Peritoneum

Question 1

what is the peritoneum

Answer 1

transparent serous lining found in the abdominal cavity

Question 2

what is the parietal peritoneum

Answer 2

lines the inner surface of the body wall

Question 3

what is the visceral peritoneum

Answer 3

covers the surface of the organs

Question 4

why does the peritoneum release a small amount of fluid

Answer 4

lubricate the internal surfaces of abdomen

Question 5

when does the peritoneal cavity become obvious

Answer 5

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

Question 6

what is the mesentry

Answer 6

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

Question 7

why does the small intestine have a mesentry

Answer 7

movement of intestine is important during peristalsis

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

Question 8

describe the movement of peritoneal fluid in the abdomen

Answer 8

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

Question 9

what are the spaces either side of the large intestine called

Answer 9

right and left paracolic gutter

Question 10

what type of nerves supply the parietal peritoneum

Answer 10

somatic nerves (final layer of abdominal wall)

Question 11

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

Answer 11

localise pain in same way as structures of abdominal wall

Question 12

the parietal peritoneum is sensitive to

Answer 12

pain, touch, temperature and pressure

Question 13

what nerves supply the lateral and anterior parietal peritoneum

Answer 13

lower 6 thoracic nerves

Question 14

what nerves supply the central part of parietal peritoneum at diaphragm

Answer 14

phrenic nerves

Question 15

what nerves supply the pelvic parietal peritoneum

Answer 15

obturator nerve

Question 16

what kind of nerves supply the visceral peritoneum

Answer 16

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

Question 17

what is the visceral peritoneum sensitive to

Answer 17

stretch via ANS afferent fibres

Question 18

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

Answer 18

over-distension

mesenteries of small and large intestine sensitive to mechanical stretching

Question 19

visceral peritoneum will refer pain to

Answer 19

body wall

Question 20

the peritoneum has a large store of what

Answer 20

fat

Question 21

give 3 fat stores in peritoneum

Answer 21

omenta
mesentery
appendices epiplocae

Question 22

define intra-peritoneal

Answer 22

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

Question 23

intraperitoneal organs

Answer 23

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

Question 24

define extraperitoneal

Answer 24

no mesentery ever or lost in development

Question 25

define retroperitoneal

Answer 25

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

Question 26

define primary retroperitoneal

Answer 26

formed on the body wall and have been covered by peritoneum

Question 27

give an example of a primary retroperitoneal organ

Answer 27

kidneys | suprarenal glands

Question 28

define secondary retroperitoneal

Answer 28

moved position during development to lie against body wall

Question 29

give an example of secondary retroperitoneal organ

Answer 29

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

Question 30

define infra-peritoneal and give examples

Answer 30

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

Question 31

does the parietal peritoneum extend into the pelvic cavity

Answer 31

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

Question 32

how is the peritoneum arranged in the abdominal cavity

Answer 32

greater and lesser sac

Question 33

what does the greater sac hold

Answer 33

intestines

Question 34

what is the greater omentum

Answer 34

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

Question 35

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

Answer 35

greater omentum

Question 36

where is the greater omentum suspended from

Answer 36

greater curvature of stomach

Question 37

the greater omentum overlies the

Answer 37

transverse colon

Question 38

what does the greater omentum contain

Answer 38

blood vessels nerves lymphatics fatty tissue

Question 39

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

Answer 39

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

Question 40

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

Answer 40

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

Question 41

how many layers is the GO

Answer 41

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

Question 42

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

Answer 42

lesser sac

Question 43

the transverse colon divides the peritoneal cavity into what

Answer 43

supra-colic compartment and infra-colic compartment

Question 44

what organs are found in the supracolic compartment of the abdomen

Answer 44

(most of foregut) liver gall bladder stomach

Question 45

what organs are found in the infracolic compartment of the abdomen

Answer 45

(midgut) intestines | and infracolic

Question 46

the greater omentum carries the blood vessels to supply what

Answer 46

greater curvature of stomach and itself

Question 47

what vessels does the greater omentum carry

Answer 47

left and right gastro-omental arteries, veins and lymphatics

Question 48

what is another name for the gastro-omental vessels

Answer 48

gastro-epiploic vessels

Question 49

what is another name for the lesser sac

Answer 49

omental bursa

Question 50

what is the lesser sac

Answer 50

space posterior to the stomach and lesser omentum

Question 51

where does the lesser omentum lie

Answer 51

between the liver and the lesser curvature of the stomach

Question 52

how many layers is the lesser omentum

Answer 52

double layer of peritoneum

Question 53

what forms the anterior wall of the lesser sac

Answer 53

lesser omentum

Question 54

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

Answer 54

epiploic foramen

Question 55

what closes the lesser sac at the lateral side

Answer 55

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

Question 56

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

Answer 56

hepatic artery, bile duct and hepatic portal vein

Question 57

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

Answer 57

hepatic artery - on left bile duct - on right ^^ both anterior) hepatic portal vein (posterior)

Question 58

what is the epiploic (omental) foramen

Answer 58

an area of communication between the greater and lesser sac

Question 59

what is the epiploic foramen

Answer 59

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

Question 60

what forms the posterior boundary of the epiploic foramen

Answer 60

IVC

Question 61

what forms the superior boundary of the epiploic foramen

Answer 61

liver

Question 62

what forms the anterior boundary of the epiploic foramen

Answer 62

lesser omentum

Question 63

what is a mesentery

Answer 63

double layer of peritoneum connecting to an organ

Question 64

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

Answer 64

it is the mesentery proper or 'the' mesentery

Question 65

what vessels does the mesentery enclose

Answer 65

jejunal and ileal branches of the superior mesenteric vessels

Question 66

what is the function of the mesentery

Answer 66

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

Question 67

the mesentery carries what to/from where

Answer 67

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

Question 68

what are mesocolons

Answer 68

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

Question 69

what do mesocolons carry

Answer 69

blood vessels, nerves and lymphatics

Question 70

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

Answer 70

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