Peritoneum, peritoneal cavity and gut vasculature. Flashcards
From superior to inferior name each section of the ailmentary tract.
What organs are in the foregut, midgut and hindgut.
Which layer of the peritoneum is innervated by what?
What pain would be more localised?
Parietal by somatic afferents are therefore very localised and discrete.
Visceral by visceral afferent therefore more generalised pain (in the areas of umbilical, epigastric and pubic regions - dermatomes).
- Receives the same neurovascular supply as the organ it covers.
- Insensitive to touch, temperature and lasceration but sensitive to stretch and chemical irritation.
- There can be referred pain e.g. gall bladder pain can be referred to the shoulder.
What are the sex differences with regard to peritoneum?
Fully closed in males but open in females bc there are openings for uterine tubes in females.
What are the extraperitoneal organs?
Subperitoneal organs = Urinary bladder and rectum.
Retroperitoneal primary (always been retro) = Kidneys, ureters, adrenal glands, aorta/IVC, rectum.
Retroperitoneal secondary (used to be intraperitoneal) = Duodenum, pancreas, ascending and descending colon.
How many layers is the greater omentum?
Where does it attach from and to?
4
From the stomach to the transverse colon.
What are the two intraperitoneal spaces? What is the communication point between these two?
Greater and lesser sac via the omental foramen/epiploic foramen.
What are the two sections that the greater sac can be separated into?
Supra and infracolic regions.
Where does the lesser omentum travel to and from?
From the inferior portion of the liver to the lesser curvature of the stomach.
Within the hepatoduodenal ligament is the ___ ____ which contains 3 important vessels: 1, 2 and 3. What is their anatomical arrangement with one another.
portal triad: hepatic portal vein (posterior), bile duct (right) and proper hepatic artery (left).
What are the recesses on the latateral aspects of the abdomen?
What is the green, pink and blue area called?
Green = supracolic, pink = infracolic.
What are these arteries? What vertebral levels are they found at?
What do they supply?
Explain the lymphatic drainage system of the gut?
The lymphatics:
Hindgut is supplies by inferior mesenteric nodes.
Midgut supplied by superior mesenteric nodes.
And the foregut the coeliac nodes.
Movement of lymphatics is inferior to superior to go to jugular vein. Coeliac node drains into the cisterna chyli then to the thoracic duct then to the left jugular vein where it meets with subclavian.
Draw the arterial supply of the celiac trunk.
(slide 68 lecture 10).
Need to know each of the limbs.
Coeliac trunk has 3 main branches: left gastric artery, which has small branch to oesophagus called oesophageal branch, next branch goes behind the stomach called splenic artery this has a branch which goes to the fundus of the stomach called short gastric artery. Also has another branch a long the greater curvature called left gastroepiploic artery. Then the last one called common hepatic artery which has a branch going to the liver which splits into left hepatic, right hepatic and cystic (to the gall bladder) artery. It also gives off a branch called the right gastric artery which goes a long the lesser curvature of the stomach. It also has one which goes a long the greater curvature called the rigth gastroepiploic. There is one which goes toward the pancreas and duodenum (superior panceratico duodenal artery) and another which goes to the upper part of duodenum (supraduodenal)
What are the branches of the superior mesenteric arteries?
What is the main branch which these all connect?
What is another main branch which is not shown?
SMA.
Inferior pancreaticoduodenal arteries (anterior and posterior).
What are the 3 main branches of the inferior mesenteric artery?
Left colic artery, sigmoid artery and superior rectal artery.
Explain the hepatic portal system?
Hepatic portal vein goes to the liver. The main veins which drain into this are the splenic vein and the superior mesenteric vein. The inferior mesenteric vein enters into the splenic vein.
What is the nervous supply to the gut? (parasympathetic vs sympathetic.
Sympathetic fibres arise from T5-L3 making greater, lesser, least and lumbar splanchic nerves and travel to prevertebral ganglia.
Sympathetic:
- Celiac ganglia supplies foregut.
- Superior mesenteric ganglia supplies midgut.
- Inferior mesenteric ganglia supplies hindgut.
Visceral afferents (pain) travel along the same nerves.
Parasympathetic:
- Vagus supplies foregut.
- Vagus supplies midgut.
- Pelvic splanchnic nerves supply hindgut.
What is lymphatic drainage of the gut?
Explain the route that the drainage goes from the lymphatics into the venous drainage.
Easy as the lymphatics follow the arteries.
- Foregut drains into celiac nodes.
- Midgut drains into superior mesenteric nodes.
- Hindgut drains into inferior mesenteric nodes.
