Part II. Peritoneum, Peritoneal Cavity pg 45-48 Flashcards
What is the mesothelium lining internal surface of the abdominopelvic wall?
Parietal peritoneum
How does the parietal peritoneum receive somatic sensory innervation for pain, temp, pressure, etc?
Via adjacent dermatomes
What is the Mesothelium covering (investing) abdominopelvic viscera?
Visceral peritoneum
How does the visceral peritoneum receive somatic sensory innervation for pain, temp, pressure, etc?
It doesn’t - no somatic sensory innervation however Visceral afferent innervation (stretch, chemical) may result in referred pain
What is the histological equivalent to the visceral peritoneum?
Serosa
Potential space present between parietal/visceral peritoneum
Peritoneal cavity
What is contained in the peritoneal cavity?
No viscera, only thin field of peritoneal fluid
What is contained in the peritoneal fluid and what is the function of those components?
- Lubricants - allows for friction-free movements of digestion on visceral surfaces
- leukocytes and antibodies to fight infection
The peritoneal cavity is open to the exterior in females (completely closed cavity in males) via what pathway?
Uterine tubes, uterus and vagina
Organs that are all or mostly covered in visceral peritoneum and suspended by mesentary are called what?
Intraperitoneal organs
NOTE: Still, technically, not inside peritoneal cavity (misnomer)
Development connection: they have invaginated into the closed peritoneal cavity during lateral folding of the embryo
What are some examples of intraperitoneal organs?
Examples: stomach, spleen, jejunum, ileum, transverse colon, liver
Organs that are partially covered by parietal peritoneum and located external or posterior to the peritoneal cavity are called what?
Extraperitoneal (retroperitoneal) organs
Extraperitoneal organs are covered with ________ on one side and ________ on the rest.
parietal peritoneum: adventitia
What are primarily retroperitoneal organs vs. secondarily retroperitoneal organs?
Primarily: Embryonically behind peritoneum and remain there in adult
Secondarily: Embryonically intraperitoneal but become retroperitoneal due to return of gut
What are some examples of primarily retroperitoneal organs?
Examples: suprarenal gland, kidney, ureter, uterus, ovary, aorta, IVC
What are some examples of secondarily retroperitoneal organs?
Examples: duodenum, ascending/descending colon, pancreas, rectum
The region below the umbilical has 5 folds. What are they?
1 median umbilical fold
2 medial umbilical folds
2 lateral umbilical folds
Which peritoneal fold extends from apex of urinary bladder to umbilicus? What ligament does it contain?
Median Umbilical Fold
Contains Median Umbilical Ligament
The median umbilical ligament is a remnant of what fetal structure?
Urachus
What peritoneal folds are located lateral to Median Umbilical Fold? What ligaments do they contain?
Medial Umbilical Folds
Contains Medial Umbilical Ligaments
The Medial Umbilical Ligaments are fetal remnants of what structures?
Umbilical arteries
What peritoneal folds are located lateral to the medial umbilical folds? What structures do they contain?
Lateral Umbilical Fold
contains Inferior Epigastric artery and vein
The depression Located between Median and Medial Umbilical Folds that is formed by reflection of parietal peritoneum from anterior wall to urinary bladder.
Supravesical fossa
The size and location of the supravesical fossa varies because of what structure?
urinary bladder as it fills and empties
The depression that is located between Medial and Lateral Umbilical Folds.
Medial inguinal fossa
What is the site of direct inguinal hernias?
Medial Inguinal Fossa (Inguinal Triangle)
What is the site for indirect inguinal hernias?
Lateral Inguinal Fossa
What depression is located lateral to Lateral Umbilical Fold and where the Deep Inguinal Ring is?
Lateral Inguinal Fossa
What is the Sagittal peritoneal fold/reflection spanning between anterior abdominal wall and liver in the region above the umbilicus?
Falciform ligament
The inferior, thickened edge of the falciform ligament.
Ligamentum Teres (Round L of liver)
The Ligamentum Teres (Round L of liver) contains fetal remnant of what structure?
