Flashcards
The Peritoneum
Cards in this deck (26)
- 1What are the boundaries of the foregut, midgut and hindgut?Foregut: Stomach to the end of the first part of the duodenum
Midgut: Caudal (end 2/3) of the duodenum to the colic flexure
Hindgut: Colic flexure to upper anal canal - 2During foetal development how is the gut tube attached to abdominal wall?To the posterior wall by the dorsal mesogastrium, to the anterior wall by the ventral mesogastrium.
Mesogastrium is mesentary. - 3What do the dorsal and ventral mesogastrium become?The dorsal mesogastrium becomes the greater omentum, the ventral mesogastrium becomes the lesser omentum.
- 4What does the greater omentum grow down to? Where does the greater omentum fuse? What effect does this have on the pancreas and duodenum? What space forms?1) The transverse colon (gastrocolic ligament), then descends below - greater omentum.
2) Fuses with the transverse mesocolon and with the posterior abdominal wall
3) Fusion with the posterior abdominal wall means that the pancreas (excluding the tail) and the duodenum become retroperitoneal through development
4) Omental bursa (anterior is the lesser omentum) - 5—X
- 6If you lift up the stomach to reveal the lesser sac (remember it's close), what recesses develop?1) Hepatic recess between posterior aspect of the stomach and the left lobe of the liver
2) Splenic recess - into the hilum of the spleen
3) Omental recess which descends from the posterior wall of the stomach down to the superior aspect of the greater omentum - 7What is the only opening into the omental bursa?Epiploic foramen
- 8How does the midgut develop?Around week 6 the intestines form a U-shaped intestinal loop which herniates into the umbilical cord as there is insufficient room within the abdomen at this point. Rotates 90 degrees. At week 10 it retracts back into the abdomen (two more ninety degree turns) as there is now enough room to accommodate the intestinal loops. 270 degree rotation in total.
- 9What is omphalocele?Congenital abnormality (1:2,000 births) failure of midgut hernia through umbilical ring to go back into the abdomen. Has to be corrected surgically.
- 10What ligament divides the left and right lobe of the liver? What does it attach the liver to?Falciform ligament, contains residue of ligamentum teres/round ligament (remnant of fetal umbilical vein).
2) Attaches to the anterior abdominal wall - 11What ligaments are located within the lesser omentum?The hepatoduodenal ligament and hepatogastric ligament.
- 12Which structures run through the epiploic foramen?Hepatic artery proper, bile duct and the hepatic portal vein. Substances can run from the lesser omentum to the greater omentum, sacs are continuous.
- 13What is the function of the transverse mesocolon?Holds the transverse colon to the posterior abdominal wall
- 14What is located within the mesentery?Suspends the small intestine from the posterior abdominal wall, provides pathway for vasculature.
- 15What is peritoneal dialysis?Inject fluid which pulls out toxins in the blood supply within the blood supply in the peritoneal cavity. Drain, fill, dwell (wait for 5-6 hours to allow for exchange of toxins with the dialocyte) then empty. Used in renal disease.
- 16Which GI organs are retroperitoneal?Duodenum, ascending and descending colon, and pancreas (except for the tail). Kidneys.
- 17What is ascites?Collection of fluid in the peritoneum, generally due to liver cirrhosis, lack of albumin leads to oedema in the peritoneal cavity.
- 18What is insufflation?Gas (CO2) can be blown into the cavity to increase the amount of room available.
- 19What are the subdivisions (potential spaces) of the peritoneal cavity?1) Subphrenic recess (space between diaphragm and liver), divided into L & R by the falciform ligament.
2) Subhepatic recess/hepatorenal recess/ pouch - is on the RHS. On the LHS is the lesser sac/omental sac - 20—X
- 21Which organs tend to be intraperitoneal?Structures which move on their own or passively e.g. the liver moves because it is attached to the diaphragm.
- 22What division does the transverse mesocolon create? What links these division?The supracolic and infracolic divisions (but they are continuous through the epiploic foramen and the paracolic gutters).
- 23—X
- 24How does infection spread through the abdomen? Where is infection more likely to spread then?Through the potential spaces and omentums. The right hand side as this is where the epiploic foramen is located. (paracolic gutters also spread infection). Infections can arise from the supracolic to the infracolic division, i.e. have to check that the an infection is definitely arising from infracolic organs, e.g. appendix, and hasn't just flowed down.
- 25Which organs are retroperitoneal (secondary or pseudo, i.e. started intraperitoneal but moved during development)1) Pancreas (except tail)
2) 2nd and 3rd parts of duodenum
3) Ascending and descending colon
4) Rectum - 26Which structures are primary retroperitoneal?Kidneys, ureter, great vessels (aorta and inferior vena cava).