Exam 3

what are the 2 layers of the peritoneum?

parietal and visceral

what does the parietal peritoneum line?

lines walls of pelvic and abdominal cavities

what does the visceral peritoneum line?

lines/directly covers organs

what does the greater omentum connect?

greater curvature of stomach to transverse colon

what is the hepatogastric ligament connected to?

liver - lesser curvature of the stomach

what does the hepatogastric ligament contain?

left and right gastric vessels

what is the hepatoduodenal ligament connected to?

liver - 1st part of the duodenum

what does the hepatoduodenal ligament contain?

proper hepatic artery, portal vein, and common bile duct

(medially -> laterally)

what are the borders of the epiploic foramen?

superior: caudate lobe

anterior: hepatoduodenal ligament

posterior: IVC

inferior: 1st part of the duodenum

what are intraperitoneal organs covered with?

visceral peritoneum

where are retroperitoneal organs located?

external to the parietal peritoneum

what are the intraperitoneal organs?

• stomach

• first part of duodenum

• jejunum

• ileum

• appendix

• transverse colon

• sigmoid colon

• liver

• spleen

• tail of pancreas

what are the retroperitoneal organs?

• duodenum (except 1st part)

• pancreas (except tail)

• kidneys and ureters

• suprarenal gland

• ascending colon

• descending colon

• great vessels and nerves (aorta & IVC)

what branch of the abdominal aorta supplies the foregut?

celiac artery

what branch of the abdominal aorta supplies the midgut?

superior mesenteric artery

what branch of the abdominal aorta supplies the hindgut?

inferior mesenteric artery

at which vertebral level does the celiac artery branch off of the abdominal aorta?

upper border of LV1

what are the 3 direct branches of the celiac artery?

left gastric artery, splenic artery, and common hepatic artery

what branches off of the left gastric artery?

esophageal branch → supplies distal esophagus

what are the branches of the splenic artery?

pancreatic artery

• dorsal branch

• major branch

• caudal branch

short gastric artery (5-7 branches)

left gastroepiploic artery

what are the branches of the common hepatic artery?

gastroduodenal artery

• right gastroepiploic artery

• superior pancreaticoduodenal artery

NAME CHANGE (after gastroduodenal branch) to proper hepatic artery

• right gastric artery

• left & right hepatic artery (terminal)

what are the 4 parts of the stomach?

cardia, fundus, body, and pylorus

what are the “borders” of the stomach?

lesser curvature, greater curvature, cardiac notch, and angular notch

what is the blood supply of the stomach in the lesser omentum?

• left gastric artery

  • esophageal branch

• right gastric artery

both gastric arteries anastomose

what is the blood supply of the stomach in the greater omentum?

• short gastric artery

• left gastroepiploic artery

• right gastroepiploic artery

left and right gastroepiploic arteries anastomose

what is the venous drainage of the stomach in the lesser omentum?

left & right gastric veins → drain to portal vein

what is the venous drainage of the stomach in the greater omentum?

short gastric vein and left gastroepiploic vein → drain to splenic vein

right gastroepiploic vein → drain to superior mesenteric vein

which 2 veins join to form the portal vein/system?

splenic & superior mesenteric veins

the esophageal vein connects which 2 systems, and to which vein does it drain next?

connects the portal and systemic circulations

next drains into the left gastric vein → portal

at which vertebral levels are the 4 parts of the duodenum?

first part → LV1

second part → LV 1-3

third part → LV3

fourth part → LV2

at which vertebral level does the third part of the duodenum cross the midline, and what structures is this part between?

crosses midline at LV3

passes between superior mesenteric artery, aorta, and IVC

what is the blood supply to the portion of the duodenum in both the foregut and midgut?

foregut: celiac artery/trunk

midgut: superior mesenteric artery

which part of the duodenum is the only part considered to be intraperitoneal?

first part → rest are retroperitoneal

what are the branches of the celiac trunk that supply the duodenum?

supraduodenal artery (branch of gastroduodenal a.) &

superior pancreaticduodenal artery (branch of gastroduodenal a.)

