The Peritoneal Cavity

Question 1

What is the peritoneal cavity?

Answer 1

Potential space between the parietal and visceral peritoneum containing a thin film of peritoneal fluid

Question 2

What is ascites?

Answer 2

Accumulation of excess fluid in the peritoneal cavity

Question 3

What can the peritoneal cavity be divided into?

Answer 3

Greater and lesser sacs

Question 4

What can the greater sac be subdivided into?

Answer 4

Supracolic compartment (above the transverse mesocolon) and infracolic compartment (below the transverse mesocolon)

Question 5

What organs are contained within the supracolic compartment?

Answer 5

Stomach
Liver
Spleen

Question 6

What organs are contained within the infracolic compartment?

Answer 6

Small intestine

Ascending and descending colon

Question 7

Where are the paracolic gutters found?

Answer 7

Between the posterolateral abdominal wall and the lateral aspect of the ascending/ descending colon

Question 8

Where are the subphrenic recesses found?

Answer 8

Potential spaces in the supracolic compartment.
Between the diaphragm and the liver.
Falciform ligament of liver divides recess into left and right.

Question 9

What is the clinical relevance of the subphrenic recesses?

Answer 9

Subphrenic abscesses (accumulation of pus in subphrenic recess)

Often caused by appendicitis or ruptured duodenal ulcers as pus can track to the subphrenic recesses via the right paracolic gutter

Question 10

Where is the lesser sac?

Answer 10

Posterior to the stomach and lesser omentum

Question 11

What is the function of the lesser sac?

Answer 11

Allows stomach to move freely against the structures posterior and inferior to it

Question 12

What is an alternative name for the lesser sac?

Answer 12

Omental Bursa

Question 13

What is the epiploic foramen?

Answer 13

Passage between the greater and lesser sac (situated posterior to the free edge of the lesser omentum - hepatoduodenal ligament)

Question 14

What is peritonitis?

Answer 14

Inflammation of the peritoneum

Question 15

What are the clinical features of peritonitis?

Answer 15

Pain/ tenderness of skin 
Guarding 
Fever
Nausea/ vomiting 
Constipation

Question 16

What is the peritoneum?

Answer 16

Continuous membrane lining abdominal cavity and covering the abdominal organs.
Two layers: parietal and visceral

Question 17

Where does the parietal peritoneum derive from embryologically?

Answer 17

Somatic mesoderm

Question 18

What is the parietal peritoneum sensitive to?

Answer 18

Pressure
Pain
Laceration
Temperature

Question 19

Where does the visceral peritoneum derive from emryologically?

Answer 19

Splanchnic mesoderm

Question 20

How is pain in the peritoneum localised?

Answer 20

Parietal - well localised

Visceral - poorly localised

Question 21

What nerve innervation does the parietal peritoneum receive?

Answer 21

Same somatic supply as the region of the abdominal wall it covers

Question 22

What nerve innervation does the visceral peritoneum receive?

Answer 22

Same autonomic supply as the viscera it covers

Question 23

What is visceral peritoneum sensitive to?

Answer 23

Stretch

Chemical irritation

Question 24

What are intraperitoneal organs?

Answer 24

Organs enveloped in visceral peritoneum (e.g. stomach, liver, spleen)

Question 25

What are retroperitoneal organs?

Answer 25

Those not covered by visceral peritoneum (only parietal) Suprarenal glands Aorta Duodenum ``` Pancreas Ureters Colon (ascending + descending) Kidneys Esophagus Rectum ```

Question 26

What is the difference between primary and secondary retroperitoneal organs?

Answer 26

Primary - those that developed and remained outside the visceral peritoneum Secondary - those that developed initially as intraperitoneal but became retroperitoneal as their mesentery fused with the posterior abdominal wall

Question 27

What organs are primary retroperitoneal?

Answer 27

Oesophagus Kidneys Rectum

Question 28

What is a mesentery?

Answer 28

Double layer of visceral peritoneum connecting intraperitoneal organs to the posterior abdominal wall

Question 29

What is the function of the mesentery?

Answer 29

Provides a pathway for nerves, blood vessels and lymphatics to travel from the body wall to the viscera

Question 30

What is an omentum?

Answer 30

Sheets of visceral peritoneum extending from the stomach and the proximal part of the duodenum to other abdominal organs.

Question 31

What is the greater omentum?

Answer 31

Four layers of visceral peritoneum descending from the greater curvature of the stomach and proximal part of the duodenum before folding back and attaching to the anterior surface of the transverse colon

Question 32

What is the function of the greater omentum?

Answer 32

Immunity - able to migrate to infected viscera or site of surgical disturbance

Question 33

What is the lesser omentum?

Answer 33

Double layer of visceral peritoneum descending from the lesser curvature of the stomach and the proximal part of the duodenum to the liver

Question 34

What is the hepatogastric ligament?

Answer 34

Flat, broad sheet of the lesser omentum

Question 35

What is the hepatoduodenal ligament?

Answer 35

Free edge of the lesser omentum containing the portal triad

Question 36

What is a peritoneal ligament?

Answer 36

Double fold of peritoneum connecting viscera together or connecting viscera to the abdominal wall