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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
What are the borders of the medial inguinal fossa (hesselbachs)
inferior epigastric a,v inguinal lig lateral border of rectus abdominis
25
Where is hesselbachs triangle located and what often occurs here
medial and lateral umbilical folds | --site for direct inguinal hernia
26
Where is the lateral inguinal fossa
lateral to the lateral umbilical fold
27
What is located in the lateral inguinal fossa
deep inguinal ring located here
28
What can occur in the lateral inguinal fossa
site for indirect inguinal hernia
29
What is the falciform lig
sagittal peritoneal fold between anterior abdominal wall and liver
30
What is the ligamentum teres hepatis (round lig of liver) and what does it contain
inferior border that has thickened of the falciform lig | --contains the remnant of fetal umbilical v
31
What is a inguinal hernia
protrusion of parietal peritoneum and viscera through an inappropriate opening
32
What is a indirect inguinal hernia
- most common - occurs in lateral inguinal fossa (lateral to inferior epigastric a,v) - occurs lateral to inguinal fossa
33
How does an indirect inguinal hernia travel
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
What is a direct inguinal hernia
occur in medial inguinal fossa (medial to inferior epigastric a,v) Traverses only medial (lower) part of inguinal canal
35
How does a direct inguinal hernia travel
exits superficial inguinal ring adjacent to spermatic cord - -hernial sac has peritoneum and transversalis fascia - -located outside spermatic fascial coverings - -rarely enters scrotum
36
Which peritoneal reflections are superior to the umbilicus and which are below
Superior: Falciform Lig Inferior: Mesentery and Omentum
37
What is the mesentery
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
Where is the mesentery
between parietal and visceral peritoneum
39
What is contained in the mesentery
connective tissue with blood vessels, lymph vessels, nerves and fat --neurovascular structures passing from body wall to intraperitoneal organ
40
What is the omentum
double fold of peritoneum from stomach and proximal duodenum to adjacent organs
41
Where is the lesser omentum
from lesser curvature of stomach and proximal duodenum to liver
42
What are the 2 parts of the of the lesser omentum
hepatogastric lig | hepatoduodenal lig
43
What is the hepatogastric lig
thin membrane from liver to lesser curvature of stomach
44
What is the hepatoduodenal lig
- thickened right side free edge of lesser omentum - from liver to proximal duodenum - surounds portal triad
45
Whats the greater omentum
peritoneal fold hanging like an apron from greater curvature of stomach and then folding back on itself to attach to transverse colon
46
What does the greater omentum do
- 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
What are the 3 parts of the greater omentum
- Gastrocolic lig - gastrosplenic lig - gastrophrenic lig
48
What is the gastrocolic lig
largest portion of greater omentum | -from greater curvature of stomach to transverse colon--drapes over small intestine
49
What is the gastrosplenic lig
from greater curvature of stomach to spleen
50
What is the gastrophrenic lig
from greater curvature of stomach to thoracic diaphragm
51
What are the subdivisions of the peritoneal cavity
``` greater sac lesser sac(omental bursa) epiploic foramen (foramen of winslow, omental foramen) ```
52
What is the greater sac
- main, large portion of peritoneal cavity | - entered via incision through anerolateral abdominal wall
53
What divides the greater sac
transverse colon and transverse mesocolon
54
What are the divisions of the greater sac
supracolic compartment | infracolic compartment
55
Where is the supracolic compartment and what does it contain
anterosuperior to greater omentum and transverse colon | --stomach, liver, spleen
56
Where is the infracolic compartment and what does it contain
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
What are the paracolic gutters
groove between lateral sides of ascending/descending colon and posterolateral abdominal wall -have right and left paracolic gutters
58
What do the paracolic gutters do
provide communication between supracolic and infracolic compartments --spread of ascites or cancerous cells
59
What is the lesser sac (omental bursa)
Small portion of peritoneal cavity posterior to stomach and lesser omentum
60
Where does the lesser sac extend
superiorly: behind liver up to thoracic diaphragm inferiorly: between superior layers of gastrocolic lig (greater omentum) - -inferior layers of gastrocolic lig fuse together
61
What is the Epiploic foramen also known as
Foramen of Winslow | Omental Foramen
62
What is the epiploic foramen
opening to the lesser sac | -provides point of communication between greater and lesser sacs
63
What are the boundaries of the epiploic foramen
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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