peritoneum are retroperitoneal
  • Vessels tend to travel between the peritoneal layers
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2
Q

Describe the peritoneal sac

A
  • consists of all visceral & parietal peritoneal membranes
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3
Q

Describe the peritoneal cavity.

A
  • a potential space within sac
  • contains only a small amount of serous fluid
  • allows organs to move freely without friction

Note: This potential space can become an actual space. May contain up to several liters of fluid (ascites). Disease, injury or infection can lead to pooling of fluids (blood, bile, pus, feces)

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4
Q

Describe the double layered peritoneal folds & ligaments in the abdomen.

A
  • Greater omentum
  • Lesser omentum
  • Mesentery proper
  • Suspensory ligament
  • Falciform ligament
  • Coronary ligament
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5
Q

Describe the suspensory ligament of the abdomen

A
  • aka suspensory ligament of Treitz
  • Fibromuscular ligament
  • descends from the R. crus of diaphragm
  • Crosses over L. crus & holds distal duodenum in place
  • Prevents duodenojejunal jxn. from sagging
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6
Q

Describe the single layered peritoneal folds in the abdomen.

A
  • aka infraumbilical peritoneal folds
  • 1 median umbilical fold
    • covers fetal urachus
  • 2 medial umbilical folds
    • covers fetal umbilical aa.
  • 2 lateral umbilical folds
    • covers inferior epigastric vessels
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7
Q

Describe the peritoneal pouches of the abdominopelvic cavity.

A
  • Potential peritoneal spaces in standing patients
  • Becomes actual spaces in recumbent patients
    • Hepatorenal pouch
    • Rectovesical or retrouterine pouch
  • Pathological fluids can accumulate in these recesses
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8
Q

Describe the general features and functions of the upper abdominal organs.

A
  • Liver
    • detoxifies chemical products & produces bile
  • Gallbladder
    • stores bile for emulsification of fats Pancreas – produces enzymes for digestion
  • Spleen
    • produces lymphocytes & filters blood
  • Stomach
    • stores food prior to entering duodenum
  • Small intestine
    • 1° for chemical digestion
  • Large intestine
    • 2° for chemical digestion
  • Kidneys
    • filter waste products out of blood
  • Adrenal glands
    • cortices produce steroid hormones & medullas act as sympathetic ganglia (release Epinephrine & NE)
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9
Q

Describe the pattern and drainage of the bile ducts.

A
  • Common bile duct joins main pancreatic duct
  • Both empty into major duodenal papilla in descending part of duodenum
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10
Q

Describe the pattern and drainage of the pancreatic ducts.

A
  • Enzymes drain from pancreas via 1 or 2 ducts
  • Main pancreatic duct
    • enters duodenum with bile duct at major duodenal papilla
  • Accessory pancreatic duct
    • may enter duodenum as well ~ 2 cm superior to major papilla

Pattern of pancreatic drainage variable

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11
Q

Describe the arterial supply of the upper abdomen

A
  • Celiac trunk
  • Common hepatic a
  • Proper hepatic a
  • Gastroduodenal a
  • Left gastric a
  • Splenic a
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12
Q

Describe common variations of the arterial supply of the upper abdomen.

A
  • hepatic aa
  • cystic a (hepatic a)
  • r gastric a
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13
Q

Greater omentum

A
  • Attaches to greater curvature of stomach and transverse colon
  • Drapes over small intestines like an ‘apron’
  • ‘Apron’ = gastrocolic ligament
    • 4 layers of peritoneum
  • Functionally it can wall off infections & inflammation sites
  • Results in formation of adhesions
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14
Q

Lesser omentum

A
  • Attaches to lesser curvature of stomach and duodenum
  • 2 portions connect these structures to the liver
  • Hepatogastric ligament
    • connects liver to stomach
  • Hepatoduodenal ligament
    • connects liver to duodenum
    • contains the portal triad
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15
Q

Mesentery proper

A
  • Anchors most of the small intestine to posterior abd. wall
  • Runs diagonally from duodenojejunal jxn. to ileocecal jxn.
    • a distance = 15 to 20 cm in adults

