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MD3002 Anatomy > Peritoneum and perineal cavity > Flashcards

Peritoneum and perineal cavity Flashcards

1
Q

What can the peritoneal cavity be divided into?

A

Greater and lesser sacs

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2
Q

What is the difference between the male and female peritoneum which affects the spread of infection?

A
  • In males the peritoneal cavity is a completely closed cavity
  • In females, there is a potential, indirect communication with the exterior which means infection can spread from exterior to inside the peritoneal cavity
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3
Q

What does the serous membrane of the peritoneum produce?

A

Serous fluid known as the peritoneal fluid

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4
Q

What does the peritoneal fluid allow for?

A

Lubricates the surfaces of the peritoneum to allow distension and free movement between the viscera (organs)

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5
Q

What structures does the peritoneum form?

A
  • omenta (greater and lesser)
  • Mesenteries
  • Ligaments
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6
Q

What is the lesser sac also known as?

A

Omental bursa

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7
Q

Where does the lesser sac lie?

A
  • Posterior to the stomach and lesser omentum

- Can extend into the greater omentum

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8
Q

What can the peritoneal cavity be used for?

A

Peritoneal dialysis or fluid administration

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9
Q

What is the part of the peritoneal cavity that lies posterior to the and lesser omentum called?

A

Leesser sac

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10
Q

What does the lesser sac use to communicate with the greater sac?

A

Epiploic foramen

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11
Q

How can one acess the lesser sac?

A
  • Through incising the lesser omentum

- Through the epiploic foramen

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12
Q

What is the lesser omentum?

A
  • Membranous structure made from peritoneum
  • Derived from ventral mesentary
  • Passes from the lesser curvature of the stomach and 1st part of duodenum to the inferior border of the liver
  • Free edge of the lesser omentum
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13
Q

What can the lesser omentum be subdivided into?

A

The heapatogastric and hepatoduodenal ligaments

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14
Q

What 3 structures make up the “portal triad”?

A
  • Hepatic portal vein
  • Hepatic artery proper
  • Common bile duct
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15
Q

What are the boundaries of the epiploic [omental] foramen / foramen of Winslow?

A
  • Anteriorly: hepatoduodenal ligament
  • Posteriorly: IVC
  • Superiorly: Caudate process of caudate lobe of liver
  • Inferiorly: 1st part of duodenum
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16
Q

What is Pringle’s manoeuvre?

A
  • During surgery when the lesser sac is approached via the epiloic foramen the hepatic artery proper and portal vein are compressed with fingers/haemostat to control bleeding
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17
Q

What is the greater omentum derived from?

A

The dorsal mesentary

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18
Q

What is the greater omentum attached to?

A

Greater curvature of the stomach and 1st part of duodenum

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19
Q

What does the greater omentum consist of?

A

Double layer of visceral peritoneum folded upon itself

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20
Q

What does the greater omentum overlie?

A

Transverse colon and much of small intestine

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21
Q

What does the greater omentum contain?

A

Fat and gastro-epiploic arteries

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22
Q

Why is the greater omentum often called the “Policeman of the abdomen”?

A
  • In addition to fat it contains lymphatic tissue and can contain inflammation
  • Can become inflammed after appendicitis
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23
Q

What is the mesentary derived from?

A

Dorsal mesentary

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24
Q

How are mesenteries named?

