2.1 Peritoneum Flashcards
What is the peritoneum?
A transparent serous membrane that covers body wall and organs
Can the peritoneum be described as one continuous layer?
Yes, but it is often described differently, depending on whether it lines the body wall or covers the organs
What can the peritoneum also form?
- folds such as mesenteries and omenta
- ligaments, which can be vascular or avascular
Define the term peritoneal cavity?
A potential space between the parietal peritoneum and visceral peritoneum
What are the 2 major divisions of the peritoneal cavity called?
- Lesser omentum
2. Greater omentum
Through which passage do the greater and lesser omenta communicate?
Epiploic foramen
Where is the epiploic passage located? Describe its relations.
It is a short neck linking the 2 sacs Anterior: hepatoduodenal ligament Posterior: IVC; right crus of diaphragm Superior: caudate lobe of liver Inferior: superior/first part of duodenum
Describe the 2 ways in which organs can be categorised based on how they are peritonised
- INTRAPERITONEAL = completely surrounded by peritoneum
- RETROPERITONEAL = only covered on their anterior surface and therefore firmly attached to the posterior wall
What is the mnemonic for remembering the retroperitoneal organs?
SAD PUCKER
List the retroperitoneal organs
- Suprarenal Glands
- Aorta / Inferior Vena Cava
- Duodenum
- Pancreas
- Ureters / Bladder
- Colon (Ascending and Descending)
- Kidneys
- Eosophagus
- Rectum (Distal 2/3)
List the intraperitoneal organs
- Stomach
- Spleen
- Jejunum
- Ilium
- Caecum
- Appendix
- Transverse Colon
- Sigmoid Colon
What is present in the peritoneal cavity?
Peritoneal fluid
Are there any organs in the peritoneal cavity?
No
Define the term extraperitoneal?
Extraperitoneal describes structures in the abdominopelvic cavity which are not covered in peritoneum
Can Retroperitoneal Structures be only partially Peritonised?
Yes, think of the Kidney having some Intraperitoneal structures and some Retroperitoneal structures resting on it
Which layer of the peritoneum is more sensitive to pain, pressure, heat & cold?
Parietal, because it receives same somatic nerve supply as abdominal wall; has very sensitive nerve supply (visceral not as sensitive - pain only felt e.g. if intestine is stretched/distended)
What are the attachments of the greater omentum?
Greater curvature of the stomach
Transverse colon
(then hangs down from these 2 points)
What are the attachments of the lesser omentum?
Lesser curvature of the stomach
Liver
(then hangs down from these 2 points)
What is the Greater Omentum referred to as by surgeons? And why?
The Abdominal Policeman, as it moves about the Abdominal Cavity in response to Peristaltic movements, and in infection (e.g. appendicitis) inflammatory exudate causes the Peritoneum to wrap itself round the infected organ - localizing the infection to a small area of the Cavity
What Nerves will Pain from the Parietal Peritoneum lining the Abdominal Wall be sent along?
T7-L1, and thus pain here is somatic and can be localized - it is sensitive to stretching and this is used in a clinical diagnosis
What is the Visceral Peritoneum innervated by?
Autonomic Nerves - so pain is often referred, dull, and poorly localized; because GI tract is a midline structure receiving bilateral nerve supply, pain is referred to the midline
