Disposition of the Peritoneum

Question 1

In general, what is the peritoneum?

Answer 1

a secretory serous membrane derived from mesenchymal cells of the embyronic mesoderm that secretes a small amount of serous fluid for lubrication between the surfaces of organs that extend into it

Question 2

What does the peritoneum line?

Answer 2

lines the peritoneal cavity, which is the largest serous cavity in the body, located in the abdominopelvic cavity

Question 3

How does the peritoneum differ between men and women?

Answer 3

in men it’s a completely closed cavity. In women it communicates with the exterior via the openings of uterine tubes

Question 4

What are the two continuous layers of the peritoneum?

Answer 4

the parietal peritoneum, (lines walls of abdominal cavity and upper pelvic cavity)

the visceral peritoneum (covers the organs)

Question 5

What are the two main divisions of the peritoneal cavity?

Answer 5

the greater sac and lesser sac

Question 6

Describe the greater sac.

Answer 6

It’s the main compartment
it extends across the entire breadth of the abodmen from the diaphragm to pelvis
Organs that extend into the greater sac are peritoneal or itnraperitoneal

Question 7

What’s another name for the lesser sac?

Answer 7

omental bursa

Question 8

Where is the lesser sac?

Answer 8

it lies behind the stomach, liver, lesser omentum and part of the greater omentum

Question 9

How is the lesser sac formed?

Answer 9

as a result of the rotation of the gut

Question 10

How do the greater and lesser sacs communicate?

Answer 10

via the epiploid (omental) foramen (of Winslow)

Question 11

What is the mesentery?

Answer 11

it’s a two-layered fold of peritoneum that attaches part of the intestines to the posterior abdominal wall and permites the intestines to be mobile

also serves as a conduit for blood vessels and nerves to the attached organ

Question 12

What is the omentum?

Answer 12

It’s a two-layered fold of peritoneum that attaches to the stoamch and other organs

Question 13

What are the two sections of the omentum?

Answer 13

greater omentum (stomach to transverse colon, four layers and potential space)

lesser omentum (stomach and and a small part of the duodenum to the liver)

Question 14

What are the three peritoneal ligaments?

Answer 14

falciform ligament
lienorenal (splenorenal) ligament
triangular ligament

Question 15

What does the falciform ligament attach to the anterior abdominal wall?

Answer 15

the liver

Question 16

What does the lienorenal ligament attach to the posterior wall?

Answer 16

attaches the spleen to the posterior wall at the level of the kidneys

Question 17

What does the traignular ligament attach?

Answer 17

the liver to the inferior diaphragm

Question 18

Mesenteries or ligaments that extend from the ANTERIOR body wall are derived from ______ and those from the posterior body wall are derived from ______

Answer 18

ventral mesentery

dorsal mesentery

Question 19

How do we designate organs that develop adjacent to the body wall outside the peritoneal cavity?

Answer 19

they are retroperitoneal or extraperitoneal

Question 20

The free inferior border of the falciform ligament encloses what?

Answer 20

the ligamentum teres, which is the remnant of the fetal left umbilical vein (extends from the umbilicus to the porta hepatis)

Question 21

As the falciform ligament’s superior attachment to the liver diverges, the right lamina forms what three ligaments which enclose the “bare area” of the liver?

Answer 21

anterior layer of the coronary ligament
right triangular ligament
posterior layer of the coronary ligament

Question 22

As the falciform ligament’s superior attachment to the liver diverges, the left lamina forms what?

Answer 22

the left triangular ligament

Question 23

Again, the lesser omentum forms ligaments between the liver and what two organs?

Answer 23

the stomach and the the first imch of the duodenum

Question 24

What are the names of these two ligaments

Answer 24

hepatoduodenal liagment

hepatogastric ligament

Question 25

The hepatoduodenal ligament encloses the portal triad, which includes what?

Answer 25

common bile duct hepatic artery portal vein

Question 26

What does the hepatogastric ligament enclose?

Answer 26

the right and left gastric arteries

Question 27

Which omentum is a derivative of the dorsal mesentery and which is a derivative of the ventral mesentery?

