Peritoneum Flashcards
What is peritoneum?
It is a thin, serous membrane lining the walls of the abdominal and pelvic cavities, and reflects onto the viscera providing complete or partial covering.
What are the 2 layers of peritoneum?
Parietal peritoneum
Visceral peritoneum
What is found between the 2 layers of peritoneum?
The peritoneal cavity, which is normally filled with only a few mm of serous fluid
What is parietal peritoneum?
The layer of peritoneum applied to the inner aspect of the abdominal and pelvic walls, and continues superiorly to the undersurface of the diaphragm
Which somatic nerves serve the parietal peritoneum?
Those that provide sensory innervation to the body wall
What is the parietal peritoneum sensitive to?
Pain, touch, pressure, heat and cold
Is pain poorly or well localised by the parietal peritoenum?
Well localised
What does the parietal peritoneum form anteriorly?
It forms peritoneal folds containing structures and vessels from foetal development
What parietal peritoneal folds are found below the umbilicus?
Median umbilical ligament
Medial umbilical ligament
Lateral umbilical ligament
What does the median umbilical ligament contain?
Urachus
What does the medial umbilical ligament contain?
Obliterated umbilical artery
What does the lateral umbilical ligament contain?
Inferior epigastric artery
What parietal peritoneal folds are found superiorly to the umbilicus?
Round ligament of the liver or Ligamentum teres hepatis
What is contained within the round ligament of the liver?
Obliterated umbilical vein
What does the visceral peritoneum line?
It lines the viscera
Which nerves serve the visceral peritoneum?
The nerves that serve the viscera
What is the visceral peritoneum sensitive to?
It is sensitive to stretching, but not heat, cold and touch
Is pain poorly or well localised by the visceral peritoneum?
It is poorly localised
Where is pain from the visceral peritoneum lining the foregut experienced?
Epigastric region
Where is pain from the visceral peritoneum lining the midgut experienced?
Umbilical region
Where is pain from the visceral peritoneum lining the hindgut experienced?
Pubic region
When is an organ classified as intraperitoneal?
When all of its surfaces are covered by peritoneum, thus the entire organ is covered by peritoneum
When is an organ classified as retroperitoneal?
When only its anterior and/or lateral surfaces are covered by peritoneum, thus the organ lies outside the peritoneal cavity
When is an organ classified as subperitoneal?
When only the superior surface of the organ is covered by peritoneum
Which organs are intraperitoneal?
Stomach
Liver
Spleen
Gallbladder
Appendix
Caecum
Jejunum
Ileum
Transverse and sigmoid colon
Part of duodenum and pancreas
Which organs are retroperitoneal?
Parts of duodenum and pancreas
Ascending and descending colon
Kidneys and ureters
Rectum
Which organs are subperitoneal?
Bladder
Uterus
What is the peritoneal cavity?
The potential space that lies between parietal and visceral peritoneum
What are the divisions of the peritoneal cavity?
Greater sac
Lesser sac (omental bursa)
Where is the greater sac located?
It begins at the diaphragm and continues into the pelvic cavity. It is the area lying anterior to the abdominal organs
Where is the lesser sac located?
It is smaller and located posterior to the stomach and liver
How does the greater and lesser sac communicate?
Through the omental/epiploic foramen
Where is the epiploic foramen located?
In the region between the stomach and liver
What is ascites?
Large accumulations of peritoneal fluid in the peritoneal cavity
What is omentum?
A double layer of peritoneum which passes from the stomach and first part of the duodenum, and connects to the abdominal viscera
What are the types of omentum?
Greater omentum and lesser omentum
What is the greater omentum derived from?
Dorsal mesentery
What does the greater omentum attach to?
It attaches to the greater curvature of the stomach and first part of the duodenum, and then drapes inferior over the transverse colon and the coils of the ileum and jejunum
It then turns posterior to ascend and become adherent to the superior and anterior surface of the transverse colon
How many layers of peritoneum makes up the greater omentum
4 layers?
Which arteries are located within the greater omentum?
Right and left gasto-omental (gastroepiploic) arteries
What is the lesser omentum derived from?
Ventral mesentery
Where does the lesser omentum extend from?
It extends from the lesser curvature of the stomach and the first part of the duodenum to the inferior surface of the liver
What are the divisions of the lesser omentum?
Hepatogastric ligament
Hepatoduodenal ligament
What is the relation of the hepatoduodenal ligament to the epiploic foramen?
It is the anterior border of the epiploic foramen
Which structures are found in the hepatoduodenal ligament?
Portal triad - hepatic artery proper, portal vein and bile duct
What is mesentery?
This is a double layer of peritoneum that attach viscera to the posterior abdominal wall
Where does mesentery arise from?
Dorsal mesentery
What does the mesentery allow movement and passage for?
It allows for movement and passage of the vessels, nerve and lymphatics, specifically the SMA
What is the mesentery associated with the transverse colon?
Transverse mesocolon
What is the mesentery associated with the sigmoid colon?
Sigmoid mesocolon
What is the root of the mesentery?
It is the point of origin of the mesentery and the point at which it attaches to the posterior abdominal wall
Where does the root of the mesentery extend from?
It extends from the duodenojejunal junction to the ileocaecal junction
Which artery is found within the root of the mesentery?
The superior mesenteric artery
What is the transverse mesocolon?
It is a long, horizontal root that connects the transverse colon to the posterior abdominal wall
What does the transverse mesocolon divide the greater sac into?
Supracolic compartment
Infracolic compartmetn
What divides the supracolic compartment?
Falciform ligament
What does the falciform ligament divide the supracolic compartment into?
2 subphrenic compartments
What divides the infracolic compartment?
The root of the mesentery
What does the root of the mesentery divide the infracolic compartment into?
Left and right infracolic compartments
What is the sigmoid mesocolon?
It is an inverted V-shaped peritoneal fold that attaches the sigmoid colon to the posterior abdominal wall
What is related to the apex of the sigmoid mesocolon?
The bifurcation of the left common iliac artery
What are ligaments?
These are 2 layers of peritoneum that connect two organs to each other or attach the organ to the body wall
Which ligaments are found on the liver?
Triangular, coronary, falciform and round ligament
Which ligaments extend from the liver to the anterior abdominal wall?
Falciform ligament
What does the falciform ligament divide the liver into?
It divides the liver into right and left lobes
What does the falciform ligament continue superior as?
Coronary ligaments
What does the coronary ligament end as?
Left and right triangular ligaments
What does the falciform ligament continue as inferiorly?
Round ligament of the liver
What does the round ligament of the liver attach to?
Umbilicus
What attaches the liver to the stomach and duodenum?
Hepatogastric and hepatoduodenal ligaments
What attaches the spleen to the stomach and kidney?
Gastrosplenic and splenorenal ligaments
What is a bare area?
An area of the organ that is not covered by visceral peritoneum to allow for entrance and exit of neurovascular structures