Umbilical vein
What is mesentary?
Double layer of peritoneum connecting intraperitoneal organ to posterior abdominal wall and spans distance between parietal peritoneum and visceral peritoneum.
NOTE: again think of the lateral folding that occurs in fetal development
What is contained in mesentary?
CT with blood vessels, lymphatics, nerves, lymph nodes and fat - neurovasculature passing from body wall to intraperitoneal organ
What is omentum?
Double layer of peritoneum spanning from stomach and/or proximal duodenum to
adjacent organs
What double layer of peritoneum spans from lesser curvature of stomach and proximal duodenum to liver?
Lesser omentum
The lesser omentum is the adult remnant of what embryonic structure?
Ventral mesentary
Thin membrane spanning from liver to lesser curvature of stomach
Hepatogastric L
The thickened right side free edge of lesser omentum that spans from liver to proximal duodenum and surrounds portal triad
Hepatoduodenal L
What is included in the portal triad?
Hepatic Portal V, Proper Hepatic A, Common Bile Duct
The double layer of peritoneum that hangs from greater curvature of stomach and then
folding back on itself to attach to transverse colon
Greater omentum
The greater omentum is the exult remnant of what embryonic structure?
Dorsal mesentary
What is the function of the greater omentum?
- Prevents abdominal viscera from adhering to anterolateral wall
- Wraps itself around inflamed organs to protect other viscera
NOTE: Sometimes referred to as the “abdominal policeman”
What is the gastrocolic ligament and where is it located?
The largest portion of greater omentum that spans from greater curvature of stomach to transverse colon and drapes over small intestine
Where is the gastrosplenic ligament located?
Spans from greater curvature of stomach to spleen
Where is the gastrophrenic ligament located?
Spans from greater curvature of stomach to thoracic diaphragm
The lesser omentum includes two ligamentous structures. What are they?
Hepatogastric ligament
Hepatoduodenal ligament
The greater omentum includes 3 ligamentous structures. What are they?
Gastrocolic ligament
Gastrosplenic ligament
Gastrophrenic ligament
The peritoneal cavity has 2 subdivisions. What are they?
Greater sac
Lesser sac
The main large subdivision of the peritoneal cavity is the greater sac. It is further subdivided into what compartments?
- supracolic compartment
- infracolic compartment
- paracolic gutters
The compartment of the greater sac of the peritoneal cavity that is located anterosuperior to the greater omentum and transverse colon
Supracolic compartment
What is contained in the Supracolic compartment?
Contains stomach, liver, spleen
The compartment of the greater sac of the peritoneal cavity that is located posterosuperior to the greater omentum and transverse colon
Infracolic compartment
What is contained in the infracolic compartment?
Contains small intestine, ascending/descending colon
The infracolic compartment is divided into right and left sides by what structure?
small intestinal mesentery
Grooves that are part of the greater sac of the peritoneal cavity and are located between lateral sides of ascending/descending colon and posterolateral
abdominal wall
Paracolic gutters
What is the function of the paracolic gutters?
- Provides communication between supracolic and infracolic compartments
NOTE: they make convenient avenues for spread of infection (ascites) or cancerous cells
The small portion of peritoneal cavity posterior to stomach and lesser omentum
Lesser sac (omental bursa)
Describe the location of the Lesser sac (omental bursa)
Posterior to stomach and lesser omentum
- extends superiorly behind liver and up to thoracic diaphragm
- Extends inferiorly between superior layers of Gastrocolic L (Greater Omentum)
What is the epiploic foramen (AKA omental foramen, foramen of Winslow)
A point of communication between greater and lesser sac, located posterior to hepatoduodenal ligament
What structures are located anterior to the epiploic foramen?
Hepatic portal vein
Proper hepatic artery
Common bile duct
* all surrounded by hepatoduodenal ligament
What structures are located posterior to the epiploic foramen?
- Inferior vena cava
- Right crus of the thoracic diaphragm
What is located superiorly to the epiploic foramen?
Caudate lobe of the liver
What is located inferiorly to the epiploic foramen?
First part of the duodenum