Answer 27

``` dorsal = greater ventral = lesser ```

Question 28

The greater omentum extends down from the greater curvature of the stomach to coil over the intestines and attach to what part of the colon?

Answer 28

transverse colon

Question 29

What are the three parts of the greater omentum?

Answer 29

gastrocolic gastrosplenic (gastrolienal) gastrophrenic

Question 30

The tastrosplenic ligament extends from the hilus of the spleen to where?

Answer 30

the fundus of the stomach

Question 31

What does the gastrosplenic ligament enclose?

Answer 31

the short gastric vessels

Question 32

THe splenorenal ligament extends from the parietal periteonum over the kidney to where?

Answer 32

the hilus of the spleen

Question 33

What does the splenorenal ligament enclose?

Answer 33

the splenic vessels

Question 34

The transverse mesocolon extends from the posterior abdominal wall to suspend what?

Answer 34

the transver colon

Question 35

What vessels are enclosed in the transverse mesocolon?

Answer 35

the middle colic vessels thy're branches of the superior mesenteric artery

Question 36

The sigmoid mesocolon extends from the posterior abdominal wall to suspend the sigmoid colon (obvi) and encloses what vessels?

Answer 36

sigmoid colon vessels (obvi) they're branches of the inferior mesenteric artery

Question 37

What parts of the small intestine are suspended by The mesentery of small intestine?

Answer 37

the jejunum and ileum

Question 38

What vessels are enclosed by the mesentery of the small intestine?

Answer 38

the intestinal and ileocolic vessels | branches of the superior mesenteric branches

Question 39

What are peritoneal recesses?

Answer 39

they are spaces and channels defined by the peritoneum as it drapes over organs - channels provide a route for pooling or flow of ascites fluids, spread of cancer cells and infection

Question 40

What are the channels that lie lateral to the ascending and descending colon?

Answer 40

right and left paracolic (by the colon) gutters

Question 41

What spaces lie on either side of the root of the mesentery? Which is a closed space?

Answer 41

the right and left infracolic spaces the right is a closed space

Question 42

What is the potential space bounded by the liver, right kidney, duodenum and colon? What does this represent when the indiivdual is supine?

Answer 42

the hepatorenal recess represents the lowest point in the peritoneal cavity when the patient is supine

Question 43

What recesses are bounded by the liver, falciform ligament and anterior abdominal wall?

Answer 43

the subphrenic recess

Question 44

What's important about abscessese that form in the subphrenic recesses?

Answer 44

they may penetrate the diaphragm

Question 45

What does primary retroperitoneal refer to?

Answer 45

organs that develop entirely outside the peritoneum

Question 46

What are the primary retroperitoneal "organs" in the abdomen?

Answer 46

kidneys, suprarenal glands, ureters, urinary bladder, aorta and inferior vena cava, lunbar plexus and branches

Question 47

What does secondary retroperitoneal refer to?

Answer 47

organs that initially develop within the peritoneal cavity but later become retroperiteonal.

Question 48

What are the secondary retroperiteonal organs?

Answer 48

most of the duodenum, ascending colon and descending colon

Question 49

How is the parietal peritoneum innervated?

Answer 49

by somatic afferent fibers from intercostal and subcostal nerves, phrenic nerves and first lumbar nerve (L1)

Question 50

How is the visceral peritoneum innervated?

Answer 50

innervated by visceral afferent fibers running with the autonomic nervous system (sensitive to stretch which leads to sensation of pain) Since it's diffuse, sensation is difficult to localize when visceral

Question 51

Why is particulate matter in the peritoneal cavity moved to the subphrenic spaces rapidly?

Answer 51

there is a continuous intraperitoneal movement of fluid toward the diaphragm where it is absorbed into the lymphatics

Question 52

What does peritonitis result in?

Answer 52

inflammation of the peritoneum results in accumulation of a serous fluid in the area (ascites)

Question 53

What are periteonal coverings capable of doing in areas of infection?

Answer 53

they stick together to essentially "wall off" infections