Disposition of peritoneum (Ach) - W1 Flashcards
Peritoneum
- derived from mesenchymal cells of embryonic mesoderm
- lines peritoneal cavity
- completely closed in male; connects to exterior in females via uterine tubes
- Parietal - lines the walls
- Visceral - covers the organs
Explain the fate of somatic, splanchnic, and dorsal mesoderm:
- somatic mesoderm - becomes trunk wall
- splanchnic mesoderm - forms walls of foregut & visceral peritoneum
- Dorsal mesoderm - 2 layers of parietal peritoneum and countinuous with ventral.
Compare the greater and lesser sac of the peritoneal cavity.
- Greater sac = main compartment. Extends entire breadth of abdomen from diaphgram to pelvis.
-
Lesser sac
- formed from rotation
- smaller
- lies behind stomach, liver, less omentum & part of greater omentum
- the 2 communicate via the epiploic foramen (of Winslow)
What is a 2 layered fold of peritoneum that attaches part of the intestines to the posterior abdominal wall and permits the intestines to be mobile.
MESENTERY
- mesentery of small intestine
- transverse mesocolon
- sigmoid mesocolon
What is a two layered fold of peritoneum that attaches the stomach to another organ.
OMENTUM
-
greater omentum
- stomach to transverse colon - 4 layers!!
- potential sapce
-
Lesser omentum
- stomach and part of the duodenum to liver
What is a 2 lyaered fold of peritoneum that attaches a less mobile, solid organ to the abdominal wall or other organs. What are some examples?
- Perionteal ligaments
-
Faliciform ligament
- liver to anterior wall
- Lienorenal ligamnet - spleen to posterior wall at level of the kidney
- Triangular ligament - liver attaches to inferior diaphragm
Where are mesenteries or ligaments that extend from the anterior wall derived from?
Ventral mesentery
Where are mesenteries or ligaments that are extened from the posterior body wall derived from?
- dorsal mesentery
What structures are derived from the ventral mesentery (4)
- Falciform ligament
- Lesser omentum
- hempatoduodenal ligament
- hepatogastric ligament
What is derived from the lamina of the falciform ligament
-
right lamina
- forms the anterior layer of coronary ligament (right triangular)
-
posterior layer layer of coronary ligament
- encloses bare area
- left lamina - forms left triangular ligament
This ligament forms porta hepatis to first inch of duodenum - forms anterior border of epiploic foramen and encloses the portal triad (common bile duct, hepatic artery, portal vein)
hepatoduodenal ligament
- sub division of lesser omentum
This ligament forms the fissure for the ligamentum venosum near porta hepatis to lesser curves of stomach. Encloses right and left gastric arteries.
Hepatogastric ligament
- part of lesser omentum of ventral mesentery
8 structures derived from the dorsal mesentery
- greater omentum
- gastrosplenic ligament
- spelnorenal ligament
- transverse mesocolon
- sigmoid mesocolon
- The Mesentery - of teh small intestine
- peritoneal recesses
- Peritoneal ligaments
3 parts of the greater omentum
- gastrocolic
- gastrosplenic
- gastrophrenic
Where does the gastrosplenic ligament extend from and what does it enclose?
- extends from the hilus of the spleen to upper greater curvature
- encloses short gastric and splenic vessels
What does the splenorenal ligament extend from?
- parietal peritoneum over kidney to hilus of spleen
What does the transverse mesocolon extend from?
- extends from posterior abdominal wall and suspends transverse colon
- encloses middle colic vessels
What does the sigmoid mesocolon extend from and enclose?
- extends from posterior abdominal wall and suspends sigmoid colon
- encloses sigmoid colon vessels
lie lateral to ascending and descending colon and drain supracolic space
right and left paracolic gutters
What is around the hepatorenal recess and when is it important?
