Peritoneal folds- lesser omentum & greater omentum

PERITONEAL FOLDS- LESSER OMENTUM & GREATER OMENTUM

Q. 1

What will be the initial management in a hemodynamically stable patient with an anterior abdominal stab injury presenting with a tag of omentum protruding through the abdominal wall near the umbilicus and showing no signs of peritonitis?

 A

FAST

 B

CECT Abdomen

 C

Exploratory Laparotomy

 D

Local Wound Exploration and Suturing

Q. 1

What will be the initial management in a hemodynamically stable patient with an anterior abdominal stab injury presenting with a tag of omentum protruding through the abdominal wall near the umbilicus and showing no signs of peritonitis?

 A

FAST

 B

CECT Abdomen

 C

Exploratory Laparotomy

 D

Local Wound Exploration and Suturing

Ans. B

Explanation:

emodynamically Stable patients with omental protrusion should be investigated thoroughly first  with an abdomino-pelvic contrast enhanced CT scan, before proceeding to surgery.

Exploratory Laparotomy is not an absolute indication for this case.

 
Ref: Reference: Trauma: A Comprehensive Emergency Medicine Approach By Eric Legome, Page222; Imaging & Intevention in Abdominal trauma (springer) 2004, Page 394; Emergency management of Trauma Patient: Cases, Algorihm, Evidence (Lippincott- Williams) 2006, Page 97; Imaging and intervention in abdominal trauma R. F. Dondelinger, Gina M. Allen, Page 392.

Q. 2

Blood supply to greater omentum is provided by:

 A

Gastric artery

 B

Gastroepiploic artery

 C

Splenic artery

 D

All of the above

Q. 2

Blood supply to greater omentum is provided by:

 A

Gastric artery

 B

Gastroepiploic artery

 C

Splenic artery

 D

All of the above

Ans. B

Explanation:

The blood supply to the greater omentum is derived from the right and left gastroepiploic arteries.

The venous drainage parallels the arterial supply to a great extent, with the left and right gastroepiploic veins ultimately draining into the portal system.
Ref: Schwartz’s principle of surgery 9th edition, chapter 35.

 


Q. 3

The greater omentum is derived from which of the following embryonic structures?

 A

Dorsal mesoduodenum

 B

Dorsal mesogastrium

 C

Pericardioperitoneal canal

 D

Pleuropericardial membranes

Q. 3

The greater omentum is derived from which of the following embryonic structures?

 A

Dorsal mesoduodenum

 B

Dorsal mesogastrium

 C

Pericardioperitoneal canal

 D

Pleuropericardial membranes

Ans. B

Explanation:

Both the omental bursa and the greater omentum are derived from the dorsal mesogastrium, which is the mesentery of the stomach region.

Must know:

The dorsal mesoduodenum is the mesentery of the developing duodenum, which later disappears so that the duodenum and pancreas come to lie retroperitoneally.

The pericardioperitoneal canal embryologically connects the thoracic and peritoneal canals.
The pleuropericardial membranes become the pericardium and contribute to the diaphragm.

Q. 4

What is the number of layers in greater omentum?

 A

1

 B

2

 C

3

 D

4

Q. 4

What is the number of layers in greater omentum?

 A

1

 B

2

 C

3

 D

4

Ans. D

Explanation:

The greater omentum is folded back on itself and is therefore made up of four layers of closely applied visceral peritoneum, which are separated by variable amounts of adipose tissue.


Q. 5

Lesser omentum has following contents except

 A

Hepatic vein

 B

Hepatic artery

 C

Portal vein

 D

Bile duct

Q. 5

Lesser omentum has following contents except

 A

Hepatic vein

 B

Hepatic artery

 C

Portal vein

 D

Bile duct

Ans. A

Explanation:

A. i.e. Hepatic vein



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