Peritoneum Flashcards
Describe embryologic development of peritoneal cavity
intermediate mesoderm –> somatic (parietal)+ splanchnic (visceral) mesoderm
what is the space enclosed by the somatic and splanchnic mesoderm?
coelom
What passes through the inguinal canal?
vaginal process, spermatic cord, round ligament; external pudendal vessels, genital nerve
What passes through vascular lacunae
femoral artery and vein, lymphatics, saphenous nerve
What passes thorugh paired slit-like openings dorsal to diaphragm and ventral to psoas muscles?
sypmathetic trunck and splanchnic nerves
also air, chlye, peritoneal fluid, other dz processes
What is the Cullen sign?
ring of SQ hemorrhage around umbilicus –> from hemoperitoneum or peritonitis
What is a mesentery?
wide serous folds by which vessels and nerves reach the organs
Name 3 portions of greater omentum
bursal
splenic
veil
What are the boundaries of the epiploic foramen? what part of the greater omentum is it found?
dorsal: caudal VC
ventral: portal vein//hepatic artery
Cranial: liver
Caudal: mesoduodenum/celiac artery
Bursal portion
Which of the following is true?
A. The veil portion forms the gastrosplenic ligament
B. Milky spots are a sign of diseased omentum
C. Parts of the lesser omentum –> hepatoduodenal ligament and hepatogastric ligament
D. Normal peritoneal protein concentration is > 3d/dL < 15 g/dL and the colloid osmotic pressure is about 35 mm Hg
A. The veil portion contains the left limb of the pancreas (dorsal leaf); splenic portion –> gastrosplenic ligament
B. Milky spots = source of WBC and important for defense
C true
D. < 3 d/dL; 28 mm Hg
What size particles can drain through peritoneal lymphatics?
<10 um
bacteria = 0.5-2 um and RBC 7-8 um
What rate of fluid can be absorbed per hour?
3-8% of body weight/hr
What is the normal intraabdominal pressure?
2-7.5 cm H2O or mean 4.5 cm H2O
Which of the following is true?
A. Renal failure can be caused by intra-abdominal pressures > 20 mm Hg
B. Dogs with MODS have a mortality rate of 70% versus 25% without the syndrome
C. Sclerosing encapsulating peritonitis is an acute reaction to a gossipyboma
D. Alpha-hemolysin is produced by streptococcal organisms and increases patient mortality
B true
A. 24 mm Hg or 32.6 cm H2O –> renal failure
C. Chronic response with a “coccoon” layering; humans peritoneal dialysis complications, infectious, chylous
D. a-Hemolysin from E.coli or Baceroides fragilis = toxic to many mammalian cells
What are known adjuvants in peritonitis?
gastric mucin
bile salts
hemoglobin
barium