Module 6 : Peritoneum and Retroperitoneum Flashcards
1
Q
what structure separates the thorax from the abdominal cavity
A
the diaphragm
2
Q
what structure separates the peritoneum from the retroperitoneum
A
peritoneal membrane
3
Q
peritoneal membrane
A
- thin layer of loose connective tissue lines abdominal cavity
- produces a serous fluid
- contains fat, blood vessels, lymphatics and nerves
- creates ligaments and folds
+ anchors organs - allows free movement between organs
+ decreases friction
4
Q
what are the 2 layers of the peritoneum
A
- parietal and visceral
5
Q
what do the 2 layers of the peritoneum create
A
- create a potential space/cavity where fluid can collect
6
Q
creation of peritoneum
A
- during fetal development some organs become enclosed with double folds of peritoneum
- others do not migrate into the cavity but remain with only the anterior surfaces covered
7
Q
intraperitoneal organs
A
- enclosed within the double folds of peritoneum
8
Q
retroperitoneal
A
- remain outside the cavity with only anterior surfaces covered
9
Q
peritoneal folds
A
- mesentery
- mesocolon
- lesser omentum
- greater omentum
10
Q
mesentery
A
- peritoneal folds connecting small bowel to posterior abdominal wall
- large and fan shaped
11
Q
mesocolon
A
- peritoneum attached to colon
- connects transverse colon and sigmoid to posterior abdominal wall
12
Q
lesser omentum
A
- double layer of mesentery
- connects lesser curvature of stomach and 1st part of duodenum to visceral surface of liver
13
Q
greater omentum
A
- apron like fold that connects greater curvature of the stomach and transverse colon
14
Q
ligaments
A
- double folds of peritoneum
- name generally relate to the specific organ they are attached
- convey blood, lymphatic vessels, nerves to organs
15
Q
falciform ligament
A
- travels from the umbilicus to the liver
- passes over the anterior superior liver surface and splits
16
Q
what structure runs through the falciform ligament
A
- ligamentum teres
17
Q
what other ligaments are formed from the splitting of the falciform ligament
A
- triangular and coronary ligament
18
Q
coronary ligaments
A
- parietal peritoneum
- posterior aspect of liver
- DEFINE BARE AREA OF LIVER
19
Q
ligamentum teres
A
- remnant of fetal umbilical vein
- runs in falciform ligament and joins left portal vein at the porta hepatis
20
Q
legamentum venosum
A
- remnant of fetal ductus venosum
- attaches to left portal vein above IVC
21
Q
triangular ligaments
A
- corners of bare area
22
Q
hepatoduodenal ligaments
A
- conducts MPV, CBD, HA
23
Q
hepatogastric ligament
A
- forms lesser omentum with hepatoduodenal
24
Q
other ligaments
A
- gastrocolic
- gstrosplenic
- splenorenal
25
peritoneal spaces
- potential spaces created between the parietal and visceral layers
- CLOSED ACCEPT IN FEMALES (Fallopian tubes)
- in pathological state, fluid and pus can collect in some spaces
26
right sub hepatic space
- MORISONS POUCH
- posterior to right lobe of liver
- anterior to upper pole of right kidney
- MOST DEPENDENT PORTION OF SUBHEPATIC SPACE
27
left sub hepatic space
- anterior and posterior recess
| - lesser sac is part of it
28
subphrenic space
- anterior and posterior sections
29
what structures define the subphenic space
- liver and diaphragm
30
what ligament divides this space into right and left
- falciform ligament
31
lesser sac
- communicates with the greater sac
32
what is an alternate name for lesser sac
- mental bursa
33
what are the terms for the opening of the lesser sac
- epiploic foramen / foramen of of Winslow
| - mental foramen / omental neck
34
what structure lies posterior to opening
IVC
35
what structure lies superior to opening
caudate
36
what structure lies anterior to opening
stomach
37
what retroperitoneal structure lies posterior to lesser sac
pancreas
38
greater sac
- accounts for most of space in peritoneal cavity
- ANTERIOR to LESSER SAC SUPERIORLY
- POSTERIOR to LESSER SAC INFERIORLY
39
what structure divides the greater sac into supramesocolic and inframesocolic compartments
```
- fold of peritoneum
+ TRANSVERSE MESOCOLON
- supramesocolic
+ subphrenic and subhepatic
- inframesocolic
+ paracolic gutter and pelvic reflection
```
40
inframesocolic compartment
- divided into right and left by the root of the mesentery
41
right and left compartments
- divided into medial and lateral areas by
+ the ascending colon (right)
+ the descending colon (left)
42
paracolic gutters - right
- space between the ascending colon and the right lateral abdominal wall
43
paracolic gutters - left
- space between the descending colon and left lateral abdominal wall
44
which portion of the inframesocolic compartment does not communicate with the pelvic cavity directly
right medial compartment
45
which ligament prevents the left lateral gutter from communicating with the left supramesocolic area
phrenocolic ligament
46
sonographic appearance
- parietal peritoneum = thin smooth echogenic line deep to abdominal wall muscle = peritoneal line
- mesentery = seen with ascites, free floating smoot leaves directed toward centre of abdomen
47
the retroperitoneum
- posterior to peritoneum
- anterior to transversals fascia
- diaphragm form superior boundary
- pelvic brim inferior boundary
- 3 compartments/spaces formed by 2 layers of fascia
48
anterior pararenal space - anterior and posterior boundry
- anterior = peritoneum (parietal)
| - posterior = gerotas fascia/ renal fascia
49
anterior pararenal space - major structures
- ascending and descending colon
- duodenum (except for 1st)
- pancreas
50
anterior pararenal space - communication
- potential midline communication
| - communicates with the posterior pararenal space and pelvis
51
perirenal space - borders
- enclosed by renal fascia
52
perirenal space - major structures
- kidneys
- adrenals
- ureters
- great vessels
53
perirenal space - communication
- communicates with pelvic space
| - no communication across midline (great vessels get in the way)
54
posterior pararenal space
- posterior renal fascia to the transversalis fascia
- no solid organs
- contains fat
55
posterior pararenal space - communication
- anterior pararenal
- pelvis
- pro peritoneal space
+ pontential space between peritoneum and transversals fascia
56
retroperitoneum - role of ultrasound
- characterize legions
- assess aortic aneurysms
- provide guidance for interventional procedures
