Peritoneum and Peritoneal Cavity Quiz

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Questions and Answers

What is the primary function of the inferior mesenteric vein?

Drains the superior rectum and rectum

Drains the stomach and duodenum

Drains the small intestine

Drains the splenic flexure, descending colon, sigmoid colon, and rectum (correct)

Which lymphatic group does the lymph from the inferior mesenteric group drain into?

Superior mesenteric group (correct)

Coeliac group

Cysterna chyli

Inferior mesenteric group

Which of these traits characterize the enteric nervous system?

It is entirely independent of the central nervous system

It consists of sensory neurons only

It regulates contraction and relaxation of smooth muscle (correct)

It solely controls the blood flow in the head

The abdominal prevertebral plexus is divided into which three plexuses?

Coeliac, aortic, superior hypogastric Signup and view all the answers

What describes the role of visceral efferent fibers?

They are involved with motor impulses to the central nervous system Signup and view all the answers

Which organ does the right gastro-omental vein primarily relate to?

The stomach Signup and view all the answers

Which of the following best explains the function of the myenteric plexus?

Controls motor functions of the gastrointestinal tract Signup and view all the answers

Where does the inferior mesenteric vein drain?

Into the splenic vein or superior mesenteric vein Signup and view all the answers

What is the primary function of the greater omentum in the abdomen?

To act as a barrier against infections. Signup and view all the answers

What types of viscera are referred to as retroperitoneal?

Viscera that are only partially covered by peritoneum. Signup and view all the answers

Which artery is primarily responsible for blood supply to the midgut?

Superior mesenteric artery. Signup and view all the answers

What is the name of the small subdivision of the peritoneal cavity located posterior to the stomach?

Omental bursa. Signup and view all the answers

Which structure connects the jejunum and ileum to the posterior abdominal wall?

Mesentery. Signup and view all the answers

Which artery supplies blood to the descending colon?

Left colic artery. Signup and view all the answers

The marginal artery provides anastomotic connections between which structures?

Inferior and superior mesenteric arteries. Signup and view all the answers

The portal vein is formed by the union of which veins?

Splenic vein and superior mesenteric vein. Signup and view all the answers

What are the primary components of the greater sac within the peritoneal cavity?

Begins at the diaphragm and extends to the pelvic cavity. Signup and view all the answers

Which ligaments are a part of the lesser omentum?

Hepatoduodenal and hepatogastric ligaments. Signup and view all the answers

Which artery supplies the rectum and anal canal?

Superior rectal artery. Signup and view all the answers

What is the primary role of mesenteries in the gastrointestinal tract?

To connect viscera to the abdominal wall and support neurovasculature. Signup and view all the answers

Which artery branches from the coeliac trunk and supplies the stomach's lesser curvature?

Right gastric artery. Signup and view all the answers

Which vascular structure drains the majority of the abdominal viscera?

Hepatic portal vein. Signup and view all the answers

Study Notes

Peritoneum

Thin membrane lining the abdominal cavity, covering internal organs.
Parietal peritoneum lines the abdominal walls.
Visceral peritoneum covers internal organs.
Peritoneal cavity is the space between the parietal and visceral peritoneum.
Organs suspended in the cavity by mesentery, folds of peritoneum, are called intraperitoneal.
Organs outside the cavity, or partially covered, are called retroperitoneal.

Peritoneal Cavity

Divided into greater sac and omental bursa.
Greater Sac is the largest part of the peritoneal cavity, extending from the diaphragm to the pelvic cavity.
Omental Bursa is a smaller subdivision, located behind the stomach, connected to the greater sac by the omental foramen.

Omental Foramen

Structures surrounding the omental foramen are covered with peritoneum:
- Anteriorly: portal vein, hepatic artery proper, bile duct.
- Posteriorly: inferior vena cava.
- Superiorly: caudate lobe of the liver.
- Inferiorly: first part of the duodenum.

