The Peritoneum and Upper Abdomen Viscera Flashcards
of or relating to the viscera
splanchnic
assoc. with the liver
hepatic
assoc. with the gall bladder
cystic
assoc. with pancreas
pancreatic
assoc. with the spleen
splenic
assoc. with the stomach
gastric
assoc. with the colon
colic
assoc. with the rectum
recto
assoc. with the diaphragm
phrenic
thin, translucent serous membrane
peritoneum
peritoneum that lines the inner abdominal wall
parietal peritoneum
peritoneum that covers organs
visceral peritoneum
organs behind the peritoneum are ____
retroperitoneal
____ tend to travel between the peritoneal layers, in the mesenteries
vessels
the ___ and ____ are intraperitoneal and are completely covered by visceral peritoneum
spleen; stomach
two peritoneal layers coming together form a _____
mesentery
retroperitoneal organs
right kidney, left kidney, inferior vena cava, aorta, portions of the duodenum and pancreas, bladder
all visceral and parietal peritoneal membranes
peritoneal sac
a potential space within the sac; contains only a small amount of serous fluid; allows organs to move freely without friction
peritoneal cavity
the peritoneal cavity potential space can become an actual space and may contain up to several liters of fluid (_____)
ascites
disease, injury, or infection can lead to ____ of fluids (____, ____, ____, or ____)
pooling; blood, bile, pus, feces
_____ enclose and fold around the viscera
peritoneal membranes
make up the portal triad
hepatic artery proper, bile duct, portal vein
examples of double layers of peritoneum
lesser omentum, gastrosplenic ligament, splenorenal ligament
folds of peritoneum form segregated spaces or sacs, for example:
omental bursa, omental foramen, greater sac
double layered peritoneal fold that attaches to greater curvature of stomach and transverse colon; drapes over small intestines like an “apron”
greater omentum
the apron portion or largest portion of greater omentum is the _____ (4 layers of peritoneum)
gastrocolic ligament
3 ligaments that make up the greater omentum
gastrocolic ligament, gastrosplenic ligament, and gastrophrenic ligament (to diaphragm)
functionally, greater omentum can wall off ____ and ____ sites; results in formation of ____ which can lead to ____ of intestines
infections; inflammation; adhesions; strangulation
all components of greater omentum are derivatives of _____
dorsal mesentery
attaches to lesser curvature of stomach and duodenum; 2 portions connect these structures to the liver
lesser omentum
connects liver to the stomach
hepatogastric ligament
connects the liver to the duodenum and contains the portal triad
hepatoduodenal ligament
all components of the lesser omentum are derivatives from the _____
ventral mesenteries
anchors most of the small intestine to the posterior abdominal wall
mesentery proper
the mesentery proper runs diagonally from _____ to the _____, a distance 15-20 cm in adults
duodenojejunal junction; ileocecal junction
duodenum is anchored by _____
suspensory ligament of Treitz
fibromuscular ligament that descends from the right crus of the diaphragm
suspensory ligament of Treitz
the suspensory ligament of Treitz crosses over the left crus and holds ____ in place; prevents _____ from sagging
distal duodenum; duodenojejunal junction
anchors portions of the colon to the posterior abdominal wall
mesocolon
____ and ____ colon have no mesentery and are attached directly to the posterior wall
ascending; descending
the transverse colon is anchored by the _____
transverse mesocolon
the sigmoid colon is anchored by the _____; ____ only partially covered by peritoneum
sigmoid mesocolon; rectum
divides the liver into right and left lobes
falciform ligament
falciform ligament anchors the liver to the ____ and _____
diaphragm; anterior body wall
the _____ is at the inferior border of the liver and contains the _____
round ligament of the liver (ligamentum teres hepatis); obliterated umbilical vein (vein that carried oxygenated blood to fetus)
reflections of peritoneum around the bare area of the liver; attach liver to inferior surface of diaphragm
coronary ligament
the bare area is in ____ liver; bare area went through ____ in fetus
upper posterior; septum transversum
infraumbilical peritoneal folds (single layered peritoneal folds)
- median umbilical fold
- medial umbilical fold (2)
- lateral umbilical folds (2)
median umbilical fold from ____ to ____; covers _____ and is the fetal ____
urinary bladder; umbilicus; median umbilical ligament; urachus
the medial umbilical folds cover the _____ or occluded portions of _____
medial umbilical ligaments; umbilical arteries
lateral umbilical folds cover _____
inferior epigastric vessels
The fossae between the medial and the lateral umbilical folds; contains inguinal triangles (hesselbach’s); potential sites for ____
medial inguinal fossae; direct inguinal hernias
fossae lateral to the lateral umbilical folds, including the deep inguinal rings; potential site for ____
lateral inguinal fossae; indirect inguinal hernia
the infraumbilical peritoneal folds are located on the ____ side of the rectus sheath
posterior
2 types of peritoneal pouches
- hepatorenal pouch
- rectovesical or rectouterine pouch
hepatorenal pouch or pouch of morrison is bounded by the ____, ____, ____, and ____; it is the lowest/deepest part of peritoneal cavity when recumbent
liver; right kidney; colon; duodenum
fluids from hepatorenal pouch may move down to rectovesical/rectouterine pouch when ___ or ____
reclining; sitting up
