Worksheet 2 - The abdominal cavity and the peritoneal reflections Flashcards
what does the parietal peritoneum line?
wall of abdominal cavity
what does the visceral peritoneum cover?
organs
name of cavity between parietal and visceral peritoneum
peritoneal cavity
somatic nerve supply to parietal peritoneum? 3
T7-11; thoracoabdominal nerve
T12; subcostal nerve
L1 - iliohypogastric + ilioinguinal nerve
explain the relation of the visceral peritoneum to the duodenum?
it passes in front of the duodenum
explain the visceral peritoneum of the small intestine
forms a mesentery
what pain is the parietal peritoneum sensitive to?
pressure, pain, heat
what type of stimulus is the visceral peritoneum sensitive to?
stretch + chemical irritation
is the peritoneal cavity the same as the abdominal cavity?
NO
what is contained within the peritoneal cavity
peritoneal fluid
2 parts of the peritoneal cavity
lesser sac
greater sac
other name for lesser sac
omental bursa
which sac lies posterior to the stomach
lesser sac
are the greater and lesser sacs continuous with each other
yes
foramen between lesser and greater sac (2 names)
epipoloic/omental
what is ascites?
excess volume of peritoneal fluid in peritoneal cavity
Intraperitoneal organs
J-STAS GILS
jejunum sigmoid colon transverse colon appendix spleen gall bladder ileum liver stomach
retroperitoneal organs
PAKI CARDD
pancreas ascending colon kidney IVC caecum abdominal aorta rectum duodenum descending colon
what is the greater omentum
double layer of peritonenum
what organ is attached to the posterior surface of the greater omentum
transverse colon
where does the greater omentum hang down from?
greater curvature of stomach
name of part of the greater omentum which passes between the greater curvature and the transverse colon
gastrocolic ligament
how many layers of peritoneum - gastrocolic ligament
2
how many layers of peritoneum - inferior to transverse colon
4
what does the transverse mesocolon connect?
transverse colon + PAW
what separates the peritoneal cavity into 2 compartments?
transverse mesocolon
2 compartments of the peritoneal cavity
supracolic + infracolic
part of the greater omentum which runs to the spleen - which side does this run to
gastrosplenic ligament - leftt
when the gastrosplenic ligament runs towards the kidney, what is it called?
lienorenal ligament
which artery runs in the lienorenal ligament?
splenic
parts of lesser omentum
gastrohepatic ligament
hepatoduodenal ligament
parts of greater omentum
gastrocolic ligament
gastrosplenic
gastrophrenic
what does the transverse mesocolon separate? and what into?
separates greater sac
into
supracolic + infracolic
3 organs in supracolic
stomach
spleen
liver
space between the liver and diaphragm
sub-phrenic space
what separates the sub-phrenic space into l+R
falciform ligament
what is the bare area?
area of liver with no peritoneum
where is the bare area?
posterior diaphragmatic surface
what is the ligamentum terres a remnant of?
umbilical vein
what channel runs under the liver?
sub-hepatic channel
inferior limit of sub-hepatic channel
transverse mesocolon
another name for pouch of Rutherford Morrison?
hepato-renal pouch
where would you find the hepato-renal pouch?
right side - PAW + kidney, inferior to the kidney
which gutter is the continous with the pouch of Rutherford Morrison?
right paracolic gutter
surgical importance of hepato-renal pouch
when supine, it is the deepest part of the supracolic compartment - fluid drains here - abcesses may form
where is the sub-hepatic space?
inferior to liver
what organs lie in the infracolic compartment?
ascending + descending colon
small intestine
what 2 things project forward in the medial infracolic compartment?
lumbar vertebrae
psoas muscle
what is on either side of the median watershed
iliolumbar fossae
where is the caecum located?
right iliac fossa
from the ceacum, where does the ascending colon run up to?
hepatic flexure
what 2 flexures does the transverse colon run through
hepatic + splenic flexure
what is the mesentery of the transverse colon
transverse mesocolon
why is the splenic flexture higher than the hepatic flexure
the hepatic flexure pushes down on the colon
what is the phrenicocolic ligament
the fold in peritoneum from the splenic flexure to the diaphragm
is there a phrenococolic ligament on the right?
NO
which is the larger gutter?
right paracolic gutter
what partially blocks the left paracolic gutter?
phrenococolic ligament
which 2 places communicate via the right paracolic gutter?
sub-hepatic channel + hepato-renal recess
why are the communications within the R paracolic gutter clincally significant?
gutters can spread pathological fluid - causing accumulation
do all parts of the small intestine have a mesentery? state which
no - not duodenum
what is the root of the mesentery
origin of mesentery of smal intestine
how does the root of mesentery divide the infracolic compartment?
obliquely - into right and left
which side of the infracolic compartment communicates with the pelvis
left
where does the sigmoid mesocolon attach to the pelvic wall?
over the division of the L common iliac artery
rectovesical pouch
male - between rectum + bladder
another name for Pouch of Douglas
Rectouterine pouch
rectouterine pouch
female - pouch between rectum + uterus
uterovesical pouch
female - uterus + bladder
where does the lesser omentum lie
between lesser curvature of the stomach + medial part of the duodenum
what allows the greater + lesser sacs to be continous with each other
epiploic/omental foramen
what is posterior of the stomch
lesser sac
3 structures enclosed with free border of lesser omentum
portal triad
- hepatic portal vein
- hepatic artery
- common bile duct
embryological origin of the lesser omentum
ventral mesentery
anterior margin of epipolic foramen
hepatoduodenal ligament
posterior margin of epipolic foramen
peritoneum covering IVC
superior margin of epipolic foramen
caudate lobe of liver
inferior margin of epipolic foramen
1st part of duodenum
what is an adhesion
fibrous bands form between tissue + organs - result of surgery
what is normal sensation?
associated with motility, distension
what is abnormal sensation
pain
which 2 TYPES of fibres transmit normal sensory info
- visceral sensory fibres
2. parasympathetic motor fibres
parasympathetic supply to the fore- + mid-gut
vagus nerve (CNX)
parasympathetic supply to the hindgut
splenosplanchnic nerves S2-S4
parasympathetic supply to the bladder
pelvic nerve S2-S4
which 2 TYPES of fibres transmit abnormal sensory info
- visceral sensory fibres
2. sympathetic motor fibres
sympathetic motor supply to the abdominal + pelvic viscera (5)
- greater splanchnic nerve T5-9
- lesser splanchinic nerve T9-10
- Lower splanchnic nerve T12
- lumbar splanchnic nerce L1-3
- Sacral splanchnic nerves
where are painful sensations to the viscera felt? and why?
away from the median plane - never the actual location as it is innervated by the motor nerves
why is pain in the parietal peritoneum localised?
as this membrane is innervated by somatic sensory nerves
which 4 somatic nerves supply the parietal peritoneum?
- thoracoabdominal nerve (T7-11)
- subcostal nerve (T12)
- L1 - iliohypogastric
- L1 - ilioinguinal
What would prevent you from running your hand on top of the liver
Coronary ligament
where does the greater omentum orginate from?
dorsal mesentery
what is the falciform ligament an embryological remnant of?
ventral mesentery
2 ligaments which hold the spleen in the abdomen
gastrosplenic
iliorenal ligament
which ligament prevents the spleen from moving superior when inflamed>
phrenico-colic ligament
where is the phrenico-colic ligament
between the splenic flexure + diaphragm
