The Gut and the Peritoneal Cavity Flashcards
Boundries
The abdomen extends from the ……………. …………… ………….. to the …………… …………..
The pelvis extends from the …………… ………….. to the …………… …………..
The perineum is inferior to the …………… …………..
Boundries
The abdomen extends from the inferior thoracic aperture to the pelvic inlet
The pelvis extends from the pelvic inlet to the pelvic floor
The perineum is inferior to the pelvic floor
State the devisions of the Gi tract and state where they start and end?
What is the peritoneum?
Draw a diagram showing the peritoneum?
What is the peritoneal cavity?
•Components of the GI tract are suspended in peritoneal reflections – ……………………….
•Components of the GI tract are suspended in peritoneal reflections – MESENTERIES.
What are mesenteries?
Visceral peritoneum surrounding the …………………
Parietal peritoneum lines the ……………….. ………………….
The ………….. ……….. has a dorsal mesentry
The …………. also has a ventral mesentry
Mesenteries – peritoneal folds attaching viscera to the abdominal wall
They contain the vessels, nerves and lymphatics that supply the viscera
Two types of peritoneum can be defined by the presence of abdominal organs
Visceral peritoneum surrounding the viscera
Parietal peritoneum lines the abdomainl cavity.
The entire gut has a dorsal mesentry
The foregut also has a ventral mesentry
The gut tube originates from the …………….. and ………………. mesoderm (splanchnic Gr.= pertaining to visceral organ)
It is suspended from the posterior abdominal wall by a peritoneal fold – the ……………. …………….
The gut tube originates from the endoderm and splanchnic mesoderm (splanchnic Gr.= pertaining to visceral organ)
It is suspended from the posterior abdominal wall by a peritoneal fold – the dorsal mesentery
INTRAperitoneal vs. RETROperitoneal
Define the two terms above?
Give examples for each?
What are 1o retroperitoneal organs and name a few?
State which part of the following are retroperitoneal organs?
Duodenum
–Pancreas
–Colon
–Duodenum (except the first part) *
–Pancreas (tail is INTRAperitoneal) *
–Colon (ascending and descending only)*
•The ENTIRE gut tube is suspended from a ………….. mesentery
•
•In addition, the FOREGUT has a ……………… mesentery
•The ENTIRE gut tube is suspended from a DORSAL mesentery
•
•In addition, the FOREGUT has a VENTRAL mesentery
The foregut also has a ventral mesentery containing the liver, which splits it into the …………. ………………and the …………. ………………
The foregut also has a ventral mesentery containing the liver, which splits it into the falciform ligament and the lesser omentum
Describe the formation of the lesser sac?
The lower part of the dorsal foregut mesentery extends down as a double fold called the …………… ……………… (= apron) anterior to the intestine.
The …………… …………….. is part of the ventral foregut mesentery.
The lower part of the dorsal foregut mesentery extends down as a double fold called the greater omentum (= apron) anterior to the intestine.
The lesser omentum is part of the ventral foregut mesentery.
The portal vein, hepatic artery and bile duct run between the posterior abdominal wall and liver within the …………… ……………….. near its ………. …………... This free edge is present because the ………. ………….. ends at the start of the midgut.
The portal vein, hepatic artery and bile duct run between the posterior abdominal wall and liver within the lesser omentum near its free edge. This free edge is present because the ventral mesentery ends at the start of the midgut.
The liver splits the ventral foregut mesentry into two:
Name them?
The liver splits the ventral foregut mesentry into two:
Falciform ligament
Lesser omentum
The spleen splits the dorsal foregut mesentry into two
name them
The spleen splits the dorsal foregut mesentry into two
Gastrosplenic ligament
Splenorenal ligament
Omental Bursa
This results in a little pocket of peritoneal cavity being formed called the lesser sac (omental bursa)
It is situated ……………… the stomach and liver.
The rest of peritoneal cavity becomes the …………… ………..
The only connection between the greater and lesser sac is the …………….. …………. which is located under the lesser omentum
Omental Bursa
This results in a little pocket of peritoneal cavity being formed called the lesser sac (omental bursa)
It is situated behind the stomach and liver.
The rest of peritoneal cavity becomes the greater sac
The only connection between the greater and lesser sac is the omental foramen which is located under the lesser omentum
The lesser omentum can be considered as made up of two ligaments
name them
Near the inferior end of the lesser omentum, three vessels run in what is known as the portal triad
name them
Lesser Omentum
The lesser omentum can be considered as made up of two ligaments
Hepatogastric
Hepatoduodenal
Near the inferior end of the lesser omentum, three vessels run in what is known as the portal triad
Common bile duct
Portal vein
Hepatic artery
The greater sac can be divided by the dorsal mesentry at the transverse colon into two compartments
Name them
This is further subdivided by the dorsal mesentry of the small intestine into
Name them
The greater sac can be divided by the dorsal mesentry at the transverse colon into two compartments
Supracolic
Infracolic
This is further subdivided by the dorsal mesentry of the small intestine into
Right infracolic
Left infracolic
The supra- and infracolic compartments are connected by the right and left ………….. ……………
Peritoneal fluid normally flows ………………. towards the diaphragm
Inflammatory exudate however flows …………….. towards the pelvis
The supra- and infracolic compartments are connected by the right and left paracolic gutters
Peritoneal fluid normally flows upwards towards the diaphragm
Inflammatory exudate however flows down towards the pelvis
At what level does the oesophagus piece the diaphragm?
