Peritoneum Flashcards

1
Q

what is the peritoneum

A

transparent serous lining found in the abdominal cavity

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2
Q

what is the parietal peritoneum

A

lines the inner surface of the body wall

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3
Q

what is the visceral peritoneum

A

covers the surface of the organs

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4
Q

why does the peritoneum release a small amount of fluid

A

lubricate the internal surfaces of abdomen

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5
Q

when does the peritoneal cavity become obvious

A

usually filled with coils of intestine - potential space - becomes obvious in disease or trauma when cavity fills with blood or fluid

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6
Q

what is the mesentry

A

double fold of peritoneum that encloses organ and connects it to body wall - intestine

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7
Q

why does the small intestine have a mesentry

A

movement of intestine is important during peristalsis
- mesentry provides support, permits movement and also allows passage of blood vessels to and from intestine

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8
Q

describe the movement of peritoneal fluid in the abdomen

A

moves up towards the diaphragm and is absorbed into venous system by small veins around diaphragm

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9
Q

what are the spaces either side of the large intestine called

A

right and left paracolic gutter

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10
Q

what type of nerves supply the parietal peritoneum

A

somatic nerves (final layer of abdominal wall)

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11
Q

the parietal peritoneum is supplied by somatic nerves - what does this mean re pain sensation

A

localise pain in same way as structures of abdominal wall

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12
Q

the parietal peritoneum is sensitive to

A

pain, touch, temperature and pressure

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13
Q

what nerves supply the lateral and anterior parietal peritoneum

A

lower 6 thoracic nerves

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14
Q

what nerves supply the central part of parietal peritoneum at diaphragm

A

phrenic nerves

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15
Q

what nerves supply the pelvic parietal peritoneum

A

obturator nerve

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16
Q

what kind of nerves supply the visceral peritoneum

A

visceral peritoneum shares the autonomic nerve fibres from the organs it covers

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17
Q

what is the visceral peritoneum sensitive to

A

stretch via ANS afferent fibres

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18
Q

give 2 examples of stretch that visceral peritoneum would be sensitive to

A

over-distension
mesenteries of small and large intestine sensitive to mechanical stretching

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19
Q

visceral peritoneum will refer pain to

A

body wall

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20
Q

the peritoneum has a large store of what

A

fat

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21
Q

give 3 fat stores in peritoneum

A

omenta
mesentery
appendices epiplocae

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22
Q

define intra-peritoneal

A

completely surrounded by mesentery except at their point of attachment - accommodates some movement needed by the organ e.g. small intestine

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23
Q

intraperitoneal organs

A

stomach
gall bladder
small intestine (only 1st part of duodenum)
spleen
liver
caecum (some appendix)
transverse and sigmoid colon

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24
Q

define extraperitoneal

A

no mesentery ever or lost in development

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25
Q

define retroperitoneal

A

structures that are partially covered by peritoneum and are held against body wall

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26
Q

define primary retroperitoneal

A

formed on the body wall and have been covered by peritoneum

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27
Q

give an example of a primary retroperitoneal organ

A

kidneys
suprarenal glands

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28
Q

define secondary retroperitoneal

A

moved position during development to lie against body wall

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29
Q

give an example of secondary retroperitoneal organ

A

ascending and descending colon
2nd, 3rd and 4th parts of duodenum
pancreas
upper 2/3 rectum

30
Q

define infra-peritoneal and give examples

A

sub-peritoneal
lower 1/3 rectum and many pelvic organs

31
Q

does the parietal peritoneum extend into the pelvic cavity

A

yes - abdominal and pelvic cavities are continuous so parietal peritoneum extends into pelvis to cover pelvic organs - sub or infra-peritoneal

32
Q

how is the peritoneum arranged in the abdominal cavity

A

greater and lesser sac

33
Q

what does the greater sac hold

A

intestines

34
Q

what is the greater omentum

A

long strip of peritoneum passing anterior to the intestines close to the body wall - helps to divide greater and lesser sac

