2.1 The Peritoneum

Question 1

What is the Peritoneum?

Answer 1

A Transparent Serous Membrane which covers the Body Wall and Organs

Question 2

Is the Peritoneum one continuous layer?

Answer 2

Yes, but it is often described differently, depending on whether it lines the Body Wall or the Organ

Question 3

What are the 2 Sub-Divisions of the Peritoneum?

Answer 3

1. Parietal - On the Body Wall

2. Visceral - On the Organ

Question 4

What can the Peritoneum form?

Answer 4

1. Mesenteries / Omenta
2. Avascular Ligaments
3. Vascualr Ligaments

Question 5

What is the definition of the term “Peritoneal Cavity”?

Answer 5

The potential space between the Parietal and Visceral layers of the Peritoneum

Question 6

What are the 2 major Divisions of the Cavity, termed as Sacs?

Answer 6

1. The Greater Omental Sac (Bursa)

2. The Lesser Omental Sac (Bursa)

Question 7

Through which passage do the Greater and Lesser Omental Bursa communicate?

Answer 7

The Epiploic Foramen, also known as the Omental Foramen

Question 8

Where is the Epiploic (Omental) Foramen located?

Answer 8

1. Superior to the Superior Duodenum
2. Inferior to the Posterior Liver
3. Superior and Posterior to the Stomach
4. Posterior to the Hepatoduodenal Ligament

Question 9

What are the 2 ways to describe Organs, dependent on how they are Peritonised?

Answer 9

1. Intraperitoneal

2. Retroperitoneal

Question 10

If organs are Intraperitoneal, how are they Peritonised?

Answer 10

They are completely surrounded by Visceral Peritoneum

Question 11

If organs are Retroperitoneal, how are the Peritonised?

Answer 11

Only their Anterior Surface is covered by Visceral Peritoneum, and they are therefore firmly attached to the posterior abdominal wall

Question 12

What is a mnemonic for remembering the Retroperitoneal Organs?

Answer 12

SAD PUCKER

Question 13

What are the Retroperitoneal Organs?

Answer 13

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 14

What are the Intraperitoneal Organs?

Answer 14

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

Question 15

Are there any organs in the Peritoneal Cavity?

Answer 15

No

Question 16

What is contained within the Peritoneal Cavity?

Answer 16

Peritoneal Fluid, but there is not much as this is just a potential space

Question 17

What does the term Extraperitoneal describe?

Answer 17

Structures in the Abdominopelvic Cavity which are not covered in Peritoneum

Question 18

Can Retroperitoneal Structures be only partially Peritonised?

Answer 18

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

Question 19

Which layer of the Peritoneum is more sensitive to Pressure, Pain, Heat and Cold?

Answer 19

Parietal, due to the Parietal Layer receiving the same Somatic Nerve Supply as the Abdominal Wall it lines.

Question 20

What are the attachments of the Greater Omentum?

Answer 20

1. The Greater Curvature of the Stomach
2. The Transverse Colon
   It then hangs down from these 2 points

Question 21

What are the attachments of the Lesser Omentum?

Answer 21

1. The Liver
2. The Lesser Curvature of the Stomach
   It then hangs down from these 2 points

Question 22

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

Answer 22

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 23

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

Answer 23

T7-L1, and thus pain can be localized - it is sensitive to stretching and this is used in a clinical diagnosis

Question 24

What is the Visceral Peritoneum innervated by?

Answer 24

Autonomic Nerves - so pain is often referred, dull, and poorly localized.