The abdominal cavity and peritoneal reflections

Question 1

What is the nerve supply of the parietal peritoneum?

Answer 1

Anterior abdo wall - T6-12, L1 Diaphragmatic region - central by phrenic, peripheral by T6-12 Pelvic region - obdurator nerve (branch of lumbar plexus)

Question 2

List the intraperitoneal organs.

Answer 2

Stomach

Appendix

Liver

Transverse colon

Duodenum (1st part)

Small intestine

Pancreas (tail)

Rectum (upper 3rd)

Sigmoid colon

Spleen

ie SALTD SPRSS

Question 3

List the retroperitoneal abdominal organs.

Answer 3

Suprarenal glands

Aorta/IVC

Duodenum (2nd, 3rd & 4th parts)

Pancreas (except tail)

Ureter/Bladder

Colon (ascending/descending) Kidneys (

O)Esophagus

Rectum (distal 2/3)

ie SADPUCKER

Question 4

List the secondarily retroperitoneal organs.

Answer 4

Pancreas

Colon (ascending and descending)

Duodenum

ie Pussy Cat Dolls

Question 5

Of what is the ligament teres a remnant?

Answer 5

Foetal umbilical vein.

Question 6

What is an adhesion?

Answer 6

Fibrous bands that form between tissues and organs as a result of injury or inflammation.

Question 7

What is the supracolic compartment?

Answer 7

The part of the abdominal cavity above the transverse mesocolon.

Question 8

What is the infracolic compartment?

Answer 8

The part of the abdominal cavity below the tranverse mesocolon.

Question 9

Which organs can be found in the supracolic compartment?

Answer 9

Liver, gallbladder, stomach, doudenum, spleen

Question 10

Where is the subphrenic space?

Answer 10

The space between the diaphragm and the liver.

Question 11

What is the coronary ligament?

Answer 11

A reflection of the diaphragmatic peritoneum that attaches to the liver.

Question 12

What is the origin of the lesser omentum?

Answer 12

The liver - suspends the lesser curvature of the stomach and the first part of the duodenum.

Question 13

What three structures are enclosed within the free border of the lesser omentum?

Answer 13

Hepatic artery Bile duct Hepatic portal vein

Question 14

What is the omental bursa?

Answer 14

The omental bursa is the small part of the peritoneal cavity behind the stomach. It communicates with the greater sac through a narrow opening, known as the omental or epiploic foramen, which lies between the first part of the duodenum and the visceral surface of the liver.

Question 15

Which structures form the boundaries of the epiploic foramen?

Answer 15

Anterior - free border of the lesser omentum

Posterior - peritoneum, IVC

Superior - peritoneum, caudate lobe of liver

Inferior - peritoneum, duodenum, hepatic artery

Question 16

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

Answer 16

6

Question 17

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

Answer 17

4

Question 18

What forms the gastrosplenic ligament?

Answer 18

The greater omentum - connects stomach to spleen.

Question 19

Define the paracolic gutters.

Answer 19

The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. The main paracolic gutter lies lateral to the colon on each side. A less obvious medial paracolic gutter may be formed, especially on the right side, if the colon possesses a short mesentery for part of its length.

Question 20

What is the clinical significance of the paracolic gutters?

Answer 20

They allow a passage for infectious fluids from different compartments of the abdomen. For example; fluid from an infected appendix can track up the right paracolic gutter to the hepatorenal recess.

Question 21

What is the parasympathetic motor supply to the fore- and midgut?

Answer 21

Vagus -> vagal trunks -> abdo prevertebral plexus

Question 22

What is the parasympathetic motor supply to the hindgut?

Answer 22

Pelvic splanchnic nerves from S2-4 -> inferior hypogastric plexus

Question 23

What is the parasympathetic nervous supply to the bladder?

Answer 23

Pelvic splanchnic nerves from S2-4 -> inferior hypogastric plexus

Question 24

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

Answer 24

Thoracic and lumbar splanchnic nerves - inferior hypogastric plexus - aortic plexus

Question 25

Which somatic nerves supply the parietal peritoneum?

Answer 25

Phrenic

Lower intercostal

Subcostal

Iliohypogastric

Ilioinguinal