Abdominal cavity and peritoneum

Question 1

What is the structural difference between the peritoneal cavity in males and females? What is the potential problem with this in females?

Answer 1

In males the peritoneal cavity is closed but in females it connects to the vagina, uterus, and uterine tubes thereby connecting it to the outside world.

“The uterine tubes open into the peritoneal cavity providing a pathway for the spread of infection”

Question 2

Although there is normally a thin film of peritoneal fluid within the peritoneal cavity, there is a condition in which this fluid has accumulated drastically. What is the name of this condition and which disease(s) is it typically associated with?

Answer 2

Ascites

Liver cirrhosis, CHF, and Ovarian cancer

Question 3

Bacteria may infect the peritoneum which causes what condition? What could cause this infection? Why is this a severe medical problem to have?

Answer 3

Peritonitis

Perforated peptic ulcer or penetrating wound

Bc the peritoneum covers an expansive SA of the body and the rapid absorption of bacterial toxins

Question 4

A patient with bacterial peritonitis is seated at a 45 degree angle. What is the purpose of this countermeasure?

Answer 4

This is done in order to reduce the chances of the infected peritoneal fluid spreading through the diaphragm. Normally, peritoneal fluid flows superiorly towards the diaphragm, whereas seaing the patient at a 45 degree angle forces the fluid inferiorly towards the pelvic cavity where the absorption is slower.

Question 5

In the case of a traumatic peritonitis, what should the provider be acutely aware of? Why?

Answer 5

Peritoneal adhesions

This fibrous bridges can cause bowel or uterine tube-obstructions as well as chronic pain.

Question 6

In the abdomonical cavity there are organs which have a covering of visceral peritoneum and are suspended by a mesentary. Under what category would these types of organs fal?

Answer 6

Intraperitoneal organs

Question 7

What are the intraperitoneal organs?

Answer 7

Abdominal esophagus

stomach

duodenum

cecum

liver and gall bladder

spleen

sigmoid colon

transverse colon

appendix

ileum

jejunum

pancreas tail

Question 8

As opposed to intraperitoneal organs there are what? What is their orientation?

Answer 8

Retroperitoneal organs

Posterior to the parietal peritoneum, covered by parietal peritoneum only on their anterior surface

Question 9

What are the retroperitoneal organs?

Answer 9

Duodenum except the cap

Ascending colon

Descending colon

Pancreas except the tail

Kidneys

Ureters

Suprarenal glands

Abdominal aorta

Inferior venacava

Question 10

Within the peritoneum there are 3 structures consisting of double layers. Which one of them is responsible for invaginating and suspending the intraperitoneal organs?

Answer 10

Mesentary

Question 11

Within the peritoneum there are 3 structures consisting of double layers. Which one of them is responsible for connecting the stomach to the liver?

Answer 11

Lesser omentum

Question 12

Within the peritoneum there are 3 structures consisting of double layers. Which one of them is responsible for connecting the stomach to the spleen? What else is this structure responsible for?

Answer 12

Greater omentum

Is actually mobile and will move to wall off infections within the peritoneal cavity to prevent peritonitis

Question 13

Within the peritoneum there are 3 structures consisting of double layers. Which one of them is responsible for connecting abdominal organs to one another or to the abdominal wall? Which other peritoneal structure is this a part of for some organs?

Answer 13

Peritoneal ligaments

Greater/lesser omentum

Question 14

Within the peritoneum there are 3 structures consisting of double layers. Each of these structures divides the peritoneal cavity into what 2 sacs?

Answer 14

Greater sac => main, larger part of peritoneum

Lesser sac => lies posterior to stomach and lesser omentum

Question 15

What is the name of the structure which facilitates communication between the greater sac and the omental bursa (lesser sac)?

Answer 15

Omental foramen

Question 16

What are the borders of the omental foramen?

Answer 16

Anterior => Hepatoduodenal ligament

Posterior => Inferior vena cava

Superior => Liver (caudet lobe)

Inferior => Duodenum (first/superior part)

Question 17

In the case of an internal hernia in the omental foramen, what must be done in order to free the swollen intestine? Why?

Answer 17

Needle decompression

Bc none of the boundaries of the foramen can be incised

Question 18

Within the greater sac of the peritoneum, both the transverse colon and mesocolon actually further divide the sac into what 2 compartments?

Answer 18

Supracolic comapartment

Infracolic compartment

Question 19

What are the contents of the supracolic compartment?

Answer 19

stomach

liver

spleen

Question 20

What are the contents of the infracolic compartment?

Answer 20

small intestine

ascending colon

descending colon

Question 21

Within the thorax, the abdominal cavity is able to communicate with the pelvic cavity via which structure(s)? As is the case with most connecting compartments in the abdomen, what is the potential risk here?

Answer 21

Right paracolic gutter - lateral to ascending colon; connects supracolic compartment with pelvic cavity

Left paracolic gutter - lateral to descending colon

Provides pathway for spread of infection or cancer cells

Question 22

What is the lowest part of the abdominal portion of the peritoneal cavity known as? Between what 2 major organs? What does it communicate with medially? Anteriorly?

Answer 22

Hepatorenal recess (Morison’s pouch)

Liver and kidney

Omental bursa

Subphrenic recess

Abscesses

Infected fluid spread from easily

Question 23

Inferior to the umbilical portion of the anterolateral abdominal wall there are 5 umbilical folds. What are the names of each?

Answer 23

1 median fold

2 medial folds

2 lateral folds

Question 24

Lateral to the umbilical folds are 3 distinct depressions otherwise known as peritoneal fossae. What is a common ailment here and what are the 3 fossae named?

Answer 24

Hernias

Supravisceral - between median and medial umbilical folds

Medial inguinal - between medial and lateral umbilical folds

Lateral inguinal - lateral to lateral umbilical folds