Note: duodenum anchored by suspensory ligament of Treitz

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16
Q

Describe the portal triad

A
  • hepatic a.
  • portal v
  • bile duct
17
Q

Describe the mesocolon

A
  • Double layered peritoneum
  • Anchors portions of the colon to the posterior abdominal wall
  • Ascending & Descending colon have no mesentery
    • attached directly to the posterior wall
  • Transverse Colon anchored by transverse mesocolon
  • Sigmoid colon anchored by sigmoid mesocolon
  • Rectum only partially covered with peritoneum
18
Q

Falciform ligament

A
  • Divides liver into R & L lobes
  • Anchors liver to diaphragm & anterior body wall
  • Round ligament of the liver

Note: inferior border contains the obliterated umbilical vein.

19
Q

Coronary ligament

A
  • Reflections of peritoneum around the bare area of the liver
  • Attach liver to inferior surface of diaphragm
  • Bare area = upper posterior liver
20
Q

Hepatorenal Pouch (Pouch of Morrison)

A
  • Peritoneal pouch Bounded by liver, R kidney, colon & duodenum
    • lowest part of peritoneal cavity when recumbent
    • fluids may move down to retrovesical/rectouterine pouch – when in reclining position or sitting up
21
Q

Rectovesical & Rectouterine pouch

A

Between rectum & bladder (♂)

  • another low point of peritoneal cavity when recumbent
  • fluids here may move up to hepatorenal pouch when in Trendelenburg position

Between rectum & uterus (♀)

  • another low point of peritoneal cavity when recumbent
  • fluids here may move up to hepatorenal pouch when in Trendelenburg position
22
Q

Gallbladder

A
  • Attached to inferior surface of liver
  • Contacts duodenum, colon & anterior abdominal wall
  • Receives bile produced by liver via bile ducts
  • Bile then drains into duodenum thru these ducts
23
Q

Bile ducts

A
  • R & L hepatic ducts
    • receives bile from R & L lobes of liver
  • Common hepatic duct
    • receives R & L hepatic ducts
  • Cystic duct
    • connected to gall bladder
  • Common bile duct
    • receives cystic & common hepatic ducts
24
Q

Celiac trunk

A
  • 1st major br. of Abd aorta
  • Supplies liver, gb, esophagus, stomach, pancreas & spleen
  • 3 main branches
    • Common hepatic
    • L. gastric
    • Splenic aa.
25
Q

Common hepatic a

A
  • Right br. of celiac trunk
  • Runs toward liver & gallbladder
  • 2 terminal branches
    • Proper hepatic a.
    • Gastroduodenal a
26
Q

Proper hepatic a

A
  • Superior br. of common hepatic a.
  • Runs toward liver & medial to bile duct
  • Splits into R & L hepatic aa
27
Q

Gastroduodenal a

A
  • Inferior br. of common hepatic a.
  • Runs toward junction of stomach & duodenum
  • sends Supr. pancreaticoduodenal aa. to pancreas/duodenum
  • sends R gastroepiploic a to gr. curvature of stomach
28
Q

L Gastric a

A
  • Superior br. of celiac trunk
  • Runs L toward lesser curvature of stomach
  • supplies stomach & esophagus (via esophageal brs.)
29
Q

Splenic a

A
  • Left br. of celiac trunk
  • Runs toward spleen
  • supplies pancreas & spleen
  • Sends short gastric aa. & L gastroepiploic a.
    • supply greater curvature of stomach
30
Q

Common variations of hepatic aa

A
  • variations ~ 40%
  • R hepatic a. may arise from SMA
  • L hepatic a. may arise from L. gastric a.
  • Both R and L hepatic aa. may arise from celiac trunk
  • Accessory R & L hepatic aa also common
31
Q

Cystic a

A
  • usually arises from R hepatic a.
  • 75% run post. to common hepatic duct
  • 24% run ant. to common hepatic duct
  • 1% are double cystic aa.
  • Supplies gallbladder & cystic duct
32
Q

R gastric a

A
  • usually arises from proper hepatic a.
  • May arise from common hepatic or gastroduodenal aa.
  • Anastomoses with L. gastric a.
  • Supplies lesser curvature of stomach

Anatomy Exam 2 (13 decks)

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