fluids in the rectovesical/rectouterine pouch may move up to hepatorenal pouch when in _____ position
tredelenburg (when head is lower than the feet)
detoxifies chemical products and produces bile
liver
stores bile for emulsification of fats
gallbladder
produces enzymes for digestion
pancreas
produces lymphocytes and filters blood
spleen
stores food prior to entering duodenum
stomach
primary site for chemical digestion
small intestine
secondary site for chemical digestion
large intestine
filter waste products out of the blood
kidneys
cortices produce steroid hormones & medullas act as sympathetic ganglia (release Epinephrine & NE)
adrenal glands
lobes of the liver
right, left, caudate (superior), and quadrate (inferior)
viscera the liver contacts
Gallbladder, stomach, duodenum, colon, and right kidney
entrance for portal triad found inferiorly, near the quadrate lobe
porta hepatis
____ over the right lobe anteriorly (on liver)
coronary ligament
_____ over left lobe of liver
left triangular ligament
attached to inferior surface of liver- with fundus, body and neck
gall bladder
the gall bladder contacts the ___, ___, and ____
duodenum; colon; anterior abdominal wall
body of the gallbladder is in the ____ on the liver; GB receives, stores, and concentrates bile from the liver; bile drains into the duodenum through the ____ and _____
cystic fossa; cystic duct; common bile duct
body of the gall bladder is in the fossa, which may be against the _____ and the superior part of the ____
transverse colon; duodenum
____ form the spiral fold on the neck of the GB
mucosal folds
the arterial supply to the GB is the _____ from the right hepatic artery, which is a branch of the______
cystic a. ; hepatic artery proper
receive bile from R and L lobes of liver
R and L hepatic ducts
receives the R and L hepatic ducts
common hepatic duct
duct connected to the gall bladder
cystic duct
receives cystic and common hepatic ducts
common bile duct
the common bile duct joins with the ____ and drains into the descending part of the duodenum at the _____
main pancreatic duct; major duodenal papilla
the pancreas consists of a ___, ____, ____, and _____
head; neck;
the pancreas is ____ and ____ across the posterior abdominal wall
retroperitoneal; transverse
pancreas is surrounded by C-shaped ____ on the right and ____ on the left
duodenum; spleen
the head of the pancreas sits in the ____
duodenal curve
area of the spleen where the vessels/innervation are coming and going; also where ducts would be draining from
hylum
____ drain from the pancreas via 1 or 2 ducts:
enzymes; main pancreatic duct or the accessory pancreatic duct
enters duodenum at major duodenal papilla
main pancreatic duct
may enter duodenum as well, about 2 cm superior to major duodenal papilla
accessory pancreatic duct
accessory pancreatic duct drains through the _____
minor duodenal papilla
diaphragmatic surface of the spleen contacts the diaphragm along ____
ribs 9-11
spleen also contacts ___, ___, ____ and ____
stomach; left kidney; pancreas; colon
spleen is connected to the greater curvature of the stomach by the _____ which contains the ____ and ____ vessels
gastrosplenic ligament; short gastric; gastro-omental vessels
the spleen is connected to the left kidney by the _____ which contains the _____
splenorenal ligament; splenic vessels
arterial supply to the spleen is the ____ from the celiac trunk
splenic artery
1st major branch of abdominal aorta inferior to the diaphragm
celiac trunk
celiac trunk supplies ____, ____, ____, ____, and ____
liver; GB; esophagus; stomach; pancreas; spleen
3 main branches of celiac trunk
- common hepatic
- L. gastric
- splenic a.
artery that follows the lesser curvature of the stomach
left gastric a.
biggest branch of celiac trunk that goes posterior to the stomach
splenic a.
right branch of the celiac trunk that runs toward liver and GB
common hepatic a.
2 terminal branches of common hepatic a.
proper hepatic a. (or hepatic artery proper) and gastroduodenal a.
superior branch of common hepatic a. that runs toward liver and medial to bile duct
hepatic artery proper
hepatic artery proper splits into:
R and L hepatic arteries
inferior branch of the common hepatic a. that runs toward junction of stomach and duodenum
gastroduodenal a.
gastroduodenal a. sends _____ to the pancreas/duodenum
superior pancreaticoduodenal arteries
gastroduodenal a. sends _____ to the greater curvature of the stomach
R gastroepiploic a. (R gastro-omental a.)
superior branch of celiac trunk; runs left toward the lesser curvature of the stomach
left gastric a.
L. gastric a. supplies ____ and _____
stomach; esophagus (via esophageal branches)
left branch of celiac trunk; runs toward spleen; supplies pancreas and spleen
splenic a.
splenic a. sends ____ and _____ to supply greater curvature of the stomach
short gastric aa. and left gastroepiploic (left gastro-omental)
variations of hepatic arteries: R hepatic a. may arise from ____
SMA
L hepatic a. may arise from ____
L gastric a.
both right and left hepatic aa may arise from ____
celiac trunk
_____ also common
accessory R and L hepatic aa.
cystic a. usually arises from ____; 75% run posterior to ____, 24% run anterior; 1% are double cystic aa. ; supplies GB and cystic duct
R hepatic a. ; common hepatic duct
R gastric a. usually arises from _____, but may arise from ____ or _____ aa.
proper hepatic a. ; common hepatic or gastroduodenal aa.
R gastric a. anastomoses with L gastric a. and supplies ____
lesser curvature of the stomach
