PERITONEAL CAVITY

Question 1

Forms from 90 clockwise rotation of stomach during embryonic development

Boundaries:

• anterior: liver, stomach, lesser omentum
• posterior: diaphragm
• R side: liver
• L side: gastrosplenic & splenorenal ligaments

Answer 1

Lesser peritoneal sac (omental bursa)

Question 2

Connection between lesser & greater sac

Anterior boundary: portal vein

Posterior boundary: IVC

Answer 2

Omental (Winslow foramen)

Question 3

Extends from diaphragm to pelvis

Paracolic gutters

• along ascending & defending colon
• normally, fluid flows upward to the subphrenic recess to enter the lymphatics associated witht en diaphragm
• excess peritoneal fluid (peritonitis, ascites) flows downward to the rectovesical pouch (males) or rectouterine pouch (females) when sitting/standing
• excess peritoneal fluid flows upward to subphrenic & hepatorenal recess when supine

Hepatorenal recess
- lowest part of peritoneal cavity when supine

Shoulder pain (referred pain)
- irritation of phrenic nerve C3,C4, and C5

Answer 3

Greater peritoneal sac

Question 4

From Porta hepatis of liver to lesser curvature of stomach

Consists of:

1. Hepatogastric ligament
2. Hepatoduodenal ligament - contains the portal triad: portal vein (posterior), CBD (anterior, to the right), hepatic artery (anterior, to the left)

Answer 4

Lesser omentum

Question 5

Hangs down from greater curvature “abdominal policeman”

Answer 5

Greater omentum

Question 6

Intraperitoneal

Answer 6

Stomach

Part 1, duodenum

Jejunum

Ileum

Cecum

Appendix

Transverse colon

Sigmoid colon

Liver

Gallbladder

Tail of pancreas

Spleen

Question 7

Retroperitoneal

Answer 7

Part 2, 3, and 4 duodenum

Ascending colon

Descending colon

Rectum

Head, neck & body of pancreas

Kidneys

Ureters

Adrenal glands

Abdominal aorta

Inferior vena cava

Question 8

Subdivision of peritoneal cavity

Answer 8

GREATER SAC - main and larger part of the peritoneal cavity; EXTENDS FROM DIAPHRAGM TO THE PELVIS

LESSER SAC/OMENTAL BURSA - smaller part; ILIES POSTERIOR TO THE STOMACH AND LESSER OMENTUM. Permits free movement of the stomach on adjacent structures.

Question 9

BOUNDARIES OF FORAMEN OF WINSLOW

Answer 9

Anterior: HEPATODUODENAL LIGAMENT, PORTAL VEIN, HEPATIC ARTERY, BILE DUCT

Posterior: IVC

Superior: CAUDATE LOBE LIVER

Inferior: SUPERIOR PART OF DUODENUM

Question 10

Potential space between visceral & parietal peritoneum

Divided into lesser & greater peritoneal sac

Contains a thin layer of peritoneal fluid thay keeps the surfaces moist

Lubricates enabling the viscera to move over each other without friction

NO ORGANS in the peritoneal cavity

Within the abdominal cavity and continues into the pelvic cavity

COMPLETELY CLOSED in males

In females - there is a communication pathway to the exterior of the body through the UTERINE TUBES, UTERINE CAVITY AND VAGINA

Answer 10

Peritoneal cavity