Upper Abdomen Flashcards by Ilana Kramer

Most viscera in the abdominal cavity are associated with _____.

Most viscera in the abdominal cavity are associated with the celiac trunk

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What are these terms associated with:

Splanchnic
Hepatic
Cystic
Pancreatic
Splenic
Gastric
Colic
Recto
Phrenic

Splanchnic = visceral
Hepatic = liver
Cystic = gallbladder
Pancreatic = pancreas
Splenic = spleen
Gastric = stomach
Colic = colon
Recto = rectum
Phrenic = diaphragm

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Parietal Peritoneum and Visceral Peritoneum are _____.

Parietal Peritoneum and Visceral Peritoneum are 2 continuous layers

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How do greater omentum and lesser omentum communicate?

Through the omental foramen

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Ascites

fluid (from peritoneum during herniation)

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Greater omentum attaches to _____ and _____.

Greater omentum attaches to the greater curvature of the stomach and the transverse colon

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Greater omentum drapes over _____ like an “apron”

small intestine

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Why is the greater omentum 4 layers?

Began as 2 double layers with a sac between but they fused during development

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What is the function of the greater omentum?

Protects underlying viscera from infection and inflammation. Greater omentum moves to do this which can result in adhesions.

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What are adhesions of the greater omentum?

Scar tissue that inhibits motion. Came from movement for protection of viscera.

Adhesions can cause risk of pinching off digestive flow. Can be severe enough for surgery

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3 ligaments of the greater omentum. What are they each derived from?

Gastrocolic ligament (largest)
Gastrosplenic ligament
Gastrophrenic ligament

*all derived from dorsal mesentery

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Lesser Omentum attaches to _____ & _____

Lesser omentum attaches to lesser curvature of stomach and duodenum

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Two portions of lesser omentum and what are they derivatives of?

Hepatogastric ligament - attaches liver to stomach
Hepatoduodenal ligament - connects liver to duodenum

They are both derivatives of ventral mesenteries

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Hepatogastric ligament

hepatogastric ligament connects the liver to the stomach

1 of the 2 portions of lesser omentum

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Hepatoduodenal ligament

hepatoduodenal ligament attaches the liver to the duodenum

contains the portal triad (portal vein, hepatic artery, bile duct)

overlays the omental foramen

1 of the 2 portions of the lesser omentum

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Mesentery Proper anchors ______

most of the small intestine to the posterior abdominal wall

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How does the mesentery proper run? Along what and in what direction? How long?

mesentery proper runs diagonally from duodenojejunal junction to the ileocecal junction

It is 15-20cm in adults

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Is the duodenojejunal junction retroperitoneal or intraperitoneal?

At this junction, the duodenum changes from retroperitoneal to intraperitoneal. *LOTS OF MOTION HERE.

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Suspensory ligament of treitz

aka Suspensory ligament of duodenum

Marks location where duodenum goes from retroperitoneal to intraperitoneal

fibromuscular ligament descends from R. Crus of diaphragm, crosses L. Crus of diaphragm and holds distal duodenum in place

Prevents duodenojejnual junction from sagging

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Mesocolon anchors _____

portions of the transverse colon to the posterior abdominal wall

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Which mesentery anchors the ascending and descending colon?

None. Ascending and descending are directly attached to posterior wall

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Three portions of mesocolon and what do they anchor?

Transverse mesocolon - anchors transverse colon
Sigmoid mesocolon - anchors sigmoid colon
Rectal mesocolon - PARTIALLY anchors rectum

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What divides the greater sac into two compartments? What are those compartments?

Transverse mesocolon divides greater sac into supracolic compartment and infracolic compartments

supracolic = stomach, liver spleen

infracolic = small intestine, asc. desc. colon, lies posterior to greater omentum, divided into R/L infracolic by small intestine

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Falciform Ligament

Ventral surface of liver - divides into R/L sides. Anchors liver to diaphragm and anterior body wall.

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What is the portion of falciform ligament that hangs off ventrally?

Part of the obliterated umbilical vein Called ligamentum terest hepatis aka round ligament of the liver

What is the bare area of the liver? What is it adjacent to?

Upper posterior liver that doesn't have visceral peritoneum, adjacent to inferior vena cava

Coronary Ligament

Reflection of visceral peritoneum around bare area of liver Attaches liver to inferior surface of diaphragm

What are the two peritoneal pouches in recumbent position?