Omenta, Mesenteries & Ligaments

Numerous peritoneal folds connecting organs to each other or the abdominal wall.
Some contain neurovasculature supplying organs.
Develop from original dorsal and ventral mesenteries.
Two layers of peritoneum:
- Greater omentum: derived from dorsal mesentery, “policeman of the abdomen,” large apron-like fold attached to the greater curvature of stomach and first part of duodenum.
- Lesser omentum: derived from ventral mesentery, attached to the lesser curvature of stomach and first part of duodenum, continuous with peritoneum on the anterior and posterior walls of the stomach.

Greater Omentum

Large, apron-like fold attached to the greater curvature of the stomach and first part of the duodenum.
Drapes over the transverse colon, jejunum, and ileum.
Attached to the peritoneum on the superior surface of the transverse colon before attaching to the posterior abdominal wall.
Contains an accumulation of fat.
Contains right and left gastro-omental vessels in relation to its attachment to the greater curvature of the stomach.

Lesser Omentum

Attached to the lesser curvature of the stomach and first part of the duodenum.
Attached to the inferior surface of the liver.
Continuous with peritoneum covering the anterior and posterior wall of the stomach.
Divided into:
- Hepatogastric ligament: medially, between the stomach and liver.
- Hepatoduodenal ligament: laterally, between the duodenum and liver, contains the portal vein, hepatic artery proper, and bile duct.
Contains gastric vessels near the lesser curvature of the stomach.

Mesentery

Peritoneal folds attaching organs to the posterior abdominal wall.
Allows for movement and transports neurovasculature.
Large, fan-shaped, double-layered fold of peritoneum connecting the jejunum and ileum to the posterior abdominal wall.
Superior attachment: Duodenojejunal junction.
Inferior attachment: Ileocecal junction.
Includes:
- Transverse mesocolon: connects the transverse colon to the posterior abdominal wall.
- Sigmoid mesocolon: V-shaped peritoneal fold with the apex near the division of the left common iliac artery, limbs related to the left psoas major muscle and ends at S3 in the pelvis.
- Mesoappendix: peritoneal fold which connects the appendix to the ileum

Blood Supply of Gastrointestinal Tract

Via branches of:
- Celiac trunk: supplies the foregut.
- Superior mesenteric artery: supplies the midgut.
- Inferior mesenteric artery: supplies the hindgut.

Stomach

Receives blood supply from:
- Left gastric artery: lies on the lesser curvature of the stomach.
- Right gastric artery: lies on the lesser curvature of the stomach.
- Left gastro-omental/gastro-epiploic artery: lies on the greater curvature of the stomach.
- Right gastro-omental/gastro-epiploic artery: lies on the greater curvature of the stomach.
- Posterior gastric artery: variation, may not be present, lies on the posterior wall of the stomach.

Duodenum

Receives blood supply from:
- Gastroduodenal artery:
  - Supraduodenal artery
  - Anterior superior pancreaticoduodenal artery
  - Posterior superior pancreaticoduodenal artery
- Superior mesenteric artery:
  - First jejunal branch
  - Anterior inferior pancreaticoduodenal artery
  - Posterior inferior pancreaticoduodenal artery

Jejunum & Ileum

Receives blood supply from the superior mesenteric artery via jejunal and ileal arteries.

Caecum & Appendix

Receives blood supply from the superior mesenteric artery via branches of the ileocolic artery:
- Anterior caecal artery
- Posterior caecal artery
- Appendicular artery.

Ascending Colon

Receives blood supply from the superior mesenteric artery and the ileocolic artery:
- Colic branch: from the ileocolic artery.
- Posterior caecal artery: from the ileocolic artery.
- Appendicular artery: from the ileocolic artery.
- Right colic artery: from the superior mesenteric artery.

Transverse Colon

Receives blood supply from:
- Right colic artery: from the superior mesenteric artery.
- Middle colic artery: from the superior mesenteric artery.
- Left colic artery: from the inferior mesenteric artery.

Descending Colon & Sigmoid Colon

Receives blood supply from:
- Descending Colon: Left colic artery from the inferior mesenteric artery.
- Sigmoid Colon: Sigmoidal arteries from the inferior mesenteric artery.
- Marginal artery: anastomotic connections between arteries supplying the colon.

