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NME > Understanding the Peritoneal Cavity > Flashcards

Understanding the Peritoneal Cavity Flashcards

1
Q

Boundaries of the Abdominal Wall:
- superiorly?
- inferiorly?
- posteriorly?
- anterolaterally?

A
  • Superior - Costal margin, Xiphoid process
  • Inferior - Pelvic bones, iliac crest
  • Posterior - Lumbar vertebrae
  • Anterolateral - Abdominal muscles
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2
Q

Boundaries of the Abdominal Cavity:
- superiorly?
- inferiorly?
- posteriorly?
- anterolaterally?

A
  • Superior - Diaphragm
  • Inferior – Pelvic inlet
  • Posterior – Abdominal wall muscles
  • Anterolateral - Abdominal wall muscles
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3
Q

Boundaries/Contents of the pelvic cavity:
- superiorly?
- posteriorly?
- anteriorly?
- inferiorly?
- laterally?

A
  • Superiorly – pelvic brim
  • Posteriorly - sacrum and coccyx
  • Anterior – pubic symphysis
  • Floor – pelvic floor muscles
  • Lateral – Obturator internus
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4
Q

Five main layers of the anterolateral abdominal wall:

A
  • Skin
  • Superficial fascia: Camper’s (fatty) and Scarpa’s (membranous)
  • Muscles: Obliques (lateral), Rectus Abdominis (anterior)
  • Deep Fascia: Transversalis Fascia
  • Peritoneum: Parietal, Visceral
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5
Q

Abbrieviation to remember the five main layers of the anterolateral abdominal wall:

A
  • SSMDP
  • skin, superficial fascia, muscles, deep fascia, peritoneum
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6
Q

Abbrieviation to remember the five main layers of the anterolateral abdominal wall:

A
  • SSMDP
  • skin, superficial fascia, muscles, deep fascia, peritoneum
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7
Q

Abdominal Cavity

A
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8
Q

Abdominal Cavity

A
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9
Q

Pelvic Cavity

A
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10
Q

Layers of the anterolateral abdominal wall

A
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11
Q

Muscle of the Anterolateral Abdominal Wall: What is the function of the external oblique muscle?

A

Works with the internal oblique muscle for torisional movement of the trunk

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12
Q

Muscle of the Anterolateral Abdominal Wall: What is the function of the internal oblique muscle?

A

flex and rotate trunk; compress viscera

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13
Q

Muscle of the Anterolateral Abdominal Wall: What is the function of the transversus abdominis?

A

compress and support viscera

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14
Q

Muscle of the Anterolateral Abdominal Wall: What is the function of the rectus abdominis?

A

flexes trunk; compress viscera

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15
Q

Muscles of the Anterolateral Abdominal Wall:

A
  • external oblique
  • works with the internal oblique for torsional movement of the trunk
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16
Q

Muscles of the Anterolateral Abdominal Wall:

A
  • internal oblique
  • flex and rotate trunk; compress viscera
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17
Q

Muscles of the Anterolateral Abdominal Wall:

A
  • transversus abdominis
  • compress and support viscera
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18
Q

Muscles of the Anterolateral Abdominal Wall:

A
  • rectus abdominis
  • flexes trunk; compress viscera
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19
Q

Formation of Rectus Sheath

A
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20
Q

Abdominal Wall Blood Supply: Centrally:

A
  • Superior epigastric artery, arises
    from the internal thoracic artery
  • Inferior Epigastric artery, arises
    from external iliac artery, enters
    rectus sheath at Arcuate line
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21
Q

Abdominal Wall Blood Supply: Laterally:

A

Musculophrenic artery, Deep Circumflex Iliac artery, Subcostal artery

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22
Q

Abdominal Wall Blood Supply: Venous Drainage:

A
  • corresponds to the named arteries
  • superior epigastric veins and
    superficial iliac veins drain into
    Great Saphenous Vein
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23
Q

Foregut:

A
  • upto duodenum proximal to major
    papilla
  • oesophagus
  • stomach
  • proximal half duodenum
  • liver pancreas
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24
Q

Midgut:

A
  • distal to major papilla
  • distal half duodenum, Jejunum,
    Ileum, Cecum, Ascending & 3/4
    transverse colon
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25
Q

The primitive gut is held in position by

A

mesenteries (a structure of mesodermal origin), which is formed by a double layer of peritoneum

26
Q

The primitive gut

A
27
Q

What is the exception the ventral mesentery degeneration?

A

foregut

28
Q

Peritoneum and Mesentery

A
29
Q

Dorsal Mesentery attaches

A

gut organs to the posterior anterior abdominal wall

30
Q

Dorsal Mesentery gives rise to (4)(3):

A
  • Greater Omentum
    • Gastrosplenic ligament
    • Gastrophrenic ligament
    • Gastrocolic ligament
  • Splenorenal ligament
  • Mesentery of the small and large
    bowel
31
Q

Ventral Mesentery gives rise to (3)(2):

A
  • ligaments around the liver
  • Falciform ligament
  • Lesser Omentum:
    - hepatogastric ligament
    - hepatoduodenal ligament
32
Q

The gut developed from what embryological structure?

