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Gross III Exam 2 > Peritoneum and Peritoneal Cavity > Flashcards

Peritoneum and Peritoneal Cavity Flashcards

0
Q

What is the visceral peritoneum

A

covering of the abdominopelvic viscera

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1
Q

What is the parietal peritoneum

A

lining of the internal surface of the abdominopelvic cavity

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2
Q

How is the parietal peritoneum innervated

A

somatic sensory innervation via adjacent dermatome

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3
Q

What is the innervation of the visceral peritoneum

A
  • no somatic sensory innervation

- visceral afferent innervation may result in referred pain

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4
Q

What does the peritoneal fluid do

A

lubricates visceral surfaces for friction-free digestion

-contains leukocytes and antibodies to fight infections

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5
Q

Where does the peritoneal cavity open to exterior in males and females

A

females: uterine tubes
males: closed

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6
Q

What is the peritoneal cavity

A

space present between parietal and visceral peritoneum

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7
Q

What covers the intraperitoneal organs

A

almost completely covered by visceral peritoneum

**not inside the peritoneal cavity however (misnomer)

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8
Q

What suspends the intraperitoneal organs embryonically

A

suspended by mesentery and remain suspended in the adult

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9
Q

What covers retroperitoneal organs

A

only partially covered by parietal peritoneum

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10
Q

Where are the retroperitoneal organs located

A

external or posterior to peritoneal cavity

–one side is covered with parietal peritoneum and the rest with adventitia

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11
Q

Where are the Primarily Retroperitoneal organs found and which organs are primarily retroperitoneal

A

embryonically behind peritoneum and stay there in the adult

–suprarenal gland, kidney, ureter, uterus, ovary, aorta, IVC

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12
Q

Which organs are Secondarily Retroperitoneal and how are they formed embryonically

A

embryonically intraperitoneal, but become retroperitoneal due to return of gut
–duodenum, ascending/descending colon. pancreas, rectum

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13
Q

What is peritonitis

A

painful condition due to inflammation of the peritoneum

-occurs when peritoneum is injured or infected

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14
Q

What is peritonitis a response to

A

ascites

–fluid is normally resorbed by peritoneum as inflammation subsides

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15
Q

How does ascitic fluid flow in peritonitis

A

flow along gutters

  • reabsorption is slow in pelvis
  • reabsorption is best on inferior surface of diaphragm
  • -patients often encouraged to recline or lie supine
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16
Q

What often occurs as a result of peritonitis

A

Adhesions between parietal and visceral layers is common

-can cause pain and might cause volvulus

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17
Q

What are the 5 peritoneal folds found inferior to umbilicus

A

median umbilical fold (1)
medial umbilical folds (2)
lateral umbilical folds (2)

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18
Q

Where is the median umbilical fold and what is contained within it

A

from apex of urinary bladder to umbilicus

-contains the median umbilical lig (urachus)

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19
Q

Where is the medial umbilical fold and what is contained in it

A

located laterally on either side of the median umbilical fold
–contains medial umbilical lig (obliterated umbilical a)

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20
Q

Where is the lateral umbilical folds found and what is contained in them

A

located laterally on either side of the medial umbilical folds
–contains the inferior epigastric a,v

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21
Q

What are the 3 paired shallow depressions present among the peritoneal folds

A

supravesical fossa
medial inguinal fossa
lateral inguinal fossa

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22
Q

Where is the suravesical fossa

A

between the median and medial umbilical folds

–parietal peritoneum reflects from anterior wall to urinary bladder here

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23
Q

What is another name for medial inguinal fossa

A

Hesselbachs Triangle

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24
Q

What are the borders of the medial inguinal fossa (hesselbachs)

A

inferior epigastric a,v
inguinal lig
lateral border of rectus abdominis

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25
Q

Where is hesselbachs triangle located and what often occurs here

A

medial and lateral umbilical folds

–site for direct inguinal hernia

26
Q

Where is the lateral inguinal fossa

A

lateral to the lateral umbilical fold

27
Q

What is located in the lateral inguinal fossa

A

deep inguinal ring located here

28
Q

What can occur in the lateral inguinal fossa

A

site for indirect inguinal hernia

29
Q

What is the falciform lig

A

sagittal peritoneal fold between anterior abdominal wall and liver

30
Q

What is the ligamentum teres hepatis (round lig of liver) and what does it contain

A

inferior border that has thickened of the falciform lig

–contains the remnant of fetal umbilical v

31
Q

What is a inguinal hernia

A

protrusion of parietal peritoneum and viscera through an inappropriate opening

32
Q

What is a indirect inguinal hernia

A
  • most common
  • occurs in lateral inguinal fossa (lateral to inferior epigastric a,v)
  • occurs lateral to inguinal fossa
33
Q

