2.1 Peritoneum

Question 1

What is the peritoneum?

Answer 1

A transparent serous membrane that covers body wall and organs

Question 2

Can the peritoneum be described as one continuous layer?

Answer 2

Yes, but it is often described differently, depending on whether it lines the body wall or covers the organs

Question 3

What can the peritoneum also form?

Answer 3

• folds such as mesenteries and omenta

- ligaments, which can be vascular or avascular

Question 4

Define the term peritoneal cavity?

Answer 4

A potential space between the parietal peritoneum and visceral peritoneum

Question 5

What are the 2 major divisions of the peritoneal cavity called?

Answer 5

1. Lesser omentum

2. Greater omentum

Question 6

Through which passage do the greater and lesser omenta communicate?

Answer 6

Epiploic foramen

Question 7

Where is the epiploic passage located? Describe its relations.

Answer 7

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

Question 8

Describe the 2 ways in which organs can be categorised based on how they are peritonised

Answer 8

• INTRAPERITONEAL = completely surrounded by peritoneum

- RETROPERITONEAL = only covered on their anterior surface and therefore firmly attached to the posterior wall

Question 9

What is the mnemonic for remembering the retroperitoneal organs?

Answer 9

SAD PUCKER

Question 10

List the retroperitoneal organs

Answer 10

1. Suprarenal Glands
2. Aorta / Inferior Vena Cava
3. Duodenum
4. Pancreas
5. Ureters / Bladder
6. Colon (Ascending and Descending)
7. Kidneys
8. Eosophagus
9. Rectum (Distal 2/3)

Question 11

List the intraperitoneal organs

Answer 11

1. Stomach
2. Spleen
3. Jejunum
4. Ilium
5. Caecum
6. Appendix
7. Transverse Colon
8. Sigmoid Colon

Question 12

What is present in the peritoneal cavity?

Answer 12

Peritoneal fluid

Question 13

Are there any organs in the peritoneal cavity?

Answer 13

No

Question 14

Define the term extraperitoneal?

Answer 14

Extraperitoneal describes structures in the abdominopelvic cavity which are not covered in peritoneum

Question 15

Can Retroperitoneal Structures be only partially Peritonised?

Answer 15

Yes, think of the Kidney having some Intraperitoneal structures and some Retroperitoneal structures resting on it

Question 16

Which layer of the peritoneum is more sensitive to pain, pressure, heat & cold?

Answer 16

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)

Question 17

What are the attachments of the greater omentum?

Answer 17

Greater curvature of the stomach
Transverse colon
(then hangs down from these 2 points)

Question 18

What are the attachments of the lesser omentum?

Answer 18

Lesser curvature of the stomach
Liver
(then hangs down from these 2 points)

Question 19

What is the Greater Omentum referred to as by surgeons? And why?

Answer 19

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

Question 20

What Nerves will Pain from the Parietal Peritoneum lining the Abdominal Wall be sent along?

Answer 20

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

Question 21

What is the Visceral Peritoneum innervated by?

Answer 21

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