Peritoneum & Upper Abdomen Viscera Flashcards

1
Q

What does splanchnic mean?

A

related to the viscera

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2
Q

What does hepatic mean?

A

associated with liver

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3
Q

What does cystic mean?

A

associated with gallbladder

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4
Q

What does pancreatic mean?

A

associated with pancreas

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5
Q

What does splenic mean?

A

associated with spleen

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6
Q

What does gastric mean?

A

associated with stomach

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7
Q

What does colic mean?

A

associated with the colon

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8
Q

What does recto mean?

A

associated with the rectum

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9
Q

What does phrenic mean?

A

associated with diaphragm

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10
Q

What is the peritoneum?

A

Thin, translucent, serous membrane

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11
Q

Where is the parietal peritoneum?

A

lines inner abd. wall

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12
Q

Where is the visceral peritoneum?

A

covers organs

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13
Q

Organs behind the peritoneum are called …

A

retroperitoneal

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14
Q

True or false: vessels tend to travel between the peritoneal layers

A

True

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15
Q

What makes up the peritoneal sac?

A

all visceral & parietal peritoneal membranes

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16
Q

What is the peritoneal cavity?

A
  • a potential space within sac
  • contains only a small amount of serous fluid
  • allow organs to move freely without friction
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17
Q

What are Marked Ascites & umbilical herniation?

A
  • The potential space of the peritoneal cavity 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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18
Q

What are the Double layered Peritoneal Folds & Ligaments?

A

1) Greater Omentum
2) Lesser Omentum
3) Mesentery Proper
4) Suspensory Ligament of Treitz
5) Mesocolon
6) Falciform Ligament
7) Coronary Ligament

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19
Q

Where is the 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
20
Q

What is the 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

Portal Triad = hepatic a., portal v., & bile duct

21
Q

What is the 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
22
Q

What is the Suspensory Ligament of Treitz?

A
  • Fibromuscular ligament descends from the R. crus of diaphragm
  • Crosses over L. crus & holds distal duodenum in place
  • Prevents duodenojejunal jxn. from sagging
23
Q

What is the Mesocolon?

A
  • 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
24
Q

What is the 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.

25
Q

What is the 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
26
Q

What are the Single Layered Peritoneal Folds?

A

1 median umbilical fold
covers fetal urachus

2 medial umbilical folds
covers fetal umbilical aa.

2 lateral umbilical folds
covers inferior epigastric vessels

27
Q

What are the Infraumbilical peritoneal folds?

A

median umbilical fold

  • from urinary bladder to umbilicus
  • covers median umbilical ligament

medial umbilical folds (2)

  • covers medial umbilical ligaments
  • occuded portions of umbilical aa.

lateral umbilical folds (2)
- covers inferior epigastric vessels

28
Q

What are Peritoneal Pouches?

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
29
Q

What is the Hepatorenal pouch (Pouch of Morrison)?

A
  • 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
30
Q

What is the Rectovesical 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
31
Q

What is the Rectouterine pouch?

A
  • Between rectum & uterus (♀)
  • another low point of peritoneal cavity when recumbent
  • fluids here may move up to hepatorenal pouch – when in Trendelenburg position
32
Q

What are the different sides of the liver?

A

1) Diaphragmatic Liver

2) Visceral Liver - has Porta Hepatis

33
Q

What/Where is the 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
34
Q

What/where are the Bile Ducts?

A
  • R & L hepatic ducts
  • receives bile from R & Llobes of liver
  • Common hepatic duct
  • receives R & L hepatic ducts
  • Cystic duct
  • connected to gall bladder
  • Common bile duct
  • receives cystic & common hepatic ducts
35
Q

Where do the bile ducts drain?

A
  • Common bile duct joins main pancreatic duct

- Both empty into major duodenal papilla in descending part of duodenum

36
Q

Pancreas

A
  • Consists of a head, neck, body, tail and uncinate process
  • Retroperitoneal & transverse across posterior abdominal wall
  • Surrounded by C-shaped duodenum on R & spleen on L
37
Q

Drainage of 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
38
Q

What are the surfaces of the spleen?

A

1) Diaphragmatic surface:
* contacts diaphragm along ribs 9-11

2) Visceral surface

39
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.
40
Q

Common Hepatic A.

A
  • Right br. of celiac trunk
  • Runs toward liver & gallbladder
  • 2 terminal branches
  • Proper hepatic a.
  • Gastroduodenal a.
41
Q

The common hepatic portal run into the ……

A
  • Superior br. of common hepatic a.
  • Runs toward liver & medial to bile duct
  • Splits into R & L hepatic aa
42
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
43
Q

L Gastric A.

A
  • Superior br. of celiac trunk
  • Runs L toward lesser curvature of stomach
  • supplies stomach & esophagus (via esophageal brs.)
44
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
45
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
46
Q

What is the Cystic A.?

A

An Additional Hepatic aa. Variation

  • 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
47
Q

What is the Additional Hepatic aa. Variation?

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