8.1: The Peritoneum and Peritoneal Cavity

Question 1

Answer 1

Question 2

the ___ lines tha bdominopelvic cavity. what’re the two layers of this structure?

Answer 2

peritoneum. Has parietal and visceral layers

Question 3

the intraperitoneal organs are enclosed by the ___ layer of the peritoneum, and are suspended by ____

Answer 3

enclosed by the visceral layer, and are suspended by mesenteries

Question 4

what is a mesentery

Answer 4

double layers of peritoneum that attach to the body wall– basically contexts the parietal and visceral peritoneum

Question 5

describe the location of primarily retroperitoneal structures

Answer 5

posterior to the peritoneal cavity, are not suspended by a mesentery, and are covered by peritoneum only on their anterior surface.

Question 6

describe the locations of secondarily retroperitoneal structures

Answer 6

structures were previously intraperitoneal structures that became fixed to the posterior abdominal wall when their mesentery fused with the parietal peritoneum of the posterior abdominal wall during development.

Question 7

describe the positioning of the subperitoneal structures

Answer 7

include pelvic organs that lie below the peritoneum.

Question 8

Organs associated with the gastrointestinal tract are ____ or ______. Organs of the urinary system are _____.

Answer 8

Organs associated with the gastrointestinal tract are intraperitoneal or secondarily retroperitoneal. Organs of the urinary system are retroperitoneal.

Question 9

Answer 9

Question 10

which organs are suspended by mesentery and are completely covered by the peritoneum?

Answer 10

INTRAPERITONEAL ORGANS

Stomach

Small intestine (jejunum, ileum, some of the superior part of the duodenum THE DUODENUM IS MAINLY SECONDARILY RETROPERITONEAL)

Spleen

Liver (with the exception of the bare area)

Gallbladder

Cecum with vermiform appendix (portions of variable size may be retroperitoneal)

Large intestine (transverse and sigmoid colons)

Question 11

which organs are primarily retroperitoenal?

Answer 11

kidneys, suprarenal glands

Question 12

which organs are secondarily retroperitoneal?

Answer 12

recall: SR structures were previously intraperitoneal structures that became fixed to the posterior abdominal wall when their mesentery fused with the parietal peritoneum of the posterior abdominal wall during developmenet.

these structures include:

Question 13

how many layers is a mesentery? Function?

Answer 13

mesentery is a double layer of peritoneum that connects intraperitoneal organs to the posterior abdomianl wall and transmits vessels and nerves.

Question 14

3 major mesenteries of the abdomen

Answer 14

The mesentery of the small intestine: suspends the second and third parts (jejunum and ileum) of the small intestine.

The _transverse mesocolo_n suspends the transverse section of the large intestine.

The sigmoid mesocolon suspends the sigmoid colon of the large intestine in the left lower quadrant.

Question 16

how many layers is an omentum and what is its function

Answer 16

omentum is a double layer of peritoneum that connects the stomach and duodenum to another organ.

Question 17

the greater omentum is a ____ layered apron of peritoneum that drapes ____, anterior to the coils of the small intestine, beofre looping upwards to its distal attachment on the posterior ___ wall

Answer 17

the greater omentum is a FOUR layered apron of peritoneum that drapes INFERIORLY, anterior to the coils of the small intestine, beofre looping upwards to its distal attachment on the posterior POSTERIOR ABDOMINAL wall

Question 18

the ____ ligament is a portion of the greater omentum that adheres to the transverse colon, whereas the ___ ligmaent is. alteral extension of the greater omentum that connects the stomach to the spleen and is traversed by branches of the splenic artery

Answer 18

the GASTROCOLIC ligament is a portion of the greater omentum that adheres to the transverse colon, whereas the GASTROSPLENIC ligmaent is lateral extension of the greater omentum that connects the stomach to the spleen and is traversed by branches of the splenic artery

Question 19

the lesser omentum is a ___ layer of peritoneum that extendsd from the ____ to the ____ and proximal ____. it is formed by the ____ and the _____ ligaments

Answer 19

the lesser omentum is a DOUBLE layer of peritoneum that extendsd from the LIVER to the STOMACH (INNER CURVATURE) and proximal DUODENUM. it is formed by the HEPATOGASTRIC and the HEPATODUODENAL ligaments

Question 20

locations of the hepatogastric and hepatoduodenal ligamnet

Answer 20

the hepatogastric ligament, between the liver and stomach, and

the hepatoduodenal ligament, between the liver and duodenum, which encloses the structures of the portal triad (the portal vein, hepatic artery, and bile duct) in its free edge.