• superior pancreaticduodenal artery gives off an anterior and posterior branches

what are the branches of the superior mesenteric artery that supply the duodenum?

inferior pancreaticoduodenal artery

• gives off anterior and posterior branches

what anastomoses occur between arteries involved in the blood supply to the duodenum?

ant. branch (of sup. pancreaticoduodenal a.) → ant. branch (of inf. pancreaticoduodenal a.)

post. branch (of sup. pancreaticoduodenal a.) → post. branch (of inf. pancreaticoduodenal a.)

what are the main ways to tell the difference between the jejunum and ileum of the small intestine?

jejunum

• left upper quadrant

• thicker wall

• prominent circular folds

ileum

• right lower quadrant

• thinner wall

• fewer mucosal circular folds

• more mesenteric fat

what are the three characteristics of the large intestine?

• taeniae coli

• haustra

• epiploic appendages

in what portion are the features of the large intestine not present?

rectum

when the taeniae coli contract, what do they make?

haustra

at which vertebral level does the superior mesenteric artery branch off of the abdominal aorta?

lower border of LV1

what are the 5 direct branches of the superior mesenteric artery?

inferior pancreaticoduodenal artery, middle colic artery, right colic artery, intestinal branches, and ileocolic atery

what does the middle colic artery supply?

proximal 2/3 of transverse colon

what artery does the right colic artery sometimes arise from, and what does it supply?

can branch from ileocolic artery and supplies the ascending colon

what arteries are included in the intestinal branches?

jejunal and ileal arteries

at which vertebral level does the inferior mesenteric artery branch off of the abdominal aorta?

LV3

what are the 3 direct branches of the inferior mesenteric artery?

left colic artery

• ascending branch

• descending branch

sigmoid arteries, and superior rectal artery (terminal)

what is supplied by the left colic artery and its branches?

distal 1/3 of transverse colon, left colic flexure, and descending colon

the “marginal artery of drummond” is formed by which arteries?

• ileocolic artery

• right colic artery

• middle colic artery

• left colic artery

• sigmoid artery

• superior rectal artery

the neck of the pancreas is located anterior to what?

superior mesenteric artery, superior mesenteric vein, and the formation of the portal vein

what is the tail of the pancreas located in?

lienorenal ligament

what structure is created at the junction of the main pancreatic duct and common bile duct?

hepatopancreatic ampulla (ampulla of vater)

what structure surrounds the hepatopancreatic ampulla and controls the flow of bile and pancreatic juice?

sphincter of ampulla (oddi)

what are the 4 direct branches of the celiac trunk that provide blood supply to the pancreas?

superior pancreaticoduodenal artery, dorsal pancreatic artery, major (great) pancreatic artery, and caudal pancreatic artery

the superior pancreaticoduodenal artery is a branch of what, gives off what branches, and supplies what part of the pancreas?

is a branch of the gastroduodenal artery, gives off anterior and posterior branches, and supplies the head of the pancreas

the dorsal pancreatic artery is a branch of what, gives off what branch, and supplies what part of the pancreas?

is a branch of the splenic artery, gives off the inferior pancreatic artery, and supplies the neck of the pancreas

the major (great) pancreatic artery is a branch of what, and supplies what part of the pancreas?

is a branch of the splenic artery, and supplies the body of the pancreas

the caudal pancreatic artery is a branch of what, and supplies what part of the pancreas?

is a branch of the splenic artery, and supplies the tail of the pancreas

the superior mesenteric artery gives off which artery that has anterior and posterior branches which supply the pancreas?

gives off the inferior pancreaticoduodenal artery which further gives off anterior and posterior branches

which branches of the celiac trunk and superior mesenteric artery form an anastomoses near the head of the pancreas?

superior pancreaticoduodenal artery (celiac trunk) and inferior pancreaticoduodenal artery (superior mesenteric artery)

unit 18 - slide 52

unit 18 - slide 52