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Yr 2 - GI & Metabolism > SDL - Peritoneum > Flashcards

SDL - Peritoneum Flashcards

1
Q

What is the parietal peritoneum?

A

Parietal peritoneum lines the walls of the abdominal cavity. It clothes the anterior and posterior abdominal walls, the under surface of the diaphragm and the cavity of the pelvis.

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2
Q

What is the nerve supply of the parietal peritoneum?

A

Thoracoabdominal nerves

Intercostal, subcostal, iliohypogastric, ilioinguinal nerves

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3
Q

What are the upper parts of the pelvic organs covered by?

A

The upper parts of the pelvic organs (rectum, uterus, bladder) project into the abdominal cavity and are covered by visceral peritoneum which hangs down in pouches between them

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4
Q

When in situ, are the following organs are retro/intraperitoneal?:

  1. Stomach
  2. Liver
  3. Gall bladder
  4. Spleen
  5. Duodenum
  6. Pancreas
  7. Kidneys
  8. Jejunum and ileum
  9. Caecum
  10. Appendix
  11. Ascending, transverse, descending, sigmoid colon
  12. Rectum
A

Intra: Stomach, liver, gallbladder, spleen, tail of pancreas, 1st part of duodenum, jejunum, ileum, appendix, transverse colon, sigmoid colon

Retro: Rest of duodenum, pancreas, kidneys, caecum, ascending colon, descending colon, rectum

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5
Q

What is found at the free edge of the falciform ligament?

A

Ligamentum teres

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6
Q

What is the ligamentum teres a remnant of?

A

Umbilical vein

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7
Q

What is an adhesion?

A

Pathological connection between the GI tract and the parietal peritoneum or another viscus

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8
Q

What is attached to the posterior surface of the greater omentum?

A

Transverse colon

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9
Q

What does the transverse mesocolon divide?

A

The greater sac into the supracolic and infracolic compartment

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10
Q

What is found between the liver and the diaphragm?

A

The subphrenic space (in supracolic compartment)

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11
Q

What is the subphrenic space divided into?

A

Right and left by the falciform ligament

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12
Q

What space is found under the liver?

A

Subhepatic channel

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13
Q

What is the inferior limit of the subhepatic channel?

A

The transverse mesocolon

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14
Q

What space is found to the right of the subhepatic channel? What is this pouch continuous with?

A

Hepatorenal pouch

With the right paracolic gutter

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15
Q

Why is the hepatorenal pouch of surgical importance?

A

Fluid can collect here when the individual is supine

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16
Q

Which 3 structures are enclosed within the free border of the lesser omentum?

A

Portal triad:

Anterior left - hepatic artery
Anterior right - bile duct
Posterior - hepatic portal vein

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17
Q

What is the embryological origin of the lesser omentum?

A

Ventral mesogastrium

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18
Q

What is the ventral mesogastrium?

A

A ventral mesentery of the embryonic stomach that persists as the falciform ligament and the lesser omentum

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19
Q

What forms the anterior, inferior, superior and posterior boundary of the epiploic foramen?

A

Anterior margin: Portal triad

Posterior margin: IVC

Superior margin: Caudate lobe

Inferior margin: First portion of duodenum

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20
Q

Where is the gastrocolic ligament found?

A

The part of the greater omentum between the greater curvature of the stomach and the transverse colon

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21
Q

How many layers of peritoneum make up the greater omentum as it runs between the greater curvature of the stomach and the transverse colon?

A

6

22
Q

How many layers of peritoneum make up the greater omentum inferior to the transverse colon?

A

4

23
Q

What is the space enclosed between the anterior and posterior layers of the greater omentum part of?

A

Lesser sac

24
Q

Where is the gastrosplenic ligament?

A

Part of greater omentum, runs from greater curvature to spleen

25
Q

How is the lienorenal ligament formed?

A

From the spleen, this same fold continues to the posterior abdominal wall where it attaches in the region of the left kidney

26
Q

What runs in the lienorenal ligament?

A

The terminal part of the splenic artery

27
Q

What does the infracolic compartment contain?

A

The main mass of intestinal coils.

28
Q

Where is the beginning of the large intestine?

A

In the right iliac fossa

29
Q

Is the splenic or the hepatic flexure higher?

A

The splenic flexure (due to the great bulk of liver on the right)

30
Q

What is located between the splenic flexure and the diaphragm?

A

A small transverse fold of peritoneum –> the phrenico-colic ligamen

N.B. there is NO phrenico-colic ligament on the right

31
Q

Where are the right and left paracolic gutters located?

A

On the lateral aspects of the ascending and descending colons

32
Q

Why are the paracolic gutters clinically important?

A

Movement of free fluid from compartments within the abdomen

33
Q

Describe the mesentery of the small intestine

A

First part of duodenum is intraperitoneal. Rest of duodenum is retroperitoneal. Mesentery begins at the duodenojejunal flexure so the jejunum and ileum are intraperitoneal.

34
Q

What is the root of the mesentery?

A

The line of attachment of the mesentery to the posterior wall

35
Q

What is the infracolic compartment divided into? By what?

A

Left and right parts by the mesentery of the small intestine

36
Q

What side of the infracolic compartment communicates with the pelvis?

A

Left

37
Q

Where does the small intestine terminate? What is also found here?

A

Right iliac fossa

The caecum and the appendix and its associated meso-appendix

38
Q

What does the mesoappendix contain?

A

Appendicular artery (branch of the iliocolic)

39
Q

How is ‘normal’ sensory info from an organ generally transmitted?

A

Through visceral sensory fibres that accompany the parasympathetic motor fibres supplying that organ

40
Q

What is the parasympathetic motor supply to the foregut and midgut?

A

Vagus nerve

41
Q

What is the parasympathetic motor supply to the hindgut?

A

Pelvic splanchnic

42
Q

What is the parasympathetic motor supply to the bladder?

A

Pelvic splanchnic

43
Q

How is ‘painful’ sensory info from an organ generally transmitter?

A

Through visceral sensory fibres that accompany the sympathetic motor fibres accompanying the organ

44
Q

What is the sympathetic motor supply to the abdominal and pelvic viscera?

A

Greater, lesser, least and lumbar splanchnic nerves

45
Q

Where are painful sensations from the viscera vaguely localised to?

A

The median plane

46
Q

What are the parietal layers innervated by?

A

Sensory branches of somatic nerves

47
Q

Why does pain from parietal layers localise well?

A

As it signals through the somatic systems

48
Q

Early in acute appendicitis, what is inflamed? Where is pain felt?

A

Only the vermiform appendix and visceral peritoneum

Pain felt in the central abdomen

49
Q

As soon as the parietal peritoneum becomes inflamed in appendicitis, where is the pain?

A

Pain localises to right iliac fossa (pain associated with somatic structures of the abdominal wall as you cannot feel pain ‘in the appendix’)

This is referred pain

50
Q

Where is cardiac pain felt?

A

Left arm

51
Q

Where is gall bladder pain felt?

A

Right shoulder

52
Q

Where is ureteric pain felt?

A

External genitalia

Yr 2 - GI & Metabolism (51 decks)

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