35
Q

what is the first structure seen one abdominal wall has been reflected

A

greater omentum

36
Q

where is the greater omentum suspended from

A

greater curvature of stomach

37
Q

the greater omentum overlies the

A

transverse colon

38
Q

what does the greater omentum contain

A

blood vessels
nerves
lymphatics
fatty tissue

39
Q

why is the greater omentum known as the policeman of the abdomen

A

the GO moves with the small intestine during peristalsis - if there is a problem with part of the intestine (infected or damaged) it will move less allowing the healthy, more mobile intestine to push the GO over the unhealthy intestine so GO is found in areas where there is a problem with the intestine

40
Q

what happens if the GO stays over the unhealthy tissue for some time

A

it will form connective tissue adhesions that will help to localise infection within abdominal cavity and slow spread of problem

41
Q

how many layers is the GO

A

as it passes from greater curvature of stomach it is a double layer - it meets and fuses with another double layer that has passed over the transverse colon creating a 4 layered structure

42
Q

what part of the abdominal cavity does the GO close off posterior to the stomach

A

lesser sac

43
Q

the transverse colon divides the peritoneal cavity into what

A

supra-colic compartment and infra-colic compartment

44
Q

what organs are found in the supracolic compartment of the abdomen

A

(most of foregut)
liver
gall bladder
stomach

45
Q

what organs are found in the infracolic compartment of the abdomen

A

(midgut) intestines
and infracolic

46
Q

the greater omentum carries the blood vessels to supply what

A

greater curvature of stomach and itself

47
Q

what vessels does the greater omentum carry

A

left and right gastro-omental arteries, veins and lymphatics

48
Q

what is another name for the gastro-omental vessels

A

gastro-epiploic vessels

49
Q

what is another name for the lesser sac

A

omental bursa

50
Q

what is the lesser sac

A

space posterior to the stomach and lesser omentum

51
Q

where does the lesser omentum lie

A

between the liver and the lesser curvature of the stomach

52
Q

how many layers is the lesser omentum

A

double layer of peritoneum

53
Q

what forms the anterior wall of the lesser sac

A

lesser omentum

54
Q

the lesser omentum lies anterior to the opening to the greater sac - what is this called

A

epiploic foramen

55
Q

what closes the lesser sac at the lateral side

A

gastrosplenic ligament (between the stomach and the spleen)
and the lienorenal ligament (between spleen and left kidney)

56
Q

what does the free edge of the lesser omentum that lies anterior to the epiploic foramen carry

A

hepatic artery, bile duct and hepatic portal vein

57
Q

where abouts are the structures carried by the free edge of the lesser omentum

A

hepatic artery - on left
bile duct - on right
^^ both anterior)

hepatic portal vein (posterior)

58
Q

what is the epiploic (omental) foramen

A

an area of communication between the greater and lesser sac

59
Q

what is the epiploic foramen

A

gap between the free edge of the lesser omentum and the body wall

60
Q

what forms the posterior boundary of the epiploic foramen

A

IVC

61
Q

what forms the superior boundary of the epiploic foramen

A

liver

62
Q

what forms the anterior boundary of the epiploic foramen

A

lesser omentum

63
Q

what is a mesentery

A

double layer of peritoneum connecting to an organ

64
Q

how do you know if someone is talking about the mesentery connected to the small intestine

A

it is the mesentery proper or ‘the’ mesentery

65
Q

what vessels does the mesentery enclose

A

jejunal and ileal branches of the superior mesenteric vessels

66
Q

what is the function of the mesentery

A

connects the small intestine to the body wall and allows mobility of the intestines in the peritoneal cavity

67
Q

the mesentery carries what to/from where

A

carries vessels, nerves and lymphatics to/from most of the small intestine (jejunum and ileum)

68
Q

what are mesocolons

A

folds of peritoneum that are attached to structures of the large intestine

69
Q

what do mesocolons carry

A

blood vessels, nerves and lymphatics

70
Q

what structures might you see in the DR when you remove the parietal peritoneum from the posterior abdominal wall

A

IVC
aorta
lumbar plexus
kidney (has a peri-renal fat pad)