Peritoneum & Upper Abdomen Viscera

Question 1

_____ Lines Inner abdominal wall.

Answer 1

Parietal peritoneum

Question 2

_____ covers organs.

Answer 2

Visceral peritoneum

Question 3

Organs behind peritoneum are _______.

Answer 3

Retro peritoneal

Question 4

What is difference between peritoneal sac and cavity?

Answer 4

Peritoneal sac = all visceral & pareital membranes

Peritoneal cavity = a potential space within sac. Only contains small amount of serous fluid.
Allows organs to move freely without friction.

Question 5

Describe the structure of the greater Omentum…

Answer 5

• Drapes like and apron over the small intestines.

- attaches to greater curvature of stomach and transverse colon.

Question 6

What is the function of the greater Omentum?

Answer 6

• it can wall off infection & inflammation sites.

- results in formation of adhesions.

Question 7

Describe the structure of the Lesser Omentum…

Answer 7

• attaches to lesser curvature of stomach and duodenum
• 2 portions connet these structures to the liver….
  1. Hepatogastric ligament (liver to stomach)
  2. Hepatoduodenal ligmament (Liver to duodenum) *Contains to portal triad.

Question 8

What is the portal triad?

Answer 8

• Hepatic A.
• Portal V.
• Bile duct

Question 9

Describe the Mesentery Proper….

Answer 9

• Anchors most of the small intestine to posterior wall.

- Runs diagonally from duodenojejunal jxn. to ileocecal jxn.

Question 10

Duodenum is anchored by the __________.

Answer 10

Suspensory ligament of Treitz (Fibromuscular ligament descending from the R. Crus of diaphragm)
*prevents duodenojejunal junction from sagging.

Question 11

Describe the Mesocolon…

Answer 11

• Anchors portions of the colon to the posterior abdominal wall.
• double layered peritoneum
• Ascending and Descending colon have no mesentery!

Question 12

Transverse Colon and Sigmoid colon are anchored by what?

Answer 12

Transverse and sigmoid mesocolon

Question 13

________ Divides liver into right and left lobes and anchors liver to diaphragm & ant. body wall.

Answer 13

• Falciform Ligament
• Round ligament OF LIVER!
• Inferior border contains to obliterated umbilical vein

Question 14

_______ Attaches liver to inferior surface of diaphram and is made of reflections of peritoneum around to bare area of the liver.

Answer 14

Coronary ligament

Question 15

Name the 5 single layered peritoneal folds and their function…

Answer 15

1 - Median umbilical fold = covers fetal urachus & Median umbilical ligament. (From urinary bladder to umblilicus)

2 - Medial umbilical folds = covers fetal umbilical A. & medial umbilical ligaments.

2 - Lateral umbilical folds = covers inferior epigastric vessels

Question 16

What are peritoneal pouches?

Answer 16

Potenial peritoneal spaces in standing patients that become actual spaces in recumbent patients (2 of them) *Pathologic fluids can accumulate in these recesses.

Question 17

Describe the Hepatorental pouch (Pouch of Morrison)

Answer 17

• Lowest part of peritoneal cavity when recumbent.
• bounded by liver, R. Kidney, colon and Duodenum.

*Fluids may move down to retrovesical/rectouterine pouch when in reclining position or sitting up.

Question 18

Describe Rectovesical & Rectouterine pouces

Answer 18

Rectovesical = between rectum & bladder
Rectouterine = between rectum and uterus.

• Both are low points of peritoneal cavity when recumbent.

Question 19

Fluids in the rectovesical/unterine pouches may move up to the ______ when in the Trendelenburg position.

Answer 19

Hepatorenal pouch

Question 20

Name the 9 abdominal organs:

Answer 20

1. Liver
2. Gallbladder
3. Pancreas
4. Spleen
5. Stomach
6. Small intestines
7. Large intestines
8. Kidneys
9. Adrenal glands

Question 21

The _____ attaches to the inferior surface of the liver

Answer 21

Gall bladder

Question 22

Bile drains from gallbladder to ______.

Answer 22

Duodenum

Question 23

R & L Hepatic ducts do what?

Answer 23

Receive bile from R & L liver lobes.

Question 24

Common Hepatic duct does what?

Answer 24

Receives bile from Hepatic ducts

Question 25

Cystic duct does what?

Answer 25

Joins gall bladder to common bile duct.

Question 26

Common bile duct does what?

Answer 26

empties all ducts & gall bladder into duodenum

Question 27

Common bile duct joins the ________ and both empty into the ________

Answer 27

• Main pancreatic duct

- Major duodenal papilla

Question 28

Describe te drainage of pancreatic ducts….

Answer 28

Enzymes drain from 1 or 2 ducts:

• Main pancreatic duct enters duodenum with bile duct at Major duodenal papilla.
• Accessory Pancreatic duct may enter duodenum as well (~2cm superior to major papilla)

Question 29

_______ has a diaphragm surface along ribs 9-11

Answer 29

The Spleen

Question 30

Describe briefly the Arterial supply of upper abdomen THEN DRAW IT ALL!

Answer 30

• Celiac trunk branches into Com. Hepatic, L. Gastric & Splenic Aa.
• Com. Hepatic has terminal branches: Proper hepatic A & Gastroduodenal A.

Question 31

What does Left Gastric Artery supply?

Answer 31

Supplies stomach & Esophagus (via esophageal branches).

*runs left toward lesser curvature of stomach

Question 32

Tell me about the Splenic Artery….

Answer 32

• Supplies pancreas and spleen.
• Left branch of celiac trunk.
• Runs toward spleen.
• VERY CURLY!

Question 33

What are the common variations of the Hepatic Artery?

Answer 33

• Variations about 40% of time.
• R. hepatic Artery may rise from SMA
• L. Hepatic artery may arise from L. Gastric artery.

Question 34

Tell me about the Cystic artery…

Answer 34

• Supplies gallbladder & cystic duct.
• Usually arises from R.Hepatic artery.
• Usually run posterior to common hepatic duct.
• This Artery is usually green!

Question 35

What supplies the lesser curvature of the stomach?

Answer 35

Right Gastric artery

*arises from common hepatic or gastroduodenal artery.