Peritoneal Cavity Flashcards
Is a serous membrane lined by mesothelial cells.
Peritoneum
Lines the abdominal and pelvic walls and the inferior surface of the diaphragm.
Parietal Peritoneum
What innervates Parietal Peritoneum?
somatic nerves:
- Central diaphragmatic: phrenic (C3-C5)
- Peripheral diaphragmatic: lower intercostal (7-12)
- subcostal (12)
- anterior abdominal wall: iliohypogastric (L1)
- ilioinguinal (L1)
Covers the viscera, is innervated by visceral nerves, and is insensitive to pain.
Visceral Peritoneum
What is parietal peritoneum sensitive to?
pain, temperature, touch, and pressure.
What innervates the parietal peritoneum in the pelvis?
Obturator nerve, a branch of the lumbar plexus
What is visceral peritoneum sensitive to?
only to stretch and tearing
What innervates visceral peritoneum?
Autonomic afferent nerves
What leads to the sensation of pain in viscera?
Overdistention of a viscus
What are the functions of peritoneum?
1-Secretion of peritoneal fluid to lubricate and glide mobile viscera easily on one another.
2-Peritoneal coverings of intestine tend to stick together in the presence of infection (to contain infection), remain localized by greater omentum which is called Watch dog or policeman of the abdomen.
3-Peritoneal folds (mesenteries) play an important part in suspending various organs within peritoneal cavity and serve as a means of conveying blood vessels, lymphatics, and nerves to these organs.
4- Large amounts of fat are stored in the peritoneal ligaments and mesenteries, and especially large amounts can be found in the greater omentum.
two-layered folds of peritoneum that connect solid viscera to abdominal walls. Liver is connected to diaphragm by falciform ligament, coronary ligament, and right & left triangular ligaments.
Peritoneal Ligaments
two-layered folds of peritoneum that connect stomach to another viscus.
Omenta: (omentum-single)
two-layered folds of peritoneum connecting parts of the intestines to posterior abdominal wall
Mesenteries
Support the viscera and provide pathways for associated neurovascular structures.
Peritoneal Reflections
Is a fold of peritoneum extending from the stomach to adjacent abdominal organs.
Omentum
Is a double layer of peritoneum extending from the porta hepatis of the liver to the lesser curvature of the stomach and the beginning of the duodenum.
Lesser Omentum
What consists the lesser omentum?
hepatogastric ligament
hepatoduodenal ligament
What run between the two layers of lesser omentum along the lesser curvature?
left and right gastric vessels
What is enclosed in the hepatoduodenal ligament?
A right free margin - PORTAL TRIAD:
- proper hepatic artery
- bile duct
- portal vein
What is between porta hepatis and superior aspect of 1st part of duodenum?
hepatoduodenal ligament
What is between the groove for ligamentum venosum and lesser curvature of stomach?
hepatogastric ligament
Hangs down like an apron from the greater curvature of the stomach, covering the transverse colon and other abdominal viscera.
Greater Omentum
Where is Greater Omentum derived?
embryonic dorsal mesentery
What runs in the greater omentum along the greater curvature?
right and left gastroepiploic vessels
What does greater omentum do in preventing the entrance of coils of the small intestine?
Plugs the neck of a hernial sac
Where does greater omentum adheres and wraps itself around the inflamed organs?
areas of inflammation
an inflammation of the peritoneum, characterized by an accumulation of peritoneal fluid that contains fibrin and leukocytes (pus)
Peritonitis
What are ligaments in greater omentum?
gastrolienal,
lienorenal,
gastrophrenic,
and gastrocolic ligaments.
Extends from the left portion of the greater curvature of the stomach to the hilus of the spleen and contains the short gastric and left gastroepiploic vessels.
Gastrolienal (Gastrosplenic) Ligament
Runs from the hilus of the spleen to the left kidney and contains the splenic vessels and the tail of the pancreas.
Lienorenal (Splenorenal) Ligament
Runs from the upper part of the greater curvature of the stomach to the diaphragm.
Gastrophrenic Ligament
Runs from the greater curvature of the stomach to the (large intestine) transverse colon.
Gastrocolic Ligament
Is a fan-shaped double fold of peritoneum that suspends the jejunum and the ileum from the posterior abdominal wall and transmits nerves and blood vessels to and from the small intestine
Mesentery of the Small Intestine (Mesentery Proper)
Where does root of mesentery extend?
duodenojejunal flexure to the right iliac fossa
How long is the extension of root of mesentery?
approximately 15 cm (6 in.) long
What does mesentery proper contain?
superior mesenteric and intestinal (jejunal and ileal) vessels, nerves, and lymphatics.
Connects the posterior surface of the transverse colon to the posterior abdominal wall.
Transverse Mesocolon
What does the fusion of Transverse Mesocolon and greater omentum form?
gastrocolic ligament
What does transverse colon contain?
middle colic vessels, nerves, and lymphatics.
