peritoneum/ esophagus

intraperitoneal organs

stomach

small intestine (J, I, some superior part of duodenum)

spleen

liver

gall bladder

cecum w appendix

large intestine (transverse + sigmoid)

stomach

intraperitoneal

small intestine (J, I, some superior part of duodenum)

intraperitoneal

spleen

intraperitoneal

liver 

intraperitoneal

gall bladder

intraperitoneal

cecum w vermiform appendix

intraperitoneal

large intestine (transverse + sigmoid)

intraperitoneal

Retroperitoneal organs

uterine cervix

kidneys

suprarenal glands

pancreas

duodenum

ascending + descending colon

rectum (upper 2/3)

kidneys

retroperitoneal

uterine cervx

retroperitoneal

suprarenal glands

retroperitoneal

pancreas

retroperitoneal

duodenum

retroperitoneal

ascending and descending colon

retroperitoneal

upper 2/3 of rectum considered

retroperitoneal

Cs of lesser sac and epiploic foramen

opening to the lesser sac is epiploic foramen, beneath portal triad

+site of herniation/strangulation

If there is an increase in intra-abdominal fat or pressure, can displace/displace the intestines up, allowing for a loop of small intestine to go thru epiploic foramen, getting into the lesser sac 

Surgery for lesser sac+ epiploic foramen

it should be done from the other side (into the sac), not touching the porta hepatis

cystic artery of the gall bladder can be reached thru epiploic foramen

Greater omentum

prevents visceral peritoneum to adhere to parietal peritoneum

Greater omentum

has mobility nd moves by peristaltic movements of the viscera

what contains fat and lymphocytes, along w other immune cells to protect against infection or inflammatory conditions in the abdominal cavity?

the greater omentum

what moves towards inflamed/infected area (i.e appendicitis)?

the greater omentum

what protects abdominal organs against injury and acts as an insulator against loss of body heat?

the greater omentum (has 4 layers)

Cs of peritoneal spaces nd compartments

bc of arrangement of the peritoneum, fluid in the abdominal cavity tends to collect and become localized in certain regions

—subphrenic space, paracolic gutters, right and left subhepatic space nd infracolic spaces

-fluid will accumulate post-op due to not moving properly, respiratory problems due to diaphragm irritation

Blood supply to cervical portion of the esophagus?

inferior thyroid artery

bloody supply to thoracic portion of esophagus?

thoracic aorta and bronchial arteries

blood supply to lower part of esophagus including abdominal portion?

left gastric artery and inferior phrenic artery

Venous drainage of the esophagus

inferior thyroid vein

azygous vein

hemizygous and gastric vv (HAIG)

Cs of esophageal varices

gastric vv drain into portal vein (Porto-caval anastomoses), if liver is compromised portal hypertension develop and blood will back into the lower part of esophagus as its being pushed back into the gastric vv

—veins very dilated, push into lumen of esophagus

Esophagus histology- mucosa

stratified non-keratinized squamous epthelium

esophagus histology- after mucosa comes what layer?

submucosa

esophagus histology-tunica muscularis

consists of inner circular n outer longitudinal muscular layers

esophagus histology- what is the outermost layer?

adventitia/ serosa

epithelium lining GI tract- mouth to stomach(cardia)

stratified non-keratinized squamous epithelium

epithelium lining GI tract- inside stomach to upper anal canal

simple columnar

epithelium lining GI tract- below pectinate line, lower anal canal

stratified non-keratinized squamous

 Zenker’s diverticulum complications

ulceration, bleeding, inflammation

Zenker’s diverticulum location/signs

upper esophagus

dysphasia, halitosis

How can you treat Zenker’s diverticulum?

surgery

Achalasia

restrosternal pain

neuromotor disorder of lower esophageal sphincter; increased pressure too

decreased cells in myenteric plexus

dysphagia (solid n liquid)

dilated proximal esophagus+ aperistalsis

Barrett’s esophagus

columnar cell metaplasia of the squamous epithelium due to acid injury

Foregut

esophagus n stomach down to 2nd part of duodenum

-includes liver, biliary system, gall bladder, pancreas

Midgut

starts from lower half of 2nd part of duodenum and jejunum, ileum, colon (cecum, ascending nd the right 2/3 of the transverse colon)

hindgut

left 1/3 of the transverse colon, descending colon, sigmoid colon, rectum nd upper part of anal canal

Blood supply: foregut

celiac trunk

blood supply: midgut

superior mesenteric artery

blood supply: hindgut

inferior mesenteric artery

Parasympathetic innervation for foregut nd midgut

vagus nerve (CN X)

from esophagus up to the right 2/3 of transverse colon

Parasympathetic innervation for hindgut

pelvic splanchnic nerves (s2-s4) 

from 1/3 left of transverse colon down to anal canal

Sympathetic innervation for Foregut, midgut, hindgut

from lower esophagus to anus by (T5-L2) spinal liagements