Peritoneam Flashcards

1
Q

Def ?

A
  • closed sac in the abdomen formed by serous memberane in which organs invaginate in forming inner visceral layer that is mesothelial layer secreting serous fluid and outer parietal fibrous layer
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2
Q

Intraperitoneal organs ?

A

Almost completely covered
• stomach
• 1st , last inch of duodenum
• jejunum
• ileum
• cecam
• appendix
• transverse colon
• sigmoid colon
• spleen
• ovary

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3
Q

Retroperitoneal organs

A

Anteriorly , lateraly covered by peritoneam only

• majority of duodenum
• kidney
• suprarenal gland
• ureter
• pancreas

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4
Q

Peritoneal folds
( def , function )

A
  • double layers of visceral peritoneam that connects organs with each other or with abdominal walls
  • fixation of organs
  • storage of fat
  • passage for blood vessels , nerves and lymphatics
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5
Q

Talk about lesser omentum

A

(3)

• extends from lesser curvature , 1 st inch of 1 st part of duodenum to porta hepatis, ligamentum venosum
• two parts
Hepatogastric ligament ( left border )
Hepatoduodenal ligament ( right free border )
• contents
On lesser curvature: lt , rt gastric vessels on it
In the free margin ( VAD)
• common bile duct
• hepatic artery
• portal vein

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6
Q

Talk about greater omentum

A

(8)

1- extends from greater curvature to transverse colon
2- it hangs like an apron infront of small intestine
3- it is wrapped backwards onitself
4- so it is formed of 4 layers ( 2 anterior - 2 posterior ).
5- the 2 posterior layers ascend and enclose the transverse colon to form mesocolon later
6- the 4 layers are firmly adherent together into 2 layers in adults
7- function
- protection : has numerous fixed macrophages
- storage of fat
- migration and limition : limit any spread of infection as itigrate to such a site of infection and wrap itself around it preventing spread so it is referred to as policeman of peritonal cavity

8- contents
- lt, rt gastroepiploic vessels
- lympatics
- fat

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7
Q

Talk about transverse mesocolon

A

(2)
- double layers of peritoneam that enclose transverse colon and attaches it to posterior abdominal wall through anterior border of pancreas

  • contents : middle colic vessels - fat
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8
Q

Talk about sigmoid mesocolon

A

(2)

  • double layers of peritoneam that encloses sigmoid colon and connects it to pelvic wall
  • v inverted shape with the apex towards biforcation of cca and left ureter
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9
Q

Talk about mesoappendix

A

(2)

  • triangler mesentry from the terminal part of ileum to appendix
  • the free margin of it runs in it the appendicular artery
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10
Q

Talk about mesentry of small intestine
(6)

A

1- peritoneam suspending the small intestine from the posterior abdominal wall
2- fan shape and broad mesentry
3- 2 borders
- free border ( intestinal )
- root of mesentry ( attached )
4- intestinal border
• frilled
• 20 feet ( 6 m)
• seperates to enclose jejunum, ileum

5- root of mesentry
• 15 cm
• directed obliquely from the left side of l2 to right sacroiliac joint

6- contents
• jejunum
• ileum
• superior mesentric vessels in root
• jejunal and ileul branches
• autonomic nerves
• fat
• lymphatics
• loose aeroler tissue

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11
Q

Name ligaments of liver

A

Name it ياختي

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12
Q

Talk about ligaments of spleen

A

(3)

  • gastrosplenic ligament : extends from stomach to hileum of spleen
  • lienorenal or splenorenal : extends from hilum of spleen to left kidney ,

contents of lieno : splenic vessels , tail of pancreas

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13
Q

Talk aboit ligaments of stomach

A

(4)

  • hepatogastric
  • gastrosplenic
  • gastrocolic ( upper part of greater omentum that attaches stomach to transverse colon )
  • gastrophrenic ( attaches upper part of greater cuvature to diaphragm)
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14
Q

Blood supply , innervation, lymphatics
Of parietal , visceral

A

Parietal
Blood supply , lympatics similar to body wall

Innervation similar to body wall
- lower 6 thoracic nerves
- iliohypogastric
- ilioguinal
- phrenic nerve
So it sensitve to pain& temperature

Visceral
Blood supply , lymphatics similar to viscera

Innervation similar to viscera

Autonomic nerves related to viscera
So it is sensitive to stretch only

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15
Q

Talk about peritoneal cavity

A

(6)

1- potential space between visceral, parietal layers
2- completely closed in men
3- not closed in women as it communicates with exterior by uterine tubes , uterus and vagina
4- so PID is most likely to happen in women
5- it seperated into greater , lesser sac
6- communicates together by epiploic foramen ( foramen for winslaw ) ( omental foramen)

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16
Q

Talk about lesser sac
Boundries - other name - position )

A

• anterior : 4
Caudate lobe
Lesser omentum
Stomach
2 anterior layers of greater omentum

• posterior :4
2 posterior laters if greater omentum
Transverse colon
Transverse mesocolon
Peritoneam covering stomach bed

• roof
Peritoneum lining diaghram

• floor
Fusion of 4 layers of greater omentum

• right
Right border of greater omentum
Epiploic foramen

• left
Left border of greater omentum
Hilum of spleen with 2 ligaments of it

Other name : omental bursa

Position : behind lesser omentum , stomach

17
Q

Boundries of epiploic foramen

A

Anterior
Free margin of lesser omentum with its contents
( vad )

Posterior
IVC

Superior
Liver

Inferior
1st inch of 1st part of duodenum

18
Q

Talk about greater sac
( parts - position )

A

1- divided by transverse colon , mesocolon into supracolic compartments
Infracolic compartments

2- supracolic compartments are divided by falciform ligament and liver into
1- rt subphrenic space
2- lt subphrenic space
3- rt subhepatic space ( morison pouch ) ( hepatorenal pouch as it lies between rt lobe and rt kidney )
4- lt subhepatic space

3- infracolic compartments are divided by root of mesentry into rt , lt infracolic recesses

4- position : deep to aaw , below diaphragm, above pelvic vicera

19
Q

Talk about morison pouch

A

1- the most dependent part of peritoneum in supine position
2- the most common part for subphrenic abcesses after peptic upcer or perforation if appendix
3- most common for ascites

20
Q

Talk about paracolic gutter

A

Peritoneal depressions alongside the ascending, descending colon that communicates freely with rt , lt recesses

21
Q

Applied anatomy of peritoneam

A

1- ascites : abnormal colloection of fluid inside peritoneal cavity
2- it is recoverd from by paracentesis but not by one time as it can cause hypotension, hypovolic shock
3- peritonitis

22
Q

Function of peritoneam

A

1- protection of organs and mantain their positions by suspending them with ligaments
2- lubrication of surfaces of organs to prevent friction by serous fluid
3- greater omentum is the policman of peritoneum
4- provide passages for blood vessels , nerves and lymphatics
5- storage of fat eg greater omentum