Connects the sigmoid colon to the pelvic wall and contains the sigmoid vessels. Its line of attachment may form an inverted V.
Sigmoid Mesocolon
Connects the appendix to the mesentery of the ileum and contains the appendicular vessels.
Mesoappendix
Runs from the left colic flexure to the diaphragm.
Phrenicocolic Ligament
Is a sickle-shaped peritoneal fold connecting the liver to the diaphragm and the anterior abdominal wall.
Falciform Ligament
What does . Falciform Ligament contain?
ligamentum teres hepatis
paraumbilical vein
What connects the left branch of the portal vein with the subcutaneous veins in the region of the umbilicus?
paraumbilical vein
Lies in the free margin of the falciform ligament and ascends from the umbilicus to the inferior (visceral) surface of the liver, lying in the fissure that forms the left boundary of the quadrate lobe of the liver.
Ligamentum Teres Hepatis (Round Ligament of the Liver)
What is the embryonic form of Ligamentum Teres Hepatis?
left umbilical vein
What happened to the right umbilical artery?
obliterated during the embryonic period
What does right umbilical artery and left umbilical vein carry during embryonic development?
right umbilical artery: deoxygenated blood
left umbilical vein: oxygenated blood
Is a peritoneal reflection from the diaphragmatic surface of the liver onto the diaphragm and encloses a triangular area of the right lobe, the bare area of the liver.
Coronary Ligament
What does coronary ligament form?
right and left triangular ligaments
Is the fibrous remnant of the ductus venosus
Ligamentum Venosum
Ligamentum Venosum lies in the fissure on the inferior surface of the liver, forming the left boundary of the?
caudate lobe of the liver
Are five folds of peritoneum below the umbilicus, including the median, medial, and lateral umbilical folds.
Umbilical Folds
Extends from the cervix of the uterus, along the side of the rectum, to the posterior pelvic wall, forming the rectouterine pouch (of Douglas).
Rectouterine Fold
What is the most dependent portion of infracolic space?
Rectouterine pouch (of Douglas)
It can be palpated during examination by the finger to detect pain and accumulation of fluid
Rectouterine Fold
Extends from the terminal ileum to the cecum
lleocecal Fold
Is a potential space between the parietal and visceral peritoneum and contains a film of fluid that lubricates the surface of the peritoneum and facilitates free movements of the viscera.
Peritoneal Cavity
How is the Peritoneal Cavity
in male and female?
completely closed sac in the male
open in the female through the uterine tubes, uterus, and vagina
Is an irregular space that lies behind the liver, lesser omentum, stomach, and upper anterior part of the greater omentum.
Lesser Sac (Omental Bursa)
The exception of the closed sac for its communication with the greater sac
epiploic (omental) foramen
lies behind the stomach, lesser omentum, and left lobe of the liver
superior recess
lies behind the stomach, extending into the layers of the greater omentum
inferior recess
extends to the left at the hilus of the spleen.
splenic recess
Extends across the entire breadth of the abdomen and from the diaphragm to the pelvic floor and presents numerous recesses.
Greater Sac
Is a peritoneal pocket between the diaphragm and the anterior and superior part of the liver and is separated into right and left recesses by the falciform ligament.
Subphrenic (Suprahepatic) Recess
Is a deep peritoneal pocket between the liver anteriorly and the kidney and suprarenal gland posteriorly and communicates with the lesser sac via the epiploic foramen and the right paracolic gutter, thus the pelvic cavity.
Subhepatic Recess or Hepatorenal Recess (Morrison Pouch)
The most dependent portion of the right supramesocolic spaces
Subhepatic Recess or Hepatorenal Recess (Morrison Pouch)
Can be used as parameter if there’s too much fluid loss because of the accident
Subhepatic Recess or Hepatorenal Recess (Morrison Pouch)
Lie lateral to both the ascending colon (right paracolic gutter) and the descending colon (left paracolic gutter).
Paracolic Recesses (Gutters)
Is a natural opening between the lesser and greater sacs.
Epiploic or Omental (Winslow) Foramen
What are the boundaries of Epiploic or Omental (Winslow) Foramen?
superiorly: caudate lobe of the liver
inferiorly: first part of the duodenum
anteriorly: free edge of the lesser omentum: Portal Triad
posteriorly: IVC
inflammation and/or infection of the peritoneum
Peritonitis
a procedure in which a needle is inserted 1 to 2 in. through the abdominal wall into the peritoneal cavity to obtain a sample or drain fluid while the patient is sitting upright.
Paracentesis (abdominal tap)
Where is the entry site for paracentesis?
midline at approximately 2 cm below the umbilicus or lateral to McBurney’s point
right anterior superior iliac spine of pelvic bone
McBurney’s point
Most common site of subphrenic abscess
Morrison pouch