Rectum & Anal Canal

Receives blood supply from:
- Superior rectal artery: from the inferior mesenteric artery.
- Middle rectal artery: from the internal iliac artery.
- Inferior rectal artery: from the internal pudendal artery.

Portal System of Veins

Veins mainly drain through the portal system.
Portal vein formed by the union of the splenic vein and superior mesenteric vein, posterior to the neck of the pancreas at the level of L2.
Passes superior to the superior part of the duodenum.
Enters the right margin of the lesser omentum.
Lies anterior to the omental foramen.
Receives:
- Right and left gastric veins.
- Cystic veins (from the gallbladder).
- Para-umbilical veins.

Splenic Vein

Forms from smaller vessels leaving the hilum of the spleen.
Passes through the splenorenal ligament.
Lies posterior to the body of the pancreas.
Joins the superior mesenteric vein to form the portal vein.
Tributaries drain the:
- Short gastric veins: drain the fundus of the stomach and the left part of the greater curvature of the stomach.
- Left gastro-omental/gastro-epiploic vein: drains the greater curvature of the stomach.
- Pancreatic vein: drains the body and tail of the pancreas.
- Inferior mesenteric vein.

Superior Mesenteric Vein

Drains the small intestine, caecum, ascending colon, and transverse colon.
Begins as a fusion of veins draining the terminal ileum, caecum, and appendix.
Ascends to form the portal vein with the splenic vein.
Tributaries accompany the superior mesenteric artery branches.
Additional tributaries:
- Right gastro-omental/ gastro-epiploic vein: drains the greater curvature of the stomach.
- Anterior & Posterior inferior pancreaticoduodenal veins.

Inferior Mesenteric Vein

Drains the splenic flexure, descending colon, sigmoid colon, and rectum.
Begins as the superior rectal vein and ascends.
Receives tributaries from the sigmoid veins and left colic vein.
Drains into the splenic vein.
May also drain directly into the superior mesenteric vein or at the junction of the splenic and superior mesenteric veins.

Lymphatic Drainage

All drainage is to pre-aortic lymph nodes.
Via:
- Celiac, superior mesenteric, and inferior mesenteric groups.
Route:
- Lymph from the inferior mesenteric group drains to the superior mesenteric group.
- Lymph from the superior mesenteric group drains to the celiac group.
- Lymph from the celiac group drains into the cysterna chyli.

Innervation

Abdominal viscera are innervated by extrinsic and intrinsic components:
- Extrinsic:
  - Receives motor impulses and sends sensory impulses to the central nervous system.
  - Composed of visceral efferent and visceral afferent fibers.
  - Visceral efferent fibers are part of the sympathetic and parasympathetic systems.
  - Structures include anterior and posterior rami, rami communicantes, splanchnic nerves, sympathetic ganglia, prevertebral plexus.
- Intrinsic:
  - Regulation of the digestive system via the enteric nervous system.
  - Found in the walls of the gastrointestinal tract.
  - Contains motor and sensory neurons.
  - Coordinates contraction and relaxation of smooth muscle and regulates gastric secretion and blood flow.

Innervation - Sympathetic & Parasympathetic

Sympathetic: abdominal prevertebral plexus branches from ganglia.
Three divisions:
- Celiac plexus
- Aortic plexus
- Superior hypogastric plexus
Parasympathetic: vagus nerve association with prevertebral plexus.
Pelvic splanchnic nerves carry impulses to the inferior hypogastric plexus.

Innervation - Enteric System

Consists of motor and sensory neurons organized into two plexuses:
- Myenteric plexus
- Submucosal plexus
Generally independent of the central nervous system but receives input from the sympathetic and parasympathetic systems.
Regulates and coordinates gastrointestinal tract activities:
- Gastric secretory activity
- Gastrointestinal blood flow
- Peristalsis

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Description

Test your knowledge on the structure and function of the peritoneum and its subdivisions. This quiz covers the definitions of parietal and visceral peritoneum, the organization of the peritoneal cavity, and the omental foramen. Perfect for students of anatomy and physiology.