Stomach: Peritoneal Covering

Question 1

Peritoneal coverings

Answer 1

Stomach is completely covered by peritoneum except small bare area at fundus posterior surface where it is directly related to diaphragm

Question 2

Peritoneal ligaments

Answer 2

Peritoneal folds attaching stomach to surrounding organs

Question 3

Peritoneal ligaments types

Answer 3

1. Lesser omentum (gastrohepatic ligament)
2. Greater omentum (gastrocolic ligament)
3. Gastrosplenic ligament
4. Gastrophrenic ligament

Question 4

Lesser omentum

Answer 4

Peritoneal fold extending between stomach and liver representing ventral mesogastrium posterior part

Question 5

Lesser omentum structure

Answer 5

2 layers:
1. Anterior
2. Posterior

Question 6

Lesser omentum attachments

Answer 6

1. Above and to right
2. Below and to left
3. On right side

Question 7

Lesser omentum above and to right

Answer 7

1. Porta hepatis margins
2. Ligamentum venosum fissure
3. Diaphragm lower surface between Ligamentum venosum fissure and esophagus

Question 8

Lesser omentum below and to left

Answer 8

Stomach lesser curvature and duodenum 1st inch

Question 9

Lesser omentum on right side

Answer 9

Anterior and posterior layers are continuous forming lesser omentum free border which forms Epiploic foramen anterior boundary

Question 10

Lesser omentum relations anterior

Answer 10

Tuber Omental on inferior surface of liver left lobe

Question 11

Lesser omentum relations posterior

Answer 11

Lesser sac separates it from tuber omentale of pancreatic body, coeliac trunk, plexus, ganglia, and lymph nodes

Question 12

Lesser omentum contents between both layers

Answer 12

1. Right and left gastric vessels: run along lesser curvature
2. Lymph vessels and nodes
3. Sympathetic and parasympathetic fibers
4. Extraperitoneal fatty tissue

Question 13

Lesser omentum contents in lesser omentum free border

Answer 13

1. Portal vein (posterior)
2. Hepatic artery (anterior and to left)
3. Common bile duct (anterior and to right)

Question 14

Greater omentum

Answer 14

Large peritoneal fold descending from stomach superficial to intestine separating it from anterior abdominal wall

Question 15

Greater omentum structure

Answer 15

4 layers
1. 2 anterior descending
2. 2 posterior ascending
with lesser sac inferior recess in between

Question 16

Greater omentum attachments

Answer 16

It is downward extension of peritoneal covering of stomach anterior and posterior surfaces

Question 17

Greater omentum attachments anterior 2 layers

Answer 17

1. Attached to greater curvature right 2/3 and to 1st inch lower border of duodenum 1st part
2. They descend for variable distance then fold upwards and backwards forming posterior 2 layers (greater omentum has free lower border)

Question 18

Greater omentum attachments posterior 2 layers

Answer 18

1. Ascend to reach transverse colon where they split to surround transverse colon and continue as transverse mesocolon, reaching pancreas anterior border where they separate into:
   Superior layer: ascends to form lesser sac posterior wall
   Inferior layer: descends downwards over Infracolic compartment of posterior abdominal wall

Question 19

Greater omentum functions

Answer 19

1. Localizes peritoneal infection and prevents its spreading (abdomen policeman)
2. Fat storage

Question 20

Greater omentum contents

Answer 20

1. Right and left gastroepiploic arteries:
   Run between anterior 2 layers close and parallel to greater curvature anastomosing together and supplying both stomach and greater omentum
2. Lymph vessels and nodes
3. Sympathetic and parasympathetic fibers
4. Extraperitoneal fatty tissue

Question 21

Gastrosplenic ligament

Answer 21

Extends from greater curvature upper left part to spleen hilum

Question 22

Gastrophrenic ligament

Answer 22

Extends from fundus (around bare area) to diaphragm