Lecture 25: Mesenteries- Peritoneal Reflections Flashcards
peritoneal cavity
a space, filled with organs
layers of peritoneum
parietal (on the wall), visceral (on the organ)
characteristic of visceral peritoneum
lubricated by serous fluid, allows frictionless movement of organs
type of space peritoneum is
potential
bursae
sacs created during organogenesis/movement,due to mesenteries folding
mesentery
double sheet of connective tissue, has blood vessels, connects organs to abdominal wall
megogastrium
mesentery attaching to stomach region
“mesos”
middle
“enteron”
guts, intestine
“gaster”
belly (i.e. “stomach”)
dorsal mesentery
dorsal mesogastrium + mesentery
ventral mesentery location
area that’ll become stomach
“hepar”
liver
“lien”
spleen
“ren”
kidney
“pancreas”
pancreas
“epiloon”
= “omenum” = fatty skin/apron
hepatoduodenal ligament
liver-duodenum
gastrohepatic ligament
connects hepato duodenal ligament and stomach
gastrolienal ligament
connects stomach-spleen
lienorenal ligament
connects spleen-pancreas
omentum / epiploic foramen
entrance into lesser sac
organs that form out of gut tube
liver, spleen, pancreas, stomach
falciform ligament
dolphin/sickle shaped ligament
“teres”
round
“phren”
diaphragm
derivation of falciform ligament
ventral mesogastrium
hepatogastric ligament derivation
dorsal mesogastrium
greater omentum
binds against stomach; holds infections in place
where greater and lesser omentum bind
lesser sac
LARP
left vagus: anterior (to esophagus); right vagus: posterior (to esophagus)
order of intestinal folding
straight; herniate; rotate; squish(ilate)
what goes with intestinal mesentery during rotation
nerve supply
lesser sac aka
omental bursa
greater sac
peritoneal sac
epiploic/omental foramen function
communicates between lesser and greater sacs
intraperitoneal
completely enclosed in visceral peritoneum
intraperitoneal structures
liver, gall bladder, spleen, stomach, 1st part of duodenum, jejunum, ileum, vermiform appendix, transverse colon, sigmoid colon
primarily retroperitoneal
anterior surface covered by parietal peritoneum - no gut rotation, so posterior/dorsal to peritoneum
primarily retroperitoneal structures
kidney, adrenal, inferior vena cava, aorta, testis
secondarily retroperitoneal
adherent to posterior peritoneal wall
secondarily retroperitoneal structures
2nd 3rd 4th parts of duodenum, cecum, ascending colon, descending colon, rectum, pancreas
extraperitoneal
outside peritoneum, but not posterior or dorsal
extraperitoneal structures
urinary bladder, prostate, seminal vesicles, uterus, ovary
derivatives of ventral mesentery
ventral mesogastrum - lesser omentum (hepatoduodenal, hepatogastric), falciform, coronary, right triangular, left triangular
hepatoduodenal ligament contains
portal vein, hepatic artery, bile duct
obligterated umbilical vein is
ligamentum veres hepatis, falciform ligament
dorsal mesentery derivatives
dorsal mesogatrum, mesentery of small intestine, mesenteries of large intestine (colon)
dorsal mesogastrum derivatives
greater omentum, adult transver mesocolon, lienorenal or phrenicolineal ligament
greater omentum derivatives
gastrophrenic (stomach-diaphragm); gastrolienal (stomach-spleen); gastrocolic (stomach-transverse colon)
mesenteries of large intestine- derivatives
transverse mesocolon, sigmoid mesocolon, mesoappendix
upper/superior recess location
within lesser omentum
lower/inferior recess location
within greater omentum
what does lesser omentum attach to
lesser curvature of stomach; forms part of lesser sac walls
what does greater omentum attach to
greater curvature of stomach; but NOT THE GREATER SAC
layers of greater omentum
2 layers in gastrophrenic/gastrolineal portions
4 layers in gatrocolin portion (double layer, folded on itself)
6 layers where embryonic transverse mesocolon (2 layers) adheres
parietal peritoneum derivatives
secondary mesenteries
ligament
any suspender not called a “mesentery”- usu peritoneal folding containing blood vessels, unrelated to embryonic gut suspension
suspensory ligament of duodenum
aka ligament of Treitz
2 muscles- straited from diaphragm, smooth from duodenum
phrenicocolic ligament
spleen “rests” on it; closely assoc w/ dorsal mesogastrium
broad ligament of uterus
mesometrium (uterus), mesosalpinx (uterine tubes), mesovarium (ovaries)
infundibulopelvic or suspensory ligament of ovary
contains vessels, NOT ovarian/round ligament
tunica vaginalis communis
distal part of processus vaginalis, wraps around testis
“metrium”/”metro”
uterus
“salpinx”
trumpet
“ovarium”
ovary
pouches/recesses
most inferior points when recumbent or standing, infection can spread
male peritoneal pouch/gutter
rectovesical
female peritoneal pouches/gutters
rectouterine, vesicouterine
space between liver, kidney
hepatorenal pouch
infections can pool here, esp in bedridden person
paracolic gutters
lateral to ascending colon and descending colon
right lateral paracolic gutter
connects pelvis and hepatorenal pouch
left lateral paracolic gutter
limited superiorly by prenicocolic ligament
paramesenteric gutters
between small intestine and colon
left paramesenteric gutter
communicates w/ pelvis
right paramesenteric gutter
limited by surrounding mesenteries
infrahepatic or hepatorenal pouch/recess
most dorsal point when recumbent, infection can spread here, communicates w/ omental bursa
vermiform appendix
was at level of gut during umbilical herniation/rotation
sympathetic innervation: T10
left colic (splenic) flexure importance re: parasympathetic innervation
vagus innervates proximally; pelvic splanchnics innervate distally
all peritoneal pouches/gutters
rectovesical, rectouterine, vesicouterine pouches; paracolic gutters; paramesenteric gutters; infrahepatic or hepatorenal pouch/recess
