Peritoneal anatomy Flashcards

1
Q

What is the peritoneum?

A

A continuous membrane which lines the abdominal cavity and covers the abdominal organs.

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2
Q

What does the peritoneum provide?

A

Pathways for blood vessels and lymph to travel to and from the viscera.

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3
Q

Which 2 layers form the peritoneum?

A

The partietal and visceral peritoneum.

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4
Q

What cells are the peritoneal and visceral peritoneum made up of?

A

Simple squamous epithelial cells (mesothelium)

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5
Q

What does the parietal peritoneum line?

A

Internal surface of the abdominopelvic wall.

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6
Q

Where is the parietal peritoneum derived from?

A

Somatic mesoderm.

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7
Q

Why is pain from the parietal peritoneum well localised?

A

As it receives the same nerve supply as the region of the abdominal wall that it lines.

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8
Q

What is parietal peritoneum sensitive to?

A

Pressure
Pain
Lacertion
Temperature

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9
Q

What does the visceral peritoneum cover?

A

The abdominal viscera

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10
Q

Where is the visceral peritoneum derived from?

A

Splanchnic mesoderm

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11
Q

What is the nerve supply to the visercal peritoneum?

A

The same as the viscera is covers

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12
Q

What is the visceral peritoneum sensitive to?

A

Stretch
Chemical irritation

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13
Q

Where is pain from the visceral peritoneum referred to?

A

Areas of the skin that are supplied by the same sensory ganglia and spinal cord segments as the viscera.

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14
Q

What is the peritoneal cavity?

A

A potential space between the parietal and visceral peritoneum.

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15
Q

What are intraperitoneal organs?

A

Organs enveloped by visceral peritoneum which covers the organ Botha anteriorly and posteriorly.

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16
Q

Name 3 intraperitoneal organs.

A

Stomach
Liver
Spleen

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17
Q

What are retroperitoneal organs?

A

Organs that are not associated with the visceral peritoneum - only covered with parietal peritoneum.

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18
Q

What are the 2 groups of retroperitoneal organs?

A

Primarily
Secondarily

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19
Q

What are primarily retroperitoneal organs?

A

Organs that develop and remain outside of the parietal peritoneum.

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20
Q

Name 3 primarily retroperitoneal organs.

A

Oesophagus
Rectum
Kidneys

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21
Q

What are secondarily retroperitoneal organs?

A

Organs which were initially intraperitoneal but became retroperitoneal as their mesentery fused with the posterior abdominal wall.

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22
Q

Name a secondarily retroperitoneal organ.

A

Ascending and descending colon.

23
Q

Name the retroperitoneal organs.

A

Suprarenal (adrenal) glands
Aorta/ IVC
Duodenum (except proximal 2cm)
Pancreas (except tail)
Ureters
Colon (ascending and descending)
Kidneys
Oesophagus
Rectum

**SADPUCKER

24
Q

What is a mesentery?

A

A double layer of visceral peritoneum that connects and intraperitoneal organ to the posterior abdominal wall.

25
Q

What is omentum?

A

Consists of omenta sheets which extend from the stomach and proximal duodenum to connect them to other abdominal organs.

26
Q

How many layers of visceral peritoneum does the greater momentum consist of?

A

4

27
Q

Where does the greater omentum span between?

A

Greater curvature of the stomach > proximal part of the duodenum > anterior surface of transverse colon.

28
Q

What is the role of the greater omentum in immunity?

A

It can migrate to infected viscera or to a site of surgical disturbance and wrap itself around the inflammation to ‘wall it off’ and protect other viscera.

29
Q

What volume of lubricating fluid is secreted into the peritoneal cavity per day?

A

50ml

30
Q

What can the peritoneal cavity be divided into?

A

Greater and lesser peritoneal sacs.

31
Q

What is the greater peritoneal sac subdivided by?

A

Mesentery of the transverse colon.

32
Q

What is the greater peritoneal sac divided into?

A

The supracolic and infra colic compartments.

33
Q

Where does the supra colic compartment lie?

A

Above the transverse mesocolon.

34
Q

Where does the infracolic compartment lie?

A

Below the transverse mesocolon.

35
Q

What divides the infra colic compartment?

A

The mesentery of the small intestine.

36
Q

What is the infra colic compartment divided into?

A

Right and left infra colic spaces.

37
Q

What 3 things are contained within the supracolic compartment?

A

Stomach
Liver
Spleen

38
Q

What 3 things are contained within the infra colic compartment?

A

Small intestine
Ascending colon
Descending colon

39
Q

Where is the supracolic compartment positioned?

A

Largely under the costal ligaments of the thoracic cage.

40
Q

What do the mesenteries do?

A

Enclose the intestines and attach them to the posterior abdominal wall.

41
Q

What are the 4 mesenteries?

A

Small intestine
Transverse mesocolon
Sigmoid mesocolon
Mesoappendix

42
Q

What is the small intestinal mesentery attached to?

A

Jejunum and ileum, connecting them to posterior abdominal wall

43
Q

Where is the root of the small internal mesentery attached to?

A

the duodenal jejunal junction (to the left of L2 vertebra).

44
Q

Where does the small intestinal mesentery attach to inferiorly?

A

Ileocaecal junction, close to right SI joint

45
Q

What are found in the region of the root of the small intestine mesentery?

A

Pacinian corpuscles (encapsulated mechanoreceptors)

46
Q

What is the response of stimulated encapsulated mechanoreceptors?

A

Produce a drop in BP = reflex contraction of the abdominal wall

47
Q

What does the sigmoid mesocolon do?

A

Attaches sigmoid colin to the pelvic wall.

48
Q

Where is the top of the sigmoid mesocolon attached to?

A

Near the bifurcation of the left common iliac artery.

49
Q

Where does the left limb of the sigmoid mesocolon descend to?

A

Descends medially to the medial border of the left psoas major muscle.

50
Q

Where does the right limb of the sigmoid mesocolon descend to?

A

Into the pelvis and attaches anteriorly to the S3 vertebra

51
Q

What does the greater omentum prevent?

A

The visceral peritoneum from adhering to the parietal peritoneum

52
Q

What white cells can the omentum supply to fight infection?

A

Leucocytes

53
Q

What stimulates the encapsulated mechanoreceptors of the small intestine mesentery?

A

Traction and tension on the peritoneal folds in the upper abdomen