- Oesophagus pierces diaphragm at T10
- Pierces muscular part of diaphragm – contributes to LOWER OESOPHAGEAL SPHINCTER (LOS)
What is the first part pf the duodenum known as?
What is the name of the second part of the duodenum called?
•FIRST part of duodenum = DUODENAL CAP
–Most duodenal ulcers occur here
- SECOND part of duodenum contains entrance for common bile duct – MAJOR DUODENAL PAPILLA
- Most of the duodenum is RETROPERITONEAL.
List 4 differences between the jejunum and illuim?
Midgut Intestines
The duodenum is the short, first part of the small intestine
The jejunum makes up the proximal …/….
The ileum makes up the distal …/….
The duodenum is the short, first part of the small intestine
The jejunum makes up the proximal 2/5
The ileum makes up the distal 3/5
… unpaired arteries arise from the aorta to supply the alimentary system. Branches of these arteries connect to ……………….. viscera by the ………………. ……………….
Foregut: ………………. ……………….
Supplies liver, pancreas and spleen
Midgut: ………………. ………………. artery
Supplies intestines and colon
Hindgut: ………………. ………………. artery
Supplies colon and rectum
3 unpaired arteries arise from the aorta to supply the alimentary system. Branches of these arteries connect to intraperitoneal viscera by the dorsal mesentry
Foregut: Coeliac trunk
Supplies liver, pancreas and spleen
Midgut: Superior mesenteric artery
Supplies intestines and colon
Hindgut: Inferior mesenteric artery
Supplies colon and rectum
Superior mesenteric artery
Name the branches
Name the branches of the inferior mesenteric artery
The entire gut drains into the portal system
Posterior to the first part of the duodenum the portal vein forms
It then runs to the liver through the?
Drainage:
Foregut: ………… vein and …………. vein
Midgut: …………….. ……………… vein
Hindgut: ……………… ……………… vein
The entire gut drains into the portal system
Posterior to the first part of the duodenum the portal vein forms
It then runs to the liver through the?
Drainage:
Foregut: Portal vein and splenic vein
Midgut: Superior mesenteric vein
Hindgut: Inferior mesenteric vein
List 4 sites of Portosystemic anastomosis
A.Oesophageal and left gastric veins
Site of oesophageal varices*
B.Superior and inferior rectal veins
Site of haemorrhoids*
C.Paraumbilical and epigastric veins
Site of caput medusa*
D.Colic and abdominal wall veins
Lymphatics
The lymphatic drainage of the bowel follows the arterial supply
Foregut: ………… nodes
Midgut: ………….. mesenteric nodes
Hindgut: ………… mesenteric nodes
Lymphatics
The lymphatic drainage of the bowel follows the arterial supply
Foregut: Coeliac nodes
Midgut: Superior mesenteric nodes
Hindgut: Inferior mesenteric nodes
All lymph drains into the cisterna chyli.
Cisterna chyli is an elongated lymphatic sac located in front of the L1 & L2 bodies
The thoracic duct commences from the cisterna chyli
Motor innervation of the abdominal viscera is by the parasympathetic and sympathetic nervous system
6 key nerves innervate the abdomen
name them
Vagus nerve (CNX)
Thoracic splanchnic nerves (T5-T12)
Greater splanchnic nerves (T5-T9)
Lesser splanchnic nerves (T10-T11)
Least splanchnic nerves (T12)
Lumbar splanchnic nerves (L1-L2)
Pelvic splanchnic nerves (S2-4)
Lumbar Vertebrae
Large body with thin, transverse processes
Except for LV, which has thick processes for attachment of the iliolumbar ligaments
………………… foramen
Movements:
Flexion/extension: Extensive, due to ……………… spinous processes
Lateral flexion: Moderate, due to the ………….. of the superior articular process
Rotation: Restricted, due to the ………… of the superior articular process
Large body with thin, transverse processes
Except for LV, which has thick processes for attachment of the iliolumbar ligaments
Triangular foramen
Movements:
Flexion/extension: Extensive, due to horizontal spinous processes
Lateral flexion: Moderate, due to the angle of the superior articular process
Rotation: Restricted, due to the angle of the superior articular process
Why is herniation likley in the lumbar vertebrae/
Where does pain of an posterior herniation felt?
Where is pain of a posterolateral herniation felt?
The lumbar vertebrae bear most of the weight of the upper body and therefore herniation is most likely in these vertebrae
Posterior herniation
Causes local pain in the spine
Posterolateral herniation
Causes pain in the dermatome of the corresponding spinal root
The bony pelvis is formed by the
Name them?
The bony pelvis is formed by the
Sacrum
Coccyx
2 pelvic bones
Ilium, ischium and pubis
The sacrum is made up of … fused vertebrae
It is attached to the pelvic bones by 2 ……………….. joints
It is a ……………….. joint which hardly moves. It’s main functions are:
……………………………
……………………………..
The sacrum is made up of 5 fused vertebrae
It is attached to the pelvic bones by 2 sacroiliac joints
It is a synovial joint which hardly moves. It’s main functions are:
Stability
Strength
