Peritoneal Cavity Flashcards by C L

What is the peritoneum

Thin serous membrane

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Compare the peritoneal cavity in men and women

Men= completely closed cavity

- Women= potential indirect communication with exterior

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What is the peritoneal cavity divided into

Greater and lesser sacs

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What structures does the peritoneum form

Omenta
Mesenteries
Ligaments

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Where does the greater sac extend between

Diaphragm to pelvis

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Where is the lesser sac found

Posterior to stomach and lesser omentum

- Extends slightly into greater omentum

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What is the right free border of the lesser sac

Hepatoduodenal ligament

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How do the 2 sacs communicate

Epiploic foramen

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Where is the pancreas found

Lesser sac

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What is Pringle’s manoeuvre

During surgery, the hepatic artery proper and portal vein can be compressed with fingers/haemostat to control bleeding

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Anterior border of epiploic foramen

Free border of lesser omentum (with common bile duct, hepatic artery proper and portal vein)

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Posterior border of epiploic foramen

Inferior vena cava

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Superior border of epiploic foramen

Caudate process of caudate lobe of liver

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Inferior border of epiploic foramen

First part of duodenum

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What is the lesser omentum derived from

Ventral mesentery

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Where does the lesser omentum pass between

Lesser curvature and first part of duodenum

- Inferior border of liver

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How can the lesser omentum be subdivided

Hepatogastric ligament

- Hepatoduodenal ligament

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What does the hepatoduodenal ligament contain

Hepatic artery proper
Hepatic portal vein
Common bile duct

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What is the greater omentum derived from

Dorsal mesentery

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What is the greater omentum attached to

Greater curvature of stomach

- First part of duodenum

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What does the greater omentum overlie

Transverse colon

- Much of small intestine

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Which parts of the greater omentum are free

Lateral and inferior borders are free

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Why is the greater omentum considered the policeman of the abdomen

If there is inflammation or perforation, greater omentum migrates and attempts to contain/plug this

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Why may a mass be felt in the RLQ with appendicitis

Due to migration of the greater omentum

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What is the mesentery derived from

Dorsal mesentery

Function of the mesentery

Connects the jejunum and ileum to the posterior abdominal wall

Describe the passage of the base of the mesentery

- Starts left of L2 | - Passes obliquely downwards to the right, ending just above the right sacroiliac joint

What does the mesentery cross

- 3rd part of duodenum - Aorta - IVC - Right gonadal vessels - Right ureter

What is found within the mesentery

- Branches of superior mesenteric vessels - Nerves - Lymphatics

Function of the sigmoid mesocolon

Connects the sigmoid colon to the posterior abdominal wall

Where is the root of the sigmoid mesocolon

Left iliac fossa

What does the sigmoid mesocolon cross

- Bifurcation of the left common iliac vessels | - Left ureter

What does the sigmoid mesocolon transmit

- Sigmoid branches of inferior mesenteric vessels - Nerves - Lymphatics

Function of the transverse mesocolon

Suspends the transverse colon from the posterior abdominal wall

Where is the root of the transverse mesocolon found

Inferior to the pancreas

What does the transverse mesocolon transmit

Branches of middle colic vessels

How can the greater sac be further divided

- Supracolic compartment | - Infracolic compartment

What does the supra colic compartment contain

- Duodenum - Liver - Gallbladder - Stomach - Spleen

What does the infra colic compartment contain

- Duodenum - Jejunum - Ileum - Ascending and descending colon

What communicates with the supra colic and infra colic compartments

Paracolic gutters

What are paracolic gutters

Grooves between the lateral aspect of the ascending and descending colon and posterolateral abdominal wall

Describe the hepatorenal recess

- Part of peritoneal cavity on the right side between the liver and right kidney and right suprarenal gland - Continuous with the subphrenic recess - Fluid may collect here if patient is recumbent

What are the deepest parts of the pelvic cavity

Rectovesical and rectouterine pouches

What is the rectovesical pouch

Separates rectum from urinary bladder (men)

What is the rectouterine pouch

Separates rectum from uterus

What is the vesicouterine pouch

Separates urinary bladder from uterus

What is a peritoneal fold

Reflection of peritoneum

What folds are there on the posterior abdominal wall

- Median umbilical fold - Medial umbilical folds - Lateral umbilical folds

What is the median umbilical fold the remnant of

Urachus (extends from the urinary bladder to umbilicus)

What is the medial umbilical fold the remnant of

Umbilical arteries

What is the lateral umbilical fold the remnant of

Inferior epigastric arteries

What recesses are there between the peritoneal folds

- Supravesical fossa (between median and medial) - Medial umbilical fossa - Lateral umbilical fossa (lateral to lateral fold)

What does the lateral umbilical fossa contain

Deep inguinal ring

Define intraperitoneal

- Almost totally covered with visceral peritoneum | - Suspended by a mesentery

Define retroperitoneal

- Lie behind or outside the peritoneum | - Only partially covered with visceral peritoneum

Define secondary retroperitoneal

Initially intraperitoneal but migrates retroperitoneally during embryogenesis and lose their mesentery

Give examples of circulatory retroperitoneal organs

- Abdominal aorta | - IVC

Give examples of digestive retroperitoneal organs

- Oesophagus (final part) | - Rectum (middle 1/3 with lower 1/3 totally extraperitoneak)

Give examples of urinary retroperitoneal organs

- Suprarenal glands - Kidneys - Ureters - Bladder

Give examples of secondary retroperitoneal organs

- Pancreas (except tail) - Duodenum (except first part) - Ascending and descending colon

Does irritation of parietal peritoneum refer

What supplies diaphragmatic peritoneum

Phrenic nerves

What supplies pelvic parietal peritoneum

Obturator nerves (L2-4)

What is parietal peritoneum sensitive to

- Pain (well-localised, unlike for visceral) - Temperature - Touch - Pressure

What supplies visceral peritoneum

Autonomic afferent nerves that also supply the viscera

What is visceral peritoneum sensitive to

Stretch/tearing (causes diffuse and poorly localised pain)