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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
Q

Where does the mesentary span from?

A

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
Q

How long is the base of the mesentary?

A

20 cm

27
Q

What is found within the mesentary?

A
  • Branches of the superior mesenteric vessels
  • Nerves
  • Lymphatics
28
Q

What is mesenteric lymphadenitis?

A
  • Inflammation of the lymph nodes of the mesentary

- Can present like appendicitis

29
Q

What parts of the colon does the mesocolon relate to?

A
  • Transverse mesocolon

- Sigmoid mesocolon

30
Q

Where is the root of the transverse mesocolon?

A

Inferior border of the pancrease

31
Q

What vessels does the transverse mesocolon carry?

A
  • Middle colic artery and vein
32
Q

What does the sigmoid colon transmit/contain?

A
  • Sigmoid branches of the inferior mesenteric vessels along with nerves and lymphatics
33
Q

Where is the root of the sigmoid mesocolon?

A

Left iliac fossa

34
Q

What does the sigmoid mesocolon cross?

A
  • Bifurcation of the left common iliac vessels

- Left ureter

35
Q

What is the sigmoid mesocolon?

A

Double-layered fold of visceral peritoneum connecting the sigmoid colon to the posterior abdominal wall

36
Q

What does the transverse mesocolon divide?

A

The peritoneal cavity (greater sac) into supracolic and infracolic compartments

37
Q

What does the supracolic compartment contain?

A
  • Duodenum
  • Liver
  • Gallbladder
  • Stomach
  • Spleen
38
Q

WHat does the infracolic compartment contain?

A
  • Duodenum
  • Jejunum
  • Ileum
  • Ascending and descending colon
39
Q

What do supracolic and infracolic compartments communicate with each other through?

A

Paracolic gutters

40
Q

What can peritoneal reflections create?

A

Important recesses, spaces and gutters

41
Q

What are paracolic gutters?

A
  • 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
Q

What is the hepatorenal recess / subhepatic space / Morison’s pouch?

A
  • 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
Q

Where will fluid accumulate if the patient is sitting upright?

A

The rectouterine/rectovesicle pouch, pelvic cavity

44
Q

What are the deepest parts of the pelvic cavity?

A

Retrovesical and retrouterine pouch

45
Q

What does the retrovesical pouch seperate?

A

Rectum from the urinary bladder

46
Q

What does the retrouterine pouch (of Douglas) seperate?

A

Rectum from uterus

47
Q

What does the vesicouterine pouch seperate (only in females)?

A

Bladder from uterus

48
Q

What is a peritoneal fold?

A
  • A reflection of the peritoneum

- Often formed by peritoneum covering blood vessels, ducts or obliterated foetal vessels

49
Q

What are the 5 folds on the posterior surface of the anterior abdominal wall?

A
  • 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
Q

What are peritoneal ligaments?

A

Two-layered folds of peritoneum that connect 2 organs together

51
Q

What are the depressed areas called that lie between the folds and lateral to the lateral umbilical fold?

A
  • Supravesical fossa
  • Medial umbilical fossa
  • Lateral umbilical fossa
52
Q

What does intraperitoneal mean?

A
  • Almost totally covered with visceral peritoneum

- Suspended by a mesentary

53
Q

What does retroperitoneal mean?

A
  • Lie behind or outside the peritoneum

- Only partially covered with visceral peritoneum

54
Q

What does secondary retroperitoneal mean?

A
  • Initially intraperitoneal but migrate retroperitoneally during embryogenesis and lose their mesentary
55
Q

What are some primary retroperitoneal organs?

A
  • Circulatory
    Abdominal aorta, IVC
  • Digestive
    Rectum (middle 1/3, with lower 1/3 totally extraperitoneal)
  • Urinary
    Suprarenal (adrenal) glands, kidneys, ureters, bladder
56
Q

What are some secondary retroperitoneal organs?

A
  • Pancreas (except its tail)
  • Duodenum (except 1st part)
  • Ascending and descending colon
57
Q

What is the visceral peritoneum sensitive to?

A

Stretch and tearing (which causes diffuse and poorly localised pain) but not to touch, pressure or temperature

58
Q

What is the parietal peritoneum sensitive to?

A

Pain (well-localised), temperature, touch and pressure

59
Q

What is the parietal lining the anterior abdominal wall supplied by?

A

The same nerves that supply the overlying skin

- T7 - L1

60
Q

What is the diaphragmatic peritoneum supplied by?

A
  • Intercostal nerves
  • Phrenic nerves
  • T7-9
  • C3-5
61
Q

What is the pelvic peritoneum mainly supplied by?

A
  • Obturator nerves

- L2-4

MD3002 Anatomy (14 decks)

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