- bounded by liver, R kidney, transverse mesocolon
- lowest point in peritoneal cavity when individual is supine
- fluid or air could indicate ascites, penumo or hemoperitoneum
List some of the primary retroperitoneal organs
- have development outside peritoneal cavity but within abdomen
- kidneys
- suprarenal glands
- ureters, urinary bladder
- aorta
- inferior vena cava
- lumbar plexus
list some of teh secondary retroperitoneal organs
- developed initially within the peritoneal cavity then later become retroperitoneal due to gut rotation
- duodenum
- ascending colon
- descending colon
What is the nerve supply of the parietal peritoneum
- somatic afferent fibers (pain, touch, temp, pressure)
- intercostal and subcostal
- phrenic nerves
- first lumbar nerve (L1)
What is the nerve supply of the visceral peritoneum?
- visceral AFFERENT fibers that run with ANS (sensitive to distention –> leads to pain)
- diffuse sensation, diffuclt to localize
Abscesses in what recess may penetrate the diaphgram?
- subphrenic recess
- bound by liver, falciform ligament and anterior abdominal wall
Define peritonitis
- = inflammation of peritoneum (general or localized) that results in accumulation of serious fluid (ascites)
- Which of the following statements regarding the lesser omentum is CORRECT?
A. It has a free border bounding the omental (epiploic) foramen.
B. It provides a route for the superior mesenteric artery to the jejunum.
C. It covers the transverse colon anteriorly.
D. It contains the falciform ligament of the river.
E. It contains a remnant of the umbilical artery.
A. It has a free border bounding the omental (epiploic) foramen.
B. It provides a route for the superior mesenteric artery to the jejunum.
C. It covers the transverse colon anteriorly.
D. It contains the falciform ligament of the river.
E. It contains a remnant of the umbilical artery.
- The small intestine becomes a peritoneal structure at the duodenojejunal flexure. What holds this flexure in place?
A. Greater omentum
B. Hepatoduodenal ligament
C. Lesser omentum
D. Mesentery proper
E. Suspensory ligament (of Treitz)
A. Greater omentum
B. Hepatoduodenal ligament
C. Lesser omentum
D. Mesentery proper
E. Suspensory ligament (of Treitz)
- Which of the following characteristics of the transverse colon is INCORRECT?
A. It has its longitudinal muscles grouped into three distinct bundles.
B. It possesses a mesentery (mesocolon).
C. It is innervated by the sacral splanchnic nerves.
D. It depends on the superior mesenteric artery for most of its blood supply.
E. Its venous blood drains into the portal venous system.
A. It has its longitudinal muscles grouped into three distinct bundles.
B. It possesses a mesentery (mesocolon).
C. It is innervated by the sacral splanchnic nerves.
D. It depends on the superior mesenteric artery for most of its blood supply.
E. Its venous blood drains into the portal venous system.
- Which of the following structures is retroperitoneal?
A. Liver
B. Second and third parts of the duodenum
C. Sigmoid colon
D. Stomach
E. Transverse colon
- Which of the following structures is retroperitoneal?
A. Liver
B. Second and third parts of the duodenum
C. Sigmoid colon
D. Stomach
E. Transverse colon
- To which of the following does the external oblique muscle and its fascia NOT contribute?
A. Anterior sheath of the rectus abdominus muscle
B. Conjoined tendon
C. External spermatic fascia
D. Inguinal ligament
E. Lacunar ligament
- To which of the following does the external oblique muscle and its fascia NOT contribute?
A. Anterior sheath of the rectus abdominus muscle
B. Conjoined tendon
C. External spermatic fascia
D. Inguinal ligament
E. Lacunar ligament
Which portion of the GI tract is LEAST likely to present with signs of obstruction caused by cancer?
A. Distal esophagus
B. Left side of colon
C. Mid-esophagus
D. Small bowel
E. Stomach
Which portion of the GI tract is LEAST likely to present with signs of obstruction caused by cancer?
A. Distal esophagus
B. Left side of colon
C. Mid-esophagus
D. Small bowel
E. Stomach