Question 21

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Question 22

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Question 23

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Question 24

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Question 25

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Question 26

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Question 27

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Question 28

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Question 29

Parietal peritoneum derives its neurovasculature from vessels and nerves of the ___ \_\_\_\_ - Its sensitivity to pain, pressure, and temperature is well localized (felt acutely) through ____ \_\_\_\_ of the ____ muscles and skin. Visceral peritoneum derives its neurovasculature from the **underlying organs**. **- Autonomic nerves** mediate sensitivity to stretching and chemical irritation, but the visceral peritoneum **lacks sensitivity** to touch and temperature. Sensation is poorly localized and is usually referred to regions that reflect the embryologic origins of the underlying organ. Sensation from **foregut** structures is referred to the **epigastric** region. Sensation from midgut structures is referred to the **umbilical region**. Sensation from hindgut structures is referred to the **pubic region**.

Answer 29

Parietal peritoneum derives its neurovasculature from vessels and nerves of the **body wall.** - Its sensitivity to pain, pressure, and temperature is well localized (felt acutely) through **somatic nerves** of the **overlying** muscles and skin. Visceral peritoneum derives its neurovasculature from the **underlying organs**. **- Autonomic nerves** mediate sensitivity to stretching and chemical irritation, but the visceral peritoneum **lacks sensitivity** to touch and temperature. - Sensation is poorly localized and is usually referred to regions that reflect the embryologic origins of the underlying organ. - Sensation from **foregut** structures is referred to the **epigastric** region. Sensation from midgut structures is referred to the **umbilical region.** Sensation from hindgut structures is referred to the **pubic region**.

Question 30

2 spaces of the peritoneal cavity

Answer 30

**greater sac**, which includes the entire peritoneal cavity except that space defined as the lesser sac **Omental bursa** (lesser sac), which is a small extension of the peritoneal cavity that lies behind the stomach and lesser omentum. It **communicates with the greater sac** through a single opening, the **omental (epiploic) foramen**.

Question 31

\_\_\_\_ ___ : between the diaphragm and liver is limited by the coronary ligaments and separated into right and left spaces by the falciform ligament. \_\_\_ \_\_\_:lies between the liver and the transverse colon. A posterior extension of this space, the hepatorenal recess (hepatorenal pouch, Morison’s pouch), lies between the visceral surface of the liver and the right kidney and suprarenal gland. The hepatorenal recess communicates with the right subphrenic recess. \_\_\_\_ and ____ Compartments: defined by the attachment of the transverse mesocolon on the posterior abdominal wall—with the supracolic compartment above the attachment site and the infracolic compartment below it. The root of the mesentery of the small intestine further divides the infracolic compartment into right and left spaces. \_\_\_\_ \_\_\_\_: lie adjacent to the ascending and descending colons, allow communication between the supracolic and infracolic compartments.

Answer 31

The subphrenic recess between the diaphragm and liver is limited by the coronary ligaments and separated into right and left spaces by the falciform ligament. The subhepatic space lies between the liver and the transverse colon. A posterior extension of this space, the hepatorenal recess (hepatorenal pouch, Morison’s pouch), lies between the visceral surface of the liver and the right kidney and suprarenal gland. The hepatorenal recess communicates with the right subphrenic recess. The supracolic and infracolic compartments are defined by the attachment of the transverse mesocolon on the posterior abdominal wall—with the supracolic compartment above the attachment site and the infracolic compartment below it. The root of the mesentery of the small intestine further divides the infracolic compartment into right and left spaces. The paracolic gutters, which lie adjacent to the ascending and descending colons, allow communication between the supracolic and infracolic compartments.

Question 32

ascites

Answer 32

the accumulation of excess peritoneal fluid due to a change in concentration gradients that results in loss of capillary fluid. Ascites can also accompany other pathologic conditions, such as metastatic liver cancer and portal hypertension. In these cases, many liters of ascitic fluid can accumulate in the **peritoneal cavity (often due to peritonitis).** The fluid is aspirated by paracentesis. The needle is carefully inserted into the abdominal wall so as to avoid the urinary bladder and inferior epigastric vessels.

Question 33

The flow of fluid in the peritoneal cavity can spread intraperitoneal infections and determine the sites of peritoneal abscess formation. Fluid commonly collects in the right and left ____ \_\_\_\_, although abscesses are more likely to form on the ___ side due to ___ or ____ ruptures. Fluid in the ____ compartment, such as subphrenic recesses and the ____ \_\_\_\_, can drain to the hepatorenal recess, the lowest part of the abdominal cavity in the supine patient. Therefore, this is a common site of pus accumulation and abscess formation. In the ____ compartment, the paracolic gutters direct peritoneal fluid and infections toward the pelvis.

Answer 33

The flow of fluid in the peritoneal cavity can spread intraperitoneal infections and determine the sites of peritoneal abscess formation. Fluid commonly collects in the right and left **_subphrenic recesses_**, although abscesses are more likely to form on the right side due to **duodenal or appendiceal** ruptures. Fluid in the **supracolic compartment**, such as **subphrenic** recesses and the **omental bursa**, can drain to the **hepatorenal** recess, the lowest part of the abdominal cavity in the supine patient. Therefore, this is a common site of pus accumulation and abscess formation. In the **infracolic** compartment, the paracolic gutters direct peritoneal fluid and infections toward the pelvis.