Peritoneal cavity- lesseer sac & greater sac

PERITONEAL CAVITY- LESSEER SAC & GREATER SAC

Q. 1

The boundaries of the interconnection between greater sac and lesser sac of peritoneum known as ‘Foramen of Winslow’ are all, EXCEPT:

 A

Caudate lobe of liver

 B

Inferior vena cava

 C

Free border of lesser omentum

 D

4th part of Duodenum

Q. 1

The boundaries of the interconnection between greater sac and lesser sac of peritoneum known as ‘Foramen of Winslow’ are all, EXCEPT:

 A

Caudate lobe of liver

 B

Inferior vena cava

 C

Free border of lesser omentum

 D

4th part of Duodenum

Ans. D

Explanation:

Interconnection between greater sac and lesser sac of peritoneum is known as Foramen of Winslow. It has the following boundaries:

Superior boundary: Caudate lobe of liver

Anterior boundary: Free edge of lesser omentum containing common bile duct, hepatic artery andportal vein.

Inferior boundary: First part of duodenum

Posterior boundary: Inferior vena cava and abdominal aorta


Q. 2

Epiploic foramen provides communication between greater and lesser sacs. The length of the epiploic foramen is:

 A

5 cm

 B

6 cm

 C

4 cm

 D

3 cm

Q. 2

Epiploic foramen provides communication between greater and lesser sacs. The length of the epiploic foramen is:

 A

5 cm

 B

6 cm

 C

4 cm

 D

3 cm

Ans. D

Explanation:

 
The greater and lesser sacs communicate with each other through the epiploic foramen (of Winslow). The foramen is about 3 cm in size and situated opposite the 12th thoracic vertebra.

Q. 3

True about boundaries of lesser Sac:

 A

Posteriorly stomach

 B

Crus of diaphragm anterior

 C

Spleen anteriorly

 D

Greater omentum

Q. 3

True about boundaries of lesser Sac:

 A

Posteriorly stomach

 B

Crus of diaphragm anterior

 C

Spleen anteriorly

 D

Greater omentum

Ans. D

Explanation:

D. i.e. Greater omentum


Q. 4

Lesser sac of stomach is bounded by:

 A

Posterior wall of stomach

 B

Visceral surface of spleen

 C

Under surface of liver

 D

All

Q. 4

Lesser sac of stomach is bounded by:

 A

Posterior wall of stomach

 B

Visceral surface of spleen

 C

Under surface of liver

 D

All

Ans. A

Explanation:

A. i.e. Posterior wall of stomach

–  Lesser sac/ Omental bursa is bounded anteriorly by stomach, caudate lobe of liver, lesser omentum & greater omentum (ant. 2 layers); and posteriorly by structures forming stomach bed (i.e. diaphragm, pancreas, spleen etc) & greater omentum (posterior 2 layers)

Lesser sac or omental bursa is the site for abscess formation in posterior perforation of gastric ulcer and internal hernia through epiploic foramen


Q. 5

Omental bursa (lesser sac)A posteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation in the following 

 A

Omental bursa (lesser sac)

 B

Greater sac

 C

Right subphrenic space

 D

Hepato renal space (pouch of Morison)

Q. 5

Omental bursa (lesser sac)A posteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation in the following 

 A

Omental bursa (lesser sac)

 B

Greater sac

 C

Right subphrenic space

 D

Hepato renal space (pouch of Morison)

Ans. A

Explanation:

Ans. is ‘a’ i.e., Omental bursa 

  • BDC writes – “The posterior surface of the stomach is related to structures forming the stomach bed, all of which are separated from the stomach by the cavity of the lesser sac.”
  • Thus an ulcer on the posterior wall of stomach would perforate into the lesser sac.
  • Also remember
  • Most perforated ulcers are located on the anterior wall.
  • The mortality rate for perforated gastric ulcer is higher than that for duodenal ulcer. This is generally due to the gastric ulcer patients’ more advanced age, increased medical comorbidities, delay in seeking medical attention, and the larger size of gastric ulcers.

Q. 6

Communicating opening between greater sac and lesser sac‑

 A

Foramen of winslow

 B

Foramen of Monro

 C

Hepatorenal pouch

 D

Pouch of Douglas

Q. 6

Communicating opening between greater sac and lesser sac‑

 A

Foramen of winslow

 B

Foramen of Monro

 C

Hepatorenal pouch

 D

Pouch of Douglas

Ans. A

Explanation:

Epiploic foramen (foramen of winslow or aditus to lesser sac) is a slit-like opening through which lesser sac communicates with greater sac. It is situated at the level of T12 vertebra. Its boundries are :-

  • Anterior :- Right free margin of lesser omentum (contains portal vein, hepatic artery proper and bile duct).
  • Posterior :- IVC, right suprarenal gland and T12 vertebra.
  • Superior :- Caudate lobe of liver.
  • Inferior :- 1 part of duodenum and horizontal part of hepatic artery.


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