peritoneum stomach liver biliary tract n spleen

• Peritoneum


  Serous membrane lining the abdomino-pelvic cavity and investing the viscera
• Parietal peritoneum


  Lines the abdominopelvic cavity

  
• Visceral peritoneum


  Covering the organs
• As peritoneum envelopes abdominal organs, it folds over itself, forming omenta, ligaments, and mesenteries
• Peritoneal cavity


  A potential space within the layer of peritoneum

  
• The peritoneal cavity is a completely closed system in males, but has external communication between the vagina and uterine cavity in females
• Lesser Omentum


  A double layered peritoneal fold extending from the liver to the lesser curvature of the stomach
• Greater Omentum


  A double layered peritoneal fold extending between greater curvature of the stomach and the transverse colon

  
• Ligament


  A fold connecting one organ with another or one organ with any area of the body wall
• Mesentery


  A fold connecting an organ to the posterior abdominal wall, serving as a conduit for vessels, nerves and lymphatics

  
• The portal vein, hepatic artery and bile duct run within the lesser omentum near its free edge
• Intraperitoneal


  Structures suspended from the abdominal wall by mesenteries

  
• Retroperitoneal


  Structures lying between the parietal peritoneum and abdominal wall

  
• Epiploic (omental) foramen


  The entrance to the lesser sac (omental bursa)
• The esophagus pierces the diaphragm at T10
• Stomach


  • Lies between the esophagus and small intestine, has 4 main regions (cardia, fundus, body, pylorus), 2 orifices (cardiac, pyloric), 2 curvatures (greater, lesser), completely covered by peritoneum, involved in enzymatic digestion
• The stomach is a common site for ulcers and cancerous growth, which can penetrate the wall and spread by lymphatics
• Foregut


  Distal 3rd of esophagus to 2nd part of duodenum
• Midgut


  2nd part of duodenum to 2/3 along transverse colon
• Hindgut


  Distal 1/3 of transverse colon to rectum
• Celiac trunk


  Supplies the entire foregut and its derivatives (liver, part of pancreas), as well as the spleen
• Arterial supply to stomach

  • Gastric arteries arising from celiac trunk and branches (left/right gastric, left/right gastro-omental, short gastric)
• Venous drainage of stomach

  • Left and right gastric veins are tributaries of portal vein
• Lymphatic drainage of stomach

  • Gastric lymphatic vessels along greater and lesser curvature, draining to gastric nodes then celiac nodes and thoracic duct
• Lymph node metastasis is the most important prognostic factor in curable gastric cancer, and lymph node dissection is a key area of surgical research
• Nerve supply to stomach

  • Sympathetic from T5-T9 spinal segments, parasympathetic from right and left vagus nerves
• Gastric veins


  Run parallel to the gastric arteries in position and course
• Left and right gastric veins

  Tributaries of portal vein
• Lymphatic vessels of the stomach

  • Found along the greater and lesser curvature of the stomach
• Gastric lymph nodes


  • Right and Left gastro-omental nodes
• Lymphatic drainage of the stomach

  1. Efferent vessels from gastric nodes drain into celiac nodes

  2. Then to thoracic duct
• The lymphatic system of the stomach is a multidirectional and complex network composed of lymphatic nodes and vessels
• Lymph node metastasis is the most important prognostic factor in curable gastric cancer and lymph node dissection is one of the main areas of surgical research in gastric cancer
• Nerve supply of the stomach

  • Sympathetic nerve fibres from the T5-T9 spinal segments
  • Parasympathetic nerve fibres from the right (posterior) and left (anterior) vagus nerves
• Sympathetic nervesof the stomach


  Stimulate pyloric sphincter
• Parasympathetic nerves


  • Stimulate peristalsis movement of the stomach
  • Stimulate secretion of gastric glands (secretomotor)
• Sympathetic nerve supply of the stomach

  1. Preganglionic fibres pass through the greater splanchnic nerves and terminate in the celiac ganglion

  2. Postganglionic sympathetic nerves supply the stomach
• Sensory (pain) fibres


  Accompany the sympathetic nerve fibres and reach the T5-T9 spinal sensory ganglia
• Visceral referred pain from gastric ulcer


  Referred to the epigastric region
• The liver is critically important with respect to proper digestive function, metabolism and detoxification