A

endoderm

33
Q

Ventral Mesentery attaches

A
34
Q

Peritoneum

A

layer of serous membrane comprising of connective tissue and squamous epithelium, which lines the abdominal cavity

35
Q

Two components of the peritoneum:

A
  • parietal peritoneum
  • visceral peritoneum
36
Q

Parietal Peritoneum adheres to (3):

A
  • anterior and posterior abdominal
    walls
  • undersurface of the diaphragm
  • cavity of the pelvis
37
Q

Outside parietal peritoneum is

A

extraperitoneal connective tissue, which adheres to:

 - loose areola tissue 
 - dense, fibrous tissue
 - fat 
 - closely related to the deep layer 
   of abdominal muscles
38
Q

The parietal peritoneum anchors ——— structures such as (3):

A
  • retroperitoneal structures
  • pancreas
  • duodenum
  • ascending and descending colon
39
Q

Innervation of the parietal peritoneum

A
  • segmental spinal nerves -
    intercostal, diaphragm, lumbar
40
Q

Visceral Peritoneum

A
  • extension of the parietal peritoneum
  • invests the viscera:
    - passes over the front of organs
    (duodenum, right and left colon)
    - 2 leaves lying together which
    splits around an organ, forming
    a mesentery
  • spaces and recesses: pelvic organs
    project into the pelvis (rectum,
    uterus, bladder)
41
Q

Innervation of the Visceral Peritoneum

A

visceral nerves

42
Q

Peritoneal Cavity

A
  • potential speace between serous
    coated organs
  • small volume of fluid to lubricate
  • two spaces: greater sac (Coelom),
    Lesser Sac, outpouch of greater sac
    behind stomach)
43
Q

Peritoneal Cavity

A
44
Q

Greater Sac: Supra Colic Compartment:

A
  • above transverse mesocolon
  • Upper abdominal Organs:
    - stomach
    - liver and biliary tree
    - pancreas
    - spleen
  • lives under the costal margin,
    below the diaphragm
45
Q

Supra Colic Compartment: Greater Sac: Location:

A
46
Q

Greater Sac: Supra Colic Compartment: Investing peritoneum of upper abdominal organs:

A
  • Includes stomach from oesophagus
    to 1st part of duodenum
  • Support ligaments – gastrophrenic,
    gastrosplenic, spleno-renal
47
Q

Greater Sac: Supra Colic Compartment: Greater Omentum:

A
  • two layers which are fused and
    extend from the stomach and
    proximal duodenum to lay over the
    infracolic compartment contents
  • contains fat, blood vessels and
    lymphatics
48
Q

Greater Sac: Supra Colic Compartment: Lesser Omentum:

A
  • Investing peritoneum of stomach
    joins to form a fold:
    - Right border of oesophagus
    - Lesser curve of stomach to 1st
    part of duodenum
    • Extends upwards to
      undersurface of left lobe of liver
      upper abdominal organs
49
Q

Omentum Diagram:

A
50
Q

Greater Sac: Supra Colic Compartment: Lesser Sac: Outpouching of Greater Sac:

A
  • outpouching of Greater Sac: behind the
    stomach, anterior to pancreas and great
    vessels in the retroperitoneum
51
Q

Greater Sac: Supra Colic Compartment: Lesser Sac: Communication with Greater Sac:

A
  • Epiploic Foramen:
    • anterior: hepatoduodenal ligament,
      hepatogastric ligament
    • posterior: IVC, right crus of diaphragm
    • superior: caudate lobe of liver
    • inferior: superior part of the abdomen
52
Q

Greater Sac: Infra-Colic Compartment:

A
  • below transverse mesocolon
  • para-colic gutters: right and left
  • infracolic compartment: right and left
53
Q

Greater Sac: Infra-colic Compartment: Para-colic Gutters: Right Para-Colic Gutter:

A
  • upper pole right kidney
  • undersurface right lobe of liver (hepato-renal
    pouch)
  • lateral to ascending colon and caecum to
    pelvic cavity
54
Q

Greater Sac: Infra-colic Compartment: Para-colic Gutters: Left Para-Colic Compartment:

A
  • wholly infracolic
  • bound superiorly by the phrenicocolic
    ligament
  • left side of transverse mesocolon
  • pelvic cavity
55
Q

Greater Sac: Infra-Colic Compartment:

A
56
Q

Greater Sac: Infra-Colic Compartment:

A
  • divided by root of small bowel mesentery
    attachment to the posterior abdominal wall
  • 15cm, Duodeno-jujunal flexure obliquely to
    right illiac fossa
  • fans out to up to 6m small bowel: jejunum and
    ileum
  • contains small intestine, ascending and
    descending colon)
57
Q

Greater Sac: Right Infra-Colic Compartment:

A
  • laterally (right of) caecum and ascending
    colon
  • medially small bowel mesentery
  • upper limit: right half of transverse colon
  • Upper aspect overlies 3rd/4th part of the
    duodeum and lower pole of right kidney
58
Q

Greater Sac: Left Infra-Colic Compartment:

A
  • laterally (left of) descending colon
  • medially small bowel mesentery
  • upper limit left half of transverse mesocolon
  • sweeps down into the pelvis
59
Q

Peritoneal Reflections and Folds (3):

A
  • Vesico-uterine pouch
  • Recto-uterine pouch
  • Recto-vesicle pouch
60
Q

Pelvic Pouches

A
61
Q

Peritoneum Function:
- parietal
- visceral
-
-

A
  • Parietal: innervated by somatic nerves, pain
    sensitive
  • Visceral: innervated by autonomic nerves, pain
    insensitive
  • Fluid Exchange: peritoneal dialysis
  • Infection:
    - contains phagocytes to protect viscera
    - mesothelial cells transform to fibroblasts
    for healing
    - greater omentum physically protects
62
Q

Peritonitis:

A
  • inflammation of the peritoneum
    - appendicitis
    - appendix mass
  • abscess
  • perforation

NME (52 decks)

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