A
  • According to its corresponding organ
  • Mesocolon, mesoappendix, mesometrium
  • Mesentary of small intestine = the mesentery
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25
Where does the mesentary span from?
Connects jejunum and ileum to the posterior abdominal wall - Its base starts just left of L2 and passes obliquely downwards to the right ending just above the sacroiliac joint - It crosses the 3rd part of the duodenum, the aorta and IVC, the right gonadal vessels and right ureter
26
How long is the base of the mesentary?
20 cm
27
What is found within the mesentary?
- Branches of the superior mesenteric vessels - Nerves - Lymphatics
28
What is mesenteric lymphadenitis?
- Inflammation of the lymph nodes of the mesentary | - Can present like appendicitis
29
What parts of the colon does the mesocolon relate to?
- Transverse mesocolon | - Sigmoid mesocolon
30
Where is the root of the transverse mesocolon?
Inferior border of the pancrease
31
What vessels does the transverse mesocolon carry?
- Middle colic artery and vein
32
What does the sigmoid colon transmit/contain?
- Sigmoid branches of the inferior mesenteric vessels along with nerves and lymphatics
33
Where is the root of the sigmoid mesocolon?
Left iliac fossa
34
What does the sigmoid mesocolon cross?
- Bifurcation of the left common iliac vessels | - Left ureter
35
What is the sigmoid mesocolon?
Double-layered fold of visceral peritoneum connecting the sigmoid colon to the posterior abdominal wall
36
What does the transverse mesocolon divide?
The peritoneal cavity (greater sac) into supracolic and infracolic compartments
37
What does the supracolic compartment contain?
- Duodenum - Liver - Gallbladder - Stomach - Spleen
38
WHat does the infracolic compartment contain?
- Duodenum - Jejunum - Ileum - Ascending and descending colon
39
What do supracolic and infracolic compartments communicate with each other through?
Paracolic gutters
40
What can peritoneal reflections create?
Important recesses, spaces and gutters
41
What are paracolic gutters?
- Grooves between the lateral aspect of the ascending or descending colon and posterolateral abdominal wall - Sites for the collection and movement of the peritoneal fluid
42
What is the hepatorenal recess / subhepatic space / Morison's pouch?
- Part of the peritoneal cavity on the right side between the liver and the right kidney and right suprarenal gland - Fluids may collect here if patient is recumbent
43
Where will fluid accumulate if the patient is sitting upright?
The rectouterine/rectovesicle pouch, pelvic cavity
44
What are the deepest parts of the pelvic cavity?
Retrovesical and retrouterine pouch
45
What does the retrovesical pouch seperate?
Rectum from the urinary bladder
46
What does the retrouterine pouch (of Douglas) seperate?
Rectum from uterus
47
What does the vesicouterine pouch seperate (only in females)?
Bladder from uterus
48
What is a peritoneal fold?
- A reflection of the peritoneum | - Often formed by peritoneum covering blood vessels, ducts or obliterated foetal vessels
49
What are the 5 folds on the posterior surface of the anterior abdominal wall?
- Median umbilical fold is the remnant of the urachus that extends from the urinary bladder to the umbilicus - The 2 medial umbilical folds overlie remnants of the umbilical arteries - The 2 lateral umbilical folds are formed by the inferior epigastric arteries
50
What are peritoneal ligaments?
Two-layered folds of peritoneum that connect 2 organs together
51
What are the depressed areas called that lie between the folds and lateral to the lateral umbilical fold?
- Supravesical fossa - Medial umbilical fossa - Lateral umbilical fossa
52
What does intraperitoneal mean?
- Almost totally covered with visceral peritoneum | - Suspended by a mesentary
53
What does retroperitoneal mean?
- Lie behind or outside the peritoneum | - Only partially covered with visceral peritoneum
54
What does secondary retroperitoneal mean?
- Initially intraperitoneal but migrate retroperitoneally during embryogenesis and lose their mesentary
55
What are some primary retroperitoneal organs?
- Circulatory Abdominal aorta, IVC - Digestive Rectum (middle 1/3, with lower 1/3 totally extraperitoneal) - Urinary Suprarenal (adrenal) glands, kidneys, ureters, bladder
56
What are some secondary retroperitoneal organs?
- Pancreas (except its tail) - Duodenum (except 1st part) - Ascending and descending colon
57
What is the visceral peritoneum sensitive to?
Stretch and tearing (which causes diffuse and poorly localised pain) but not to touch, pressure or temperature
58
What is the parietal peritoneum sensitive to?
Pain (well-localised), temperature, touch and pressure
59
What is the parietal lining the anterior abdominal wall supplied by?
The same nerves that supply the overlying skin | - T7 - L1
60
What is the diaphragmatic peritoneum supplied by?
- Intercostal nerves - Phrenic nerves - T7-9 - C3-5
61
What is the pelvic peritoneum mainly supplied by?
- Obturator nerves | - L2-4

MD3002 Anatomy (14 decks)

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