Peritoneal Cavity and Mesenteries Flashcards
Boundaries of the peritoneal cavity
Anterior abd wall
Post abd wall
Resp diaphragm
Floor of pelvic cavity
What does the peritoneum consist of (functionally)?
single layer of squamous epithelium on CT
What lines the inner surfaces of the abd walls?
parietal peritoneum
What covers many abd organs?
visceral peritoneum
What moistens peritoneum?
serous fluid (peritoneal)
Is the peritoneal cavity empty?
Yes–>except for peritoneal fluid
What situations fill the peritoneal cavity?
air during surgery
ascites
pus accumulation s/t infection
What are the functions of the peritoneum?
- produce peritoneal fluid
- minimize friction between abd organs
- resist infection
- storage of fat (greater omentum)
What does the peritoneum do in response to injury or infection?
- produce fluid containing antibodies
- produce leukocytes
- wall off/localizes infection
What are the subdivisions of the peritoneal cavity?
- lesser sac or omental bursa
- greater sac
Where is the lesser sac/omental bursa located?
posterior to lesser omentum, stomach and caudate lobe of liver
What is the communication between the omenal bursa/lesser sac and greater omentum?
epiploic foramen
What are the borders of the epiploic foramen?
anterior: hepatoduodenal L
superiorly: reflection of peritoneum from caudate lobe onto front of IVC
inferiorly: duodenum
posteriorly: parietal peritoneum covering IVC
How do you get to the greater sac?
Incision through anterior/lateral abdominal wall
Is the peritoneal cavity in males closed?
Yes
Is the peritoneal cavity in females closed?
No
–> communication between uterine tube, cavity and vagina to external world
Why do women have potential pathway for infection from external world to the peritoneal cavity?
The peritoneal cavity is open via vagina, uterine tubes and cavity
Generally, what are the 4 parts of the peritoneum?
1: Mesentery
2: Omentum
3: Ligaments
4: Peritoneal recesses
What causes peritonitis?
bacterial contamination via penetrating abd wound or rupture of organ
What is peritonitis?
inflammation of peritoneum
What are the sx of peritonitis?
severe abd pain tenderness nausea, vomiting FEVER constipation
What is ascites?
excess peritoneal fluid
What can cause ascites?
mechanical injury portal HTN cancer mets to abd starvation cirrhosis (main)
What is a frequent complication of ascites?
Subphrenic abscess
How does ascitic fluid spread infection?
via paracolic gutters
—>lateral to asc and desc colon
Can infection spread from the pelvis to the subphrenic recess?
Yes–>via paracolic gutters
Where is the subphrenic recess?
between the diaphragm and the liver
What can cause fluid in the omental bursa/lesser sac?
- perforated posterior stomach wall
- pancreatitis
- injured pancreas
What is the peritoneal recess?
pouch of peritoneum formed by a peritoneal fold
–> inferior recess of omental bursa (b/t layers of greater omentum)
What ligament attaches the liver to the ant abd wall?
Falciform L
What ligament attaches the lesser curvature of the stomach to the liver?
Hepatogastric L
What ligament attaches the first part of the duodenum to the liver?
Hepatoduodenal L
What ligaments make up the lesser omentum?
Hepatogastric L
Hepatoduodenal L
What ligament attaches the fundus of the stomach to the diaphragm?
Gastrophrenic L
What ligament attaches the stomach to the hilum of the spleen?
Gastrosplenic L
What ligament attaches the greater curvature of the stomach to the transverse colon?
Gastrocolic L
What ligament is the apron-like part of the greater omentum?
Gastrocolic L
What ligaments make up the greater omentum?
Gastrophrenic L
Gastrosplenic L
Gastrocolic L
What are double-layered folds of peritoneum that attach organs to each other?
Ligaments of peritoneum
What is a mesentery that extends from the stomach to adjacent organs?
Omentum
What attaches the lesser curvature of the stomach and first part of the duodenum to the liver?
Lesser omentum
What attaches the greater curvature of the stomach and the first part of the duodenum to the transverse colon?
Greater omentum
What is the mesentery attached to?
posterior abd wall where BV and N originate
What is a double-layered membrane of peritoneum that provides a channel for BV and N to travel to abd organs?
mesentery
What is the difference between mesentery and omentum?
Both part of peritoneum
–>omentum is a type of mesentery that attaches the stomach to other organs
–>mesentery is broad term of peritoneum that conveys BV and N to organs
Intraperitoneal vs Retroperitoneal
Intraperitoneal
–>completely covered with visceral peritoneum, free moving
Retroperitoneal
—> partial covered by visceral peritoneum, fused to body wall
What are the retroperitoneal organs?
SADPUCKER
–>suprarenal gland, aorta/IVC, duodenum (2-4), pancreas (except tail), ureters, ascending and descending colon, kidneys, esophagus, rectum
What does the transverse mesocolon divide?
Greater sac into supracolic and infracolic compartments
What compartments make up the greater sac?
Supracolic
Infracolic
What organs are in the supracolic compartment?
Stomach
Liver
Spleen
What organs are in the infracolic compartment?
SI
Asc colon
Desc colon
Describe the attachments of the transverse mesocolon?
from TC to post abd wall
–>lies in front of the head and body of pancreas to enclose TC
What are paracolic gutters examples of?
peritoneal recess
What are ligaments examples of in the abd?
peritoneal fold
