Peritoneum and Upper Abdomen Flashcards
Viscera is associated with what arterial supply?
Celiac trunk.
Doe not include the components of the Digestive Tract proper, just the upper accessory viscera.
hepatic
liver
cystic
gallbladder
pancreatis
pancreas
sphlenic
spleen
gastric
stomach
colic
colon
recto
rectum
phrenic
diaphragm
peritoneum
thin, translucent, serous membrane in the abdomen.
visceral and parietal
intraperitoneal
spleen and stomach, completely covered by visceral peritoneum.
where the organs are
retroperitoneal
peritoneum that is behind organs. organs may also lay here. duodenum and pancreas
peritoneal sac
all visceral and parietal peritoneal membranes
peritoneal cavity
-a potential space within the sac.
contains only a small amount of serous fluid
-allow organs to move freely without friction.
-is within the abdominal cavity and goes into the pelvic cavity.
umbillical herniation
when the peritoneal cavity fills with fluid and goes through the umbillicus.
greater omentum
-attaches to greater curvature of stomach .and transverse colon
-drapes over small intestine like an ‘apron’
‘apron’ = gastrocolic ligament (4 layers of peritoneum)
-functionally it can wall off infections and inflammation sites.
-results in formation of adhesions
lesser omentum
- attaches to lesser curvature of stomach and duodenum
- 2 portions connect these structures to the liver
- deep to lesser omentum in omental bursa
hepatogastic ligament
lesser omentum. connects liver to stomach
hepatoduodenal ligament
lesser omentum. connects liver to duodenum. contains portal triad.
portal triad
hepatic a., portal v., and bile duct.
mesentary proper
- 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
suspensory ligament of duodenum (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
Mesocolon
- 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
What divides the abdominal cavity into two compartments?
Transverse mesocolon
supracolic and infracolic compartments
supracolic compartment
contains stomach, liver and spleen.
infracolic compartment
contains small intestine and ascending and descending colon
lies posterior to greater omentum
also divided into a right and left infrcolic compartment by the mesentery of the small intestine
suprcolic + infracolic comartments =
greater sac
falciform ligament
- 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.
development of falciform ligament
left umbilical vein is obliterated after birth and becomes the ligamentum teres hepatis, which then becomes the inferior margin of the falciform ligament.
coronary ligament
- Reflections of peritoneum around the bare area of the liver
- Attach liver to inferior surface of diaphragm
-bare area = upper posterior liver
infroumbilical peritoneal folds
single layered peritoneal folds.
- median umbilical fold
- medial umbilical fold (2)
- lateral umbilical folds (2)
median umbilical fold
- from urinary bladder to umbilicus
- covers median umbilical ligament
- fetal urachus
medial umbilical folds (2)
- covers medial umbilical ligaments
- occluded portions of umbilical aa.
lateral umbilical folds (2)
-covers inferior epigastric vessels
Medial inguinal fossae =
The fossae between the medial and the lateral umbilical folds = inguinal triangles (Hesselbach triangels). Potential sites for direct inguinal hernias.
Lateral inguinal fossae =
lateral to the lateral umbililcal folds, including the deep inguinal rings. Potential site for most common type of hernia = indirect inguinal hernia
Fetal Urachus =
original allantoic diverticulum that persists throughout much of development as a stalk which extends from the bladder and is continuous (the allantois) to the umbilical region. As the allantois constricts and becomes the thick fibrous cord, the urachus. It extends from the apex of the bladder to the umbilicus = median umbilical ligament
peritoneal pouches
Potential peritoneal spaces in standing patients
Becomes actual spaces in recumbent patients
Hepatorenal pouch
Rectovesical or rectouterine pouch
Pathological fluids can accumulate in these recesses
heptorenal pouch
morrison’s pouch
Bounded by liver, R kidney, colon & duodenum
lowest part of peritoneal cavity when recumbent
fluids may move down to rectovesical/rectouterine pouch – when in reclining position or sitting up
NOTE: kidney is retroperitoneal, and this pouch is directly anterior to it.
rectovesical pouch
Between rectum & bladder (♂)
another low point of peritoneal cavity when recumbent
fluids here may move up to hepatorenal pouch – when in Trendelenburg position
rectouterine pouch
(♀)
another low point of peritoneal cavity when recumbent
fluids here may move up to hepatorenal pouch – when in Trendelenburg position
In female – recto-uterine pouch is lowest point in pelvic cavity
liver
detoxifies chemical products and produces bile
gallbladder
stores bile for emulsification of fats
pancreas
produces enzymes for digestion
spleen
produces lymphocytes and filters blood
stomach
stores food prior to entering duodenum
small intestine
primary for chemical digestion
large intestine
secondary for digestion
kidneys
filter waste products out of blood
adrenal glands
cortices produce steroid hormones and medullas act as sympathetic ganglia (release epinephrine & NE)
