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characteristics of peritoneum
- continuous (closed) serous sac except in females
- parietal and visceral layers + intermediate (mesentary)-connects parietal and visceral, not attached to body wall
- attachements/reflections-region of gut tube
- covering-intraperitoneal vs retroperitoneal
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Greater and lesser omentum (mesogastrium)
-attachments to stomach-peritoneum to stomach
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mesentery
-attachement from body wall to SI (general term)
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mesocolon
attachment from body to LI
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Ligaments
folds(sharp borders) or sheets between organs and wall
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coverings
- intraperitoneal-completely covered (suspended) except for mesentery
- retroperitoneal-covered only on anterior surface (bare area)
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cavities
- peritoneal, abdominal, pelvic, greater sac, lesser sac (omental bursa)
- greater sac + lesser sac=peritoneal cavity
- peritoneal cavity-completely covered by squamous cells
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dorsal mesogastrium
- splenorenal (linorenal)
- gastrosplenic (gastrolienal)
- greater omentum-gastrophrenic, gastrosplenic, gastrocolic
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ventral mesogastrium
- lesser omentum-hepatogastric, hepatodueodenal
- ligaments of liver
- no blood supply to liver from ventral wall-all from posterior wall and around gut tube
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what seperates dorsal mesogastrium from ventral mesogastrium?
gut tube
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components of greater omentum
- gastrophrenic ligament-greater curvature to diaphragm above others
- gastrosplenic lig.-greater curvature to spleen
- gastrocolic lig.-greater curvature to transverse colon
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functions of greater omentum
- normally hangs over small intestine but may be tightly tucked into recess or wound aroudn viscera
- keeps visceral and parietal layers apart-not static, constantly moving-b/t body wall and visceral
- capacity to be drawn to infected or inflammed area and wall off area-can get adhesions
- one of fat deposit areas of body and insulates against heat loss-2nd source of energy
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components of lesser omentum
- hepatogastric
- hepatoduodenal artery
- portal triad-free edge of hepatoduodenal lig.
- -portal vein
- -hepatic artery
- -common bile duct
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epiploic foramen
opening to lesser sac
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relations of lesser sac
- ant.-hepatoduodenal lig.
- post.-IVC covered by peritoneum
- sup.-quadrate lobe of liver
- inf.-duodenum
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recesses of lesser sac
- upper (subhepatic)
- splenic
- Lower (greater omentum)
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development of liver
- from endoderm of duodenum (4th week)
- develops in ventral mesentary (mesogastrium)-lesser omentum, falciform lig.
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fetal circulation of liver
- ligamentum teres-obliterated umbilical vein in free edge; bounded to wall by falciform lig., runs up right of midline
- ligamentum venosum-obliterated ductus venosus-carries blood back to liver
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anterior components of liver-coronary ligaments
- falciform lig. splits into 2 ligaments-connection to ant. body wall
- right and left coronary lig.-connection to diaphragm
- right and left triangular lig-limits of coronary lig. layers fused
- posterior coronary ligaments
- bare area-bounded by 4 coronary ligaments
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posterior components of liver-lesser omentum
- free edge: common bile duct, portal vein, hepatic artery
- lesser curvature of stomach to visceral surface of liver
- subdivisions-hepatogastric, hepatoduodenal
- bare area
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dorsal common mesentary
- mesentary
- mesocolon-transverse & sigmoid (ascending, descending & rectum lost)
- mesoappendix
- ascending and descending-retro
- sigmoid-intro
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peritonitis
- infection of the peritoneal cavity, both common and life threatening
- can occur from rupture of infected organ or by bacteria from stab or gunshot wounds
- localization of infections can lead to intrperitoneal abscesses
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ascites
- excess fluid in peritoneal cavity and one of the most likely sites is the subhepatic recess
- drainage of abscesses is possible without causing generalized peritonitis
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paracentesis
is drainage of large volumes of blood or serous fluid that accumulate in recesses
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where does fluid accumulate?
- standing-accumulates in pelvis-rectouterine pouch
- supine-subhepatic recess
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