How does an indirect inguinal hernia travel

A

enters deep inguinal ring and traverses inguinal canal, exits superficial ring into spermatic cord
–hernial sac has peritoneum plus all 3 fascial coverings of the spermatic cord

34
Q

What is a direct inguinal hernia

A

occur in medial inguinal fossa (medial to inferior epigastric a,v)
Traverses only medial (lower) part of inguinal canal

35
Q

How does a direct inguinal hernia travel

A

exits superficial inguinal ring adjacent to spermatic cord

  • -hernial sac has peritoneum and transversalis fascia
  • -located outside spermatic fascial coverings
  • -rarely enters scrotum
36
Q

Which peritoneal reflections are superior to the umbilicus and which are below

A

Superior: Falciform Lig
Inferior: Mesentery and Omentum

37
Q

What is the mesentery

A

double layer of peritoneum connecting intraperitoneal organs to posterior abdominal wall
–occurs a result of the invagination of the peritoneum by an organ; constitutes a continuity of visceral and parietal peritoneum

38
Q

Where is the mesentery

A

between parietal and visceral peritoneum

39
Q

What is contained in the mesentery

A

connective tissue with blood vessels, lymph vessels, nerves and fat
–neurovascular structures passing from body wall to intraperitoneal organ

40
Q

What is the omentum

A

double fold of peritoneum from stomach and proximal duodenum to adjacent organs

41
Q

Where is the lesser omentum

A

from lesser curvature of stomach and proximal duodenum to liver

42
Q

What are the 2 parts of the of the lesser omentum

A

hepatogastric lig

hepatoduodenal lig

43
Q

What is the hepatogastric lig

A

thin membrane from liver to lesser curvature of stomach

44
Q

What is the hepatoduodenal lig

A
  • thickened right side free edge of lesser omentum
  • from liver to proximal duodenum
  • surounds portal triad
45
Q

Whats the greater omentum

A

peritoneal fold hanging like an apron from greater curvature of stomach and then folding back on itself to attach to transverse colon

46
Q

What does the greater omentum do

A
  • prevents abdominal viscera from adhering to anterolateral wall
  • considerable mobility as a result of visceral peristaltic movements
  • wraps itself around inflamed organs to protect other viscera
47
Q

What are the 3 parts of the greater omentum

A
  • Gastrocolic lig
  • gastrosplenic lig
  • gastrophrenic lig
48
Q

What is the gastrocolic lig

A

largest portion of greater omentum

-from greater curvature of stomach to transverse colon–drapes over small intestine

49
Q

What is the gastrosplenic lig

A

from greater curvature of stomach to spleen

50
Q

What is the gastrophrenic lig

A

from greater curvature of stomach to thoracic diaphragm

51
Q

What are the subdivisions of the peritoneal cavity

A 
greater sac
lesser sac(omental bursa)
epiploic foramen (foramen of winslow, omental foramen)
52
Q

What is the greater sac

A
  • main, large portion of peritoneal cavity

- entered via incision through anerolateral abdominal wall

53
Q

What divides the greater sac

A

transverse colon and transverse mesocolon

54
Q

What are the divisions of the greater sac

A

supracolic compartment

infracolic compartment

55
Q

Where is the supracolic compartment and what does it contain

A

anterosuperior to greater omentum and transverse colon

–stomach, liver, spleen

56
Q

Where is the infracolic compartment and what does it contain

A

posteroinferior to greater omentum and transverse colon

  • divided into right and left sides by mesentery of small intestine
  • contains small intestine, ascending/descending colon
57
Q

What are the paracolic gutters

A

groove between lateral sides of ascending/descending colon and posterolateral abdominal wall
-have right and left paracolic gutters

58
Q

What do the paracolic gutters do

A

provide communication between supracolic and infracolic compartments
–spread of ascites or cancerous cells

59
Q

What is the lesser sac (omental bursa)

A

Small portion of peritoneal cavity posterior to stomach and lesser omentum

60
Q

Where does the lesser sac extend

A

superiorly: behind liver up to thoracic diaphragm
inferiorly: between superior layers of gastrocolic lig (greater omentum)
- -inferior layers of gastrocolic lig fuse together

61
Q

What is the Epiploic foramen also known as

A

Foramen of Winslow

Omental Foramen

62
Q

What is the epiploic foramen

A

opening to the lesser sac

-provides point of communication between greater and lesser sacs

63
Q

What are the boundaries of the epiploic foramen

A

Anteriorly: portal triad
Posteriorly: IVC, Right Crus of diaphragm
Superiorly: caudate lobe of liver
Inferiorly: First part of duodenum

Gross III Exam 2 (11 decks)

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