1. Hepatorenal pouch | 2. Rectovesical pouch / rectouterine pouch

Are the rectouterine/retovesical and hepatorenal pouches separate?

No. Pathological fluids can accumulate here and spread to one another

Hepatorenal pouch is bounded by ______

Hepatorenal pouch is pounded by the liver, right kidney, colon, duodenum

Which side is the hepatorenal pouch on? Why?

Hepatorenal pouch is on the right side of the body. Liver is on right side, weighs down so pouch is lower. Left side includes spleen - in the way of pouch

Rectovesical pouch is between _____. Male or female?

Rectum and bladder. Male.

What is the rectovesical pouch called in females? Why?

Uterine splits rectovesical pouch into two compartments. Rectouterine and vesicouterine pouch.

In females, what is the lowest point in recumbent position in pelvic cavity?

Rectouterine pouch.

Basic function of the liver

Liver detoxifies products and produces bile

Basic function of the gallbladder

Gallbladder stores bile for emulsification of bile

Basic function of pancreas

Pancreas produces enzymes for digestion

Basic function of spleen

Spleen produces lymphocytes and filters blood

Lobes of liver

Anterior surface: right and left lobes Posterior surface: caudate and quadrate lobes

Quadrate lobe vs. Caudate lobe

Posterior lobes of liver. Quadrate lobe is inferior and adjacent to gallbladder Cuadate lobe is superior and adjacent to the inferior vena cava

Diaphragm vs visceral surface of liver

Diaphragm surface: smooth and dome shaped along diaphragm Visceral surface: mostly posterior, includes fossae for each viscera in contact

Where is the portal hepatis?

On liver | Entrance for the portal triad

If you can view the portal hepatis posteriorly, what has been cut out?

The hepatoduodenal ligament has been removed if you can see the portal hepatis from posterior view

Which can hold more bile - liver or gallbladder? What do these structures do because of this relationship?

Liver produces much more bile than gallbladder can hold. So gallbladder must concentrate the bile 10-20fold

What are the parts of the gallbladder and where are they?

Fundbus of gallbladder - hangs on inferior aspect of liver Also has body and neck of gallbladder and duct system

Follow bile path from liver to gallbladder

Right and left lobes of liver to right and left hepatic ducts to common hepatic duct to cystic duct (connected to gallbladder)

Follow bile path from gallbladder to duodenum

Cystic duct and common hepatic duct join at COMMON BILE DUCT common bile duct joins with main pancreatic duct both common bile duct and main pancreatic duct drain into MAJOR DUODENAL PAPILLA

Where is the major duodenal papilla?

on the descending portion of the duodenom

Why is the major duodenal papilla important?

It is the site where the common bile duct and main pancreatic duct drain into the duodenum It is the last structure of the foregut before midgut begins

What is the location of the pancreas in relation to the stomach and duodenum?

Pancreas is posterior to stomach and posterior to most of duodenom

What is the location of the pancreas in relation to the spleen?

Tail of the pancreas is pointed towards the hilum of the spleen (on the left)

The head and the uncinate process of the pancreas sit in the ______.

C-shaped curve of the duodenom (on the right)

What is draining from the pancreas?

Digestive enzymes (exocrine)

What is the drainage system for the pancreas?

1. Main pancreatic duct or | 2. Accessory pancreatic duct

Pathway for main pancreatic duct

enters duodenum (with common bile duct) at major duodenal papilla

Pathway for accessory pancreatic duct

May enter duodenum as well | ~2cm above major papilla at the minor duodenal papilla

What is the physical relationship between major and minor duodenal papilla?

Minor duodenal papillae is ~2cm OVER major duodenal papillae

Diaphragm vs visceral surface of spleen

Diaphragmatic surface: smooth along ribs 9-11 Visceral surface: many fossae/depressions, contacts stomach, left kidney, pancreas and colon

Gastrosplenic ligament

connects spleen to greater curvature of stomach

Splenorenal ligament

connects spleen to left kidney, contains splenic vessels

Hilum of the spleen

No visceral peritoneum point of entry for splenic vessels Tail of pancreas reaches hilucm of spleen occasionally

Upper Abdomen Flashcards

(61 cards)