Peritoneum Flashcards

1
Q

What is the peritoneum

A

The largest serous sac that lines abdominal wall and
covers the abdominal viscera

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2
Q

Name The peritoneum parts

A

1- Visceral layer
2- parietal layer
3- peritoneal fold
4- peritoneal cavity

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3
Q

What is a peritoneal fold

A

when peritoneum is in contact to other peritoneal layer to form either ligament, omentum or mesentery

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4
Q

Define The peritoneal cavity

A

The potential space between the 2 layers
Not shown except when there is carcinoma

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5
Q

Name 5 functions of peritoneum

A

1- Provides smooth surfaces for viscera to avoid friction
2- Protects against infection as peritoneal fluid contains antibodies
3- Allows rapid healing of abdominal wounds
4- Can localize the spread of infection (policeman of the abdomen)
5- Storage of fat

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6
Q

Why does the peritoneum Allows rapid healing

A

Because its a serous sac, produces high amounts of fibrous tissue

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7
Q

Intraperitoneal Organs examples

A

Stomach
Liver
most of small intestine ( jej n ile)
Cecum
appendix
Transverse colon
sigmoid colon
Gall bladder
spleen

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8
Q

Name all the Primary retroperitoneal organs

A

Aorta, Inferior vena cava, kidneys, Suprarenal glands, urinary bladder, vagina, and rectum

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9
Q

Name all the 2ry retroperitoneal organs

A

duodenum, pancreas, ascending and descending colon

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10
Q

What are the two peritoneal cavities

A
  • greater sac
  • lesser sac
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11
Q

What are the Peritoneal recesses

A

1-Duodenal recesses
2-Caecal recesses
3-Intersigmoid recess or Other recesses

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12
Q

Peritoneal Reflections Develops into?
What are the terms used to describe it

A

into a highly folded, complex structures
1- Mesentery
2- Omentum
3-Peritoneal Ligaments

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13
Q

Greater sac and lesser sac extents

A

Greater sac extends from diaphragm down to the pelvis
Lesser sac; lies behind the stomach

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14
Q

Both peritoneal cavities are interconnected through?

A

Epiploic foramen (also called the foramen of
Winslow)

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15
Q

Greater Sac is divided by transverse colon & its mesentery into

A

Supracolic compartment
Infracolic compartment

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16
Q

Where does the Supracolic compartment lies

A

lies above the transverse mesocolon and contains stomach, liver and spleen

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17
Q

Where does the Infracolic compartment lies?

A

lies below the transverse mesocolon and contains the small intestine, ascending and descending colon

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18
Q

The infracolic compartment is Subdivided into

A

into left and right infracolic spaces by the mesentery of the small intestine

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19
Q

Define the Paracolic gutters

A

grooves or spaces between the abdominal wall and the lateral aspect of the ascending and descending colon

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20
Q

What are the advantages of the paracolic gutters

A

-These spaces allows communication between supra and infra colic regions of the greater sac

-It is important for peritoneal fluid flow

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21
Q

Where does the Lesser sac lies in?

A

It is the peritoneal sac that lies behind the stomach and lesser omentum

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22
Q

Other name of the Lesser sac

A

Omental Bursa

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23
Q

The omental bursa is communicated with the greater sac through an opening in the omental bursa called

A

the epiploic foramen (foramen of Winslow)

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24
Q

Anterior border of the epiploic foramen

A

Anterior border : free edge of the lesser
omentum containing the portal tirade:
a- common bile duct
b-portal vein
c-hepatic artery

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25
Q

Posterior border of the epiploic foramen

A

a- inferior vena cava
b- right crus of diaphragm

26
Q

Superior border of the epiploic foramen

A

cuadate lobe of the liver

27
Q

Inferior border of the epiploic foramen

A

first part of the duodenum

28
Q

Define recesses

A

The peritoneum wraps around the viscera, they
form several fossae or spaces within the peritoneal cavity

29
Q

These recesses are potential sites for?

A

internal herniation of the abdomino-pelvic viscera

30
Q

What are the clinigal significance of the recesses?

A

because a length of the intestine may enter and be constricted causing hernia

31
Q

Duodenal recesses site and parts

A

around the fourth part of duodenum
A-Superior duodenal recess
B- Inferior duodenal recess
C-Retroduodenal recess
D- Paraduodenal recess

32
Q

Caecal recesses site and parts

A

are spaces formed by the peritoneum around the caecum
Three caecal recesses are present:
• Superior ileocaecal recess
• Inferior ileocaecal recess
• Retrocaecal recess

33
Q

Following acute appendicitis, which reccess are common site of abscess formation

A

paracaecal recesses are common sites for abscess formation

34
Q

Name the other recesses and their sites

A

a- Sub phrenic below the diaphragm
b- Sub hepatic below the liver
c - Hepatorenal between the inferior surface of the liver and right kidney

35
Q

Mention the 3 Types of peritoneal folds

A

• Omenta.
• Mesenteries
• Ligaments

36
Q

The peritoneal ligaments, omenta, and mesenteries function (Generally)

A

permit blood, lymph vessels, and nerves to
reach the viscera

37
Q

Define the omenta

A

Two layered fold of peritoneum connecting the stomach and proximal part of the duodenum to other abdominal organs

38
Q

What’s the Lesser omentum attachment

A

It attaches from the lesser curvature of the stomach and the proximal part of the duodenum to the liver

39
Q

The lesser omentum ascends as a?

A

Ascends as a double fold to the porta hepatis of liver, and fissure for ligamentum venosum

40
Q

What are the Contents between the two layers of the
lesser omentum

A

• Close to the right free margin are the: hepatic
artery, common bile duct, portal vein, lymphatics,
and hepatic plexus of nerves
• At the attachement to the stomach, run the
right and left gastric vessels

41
Q

Define the Greater omentum

A

The largest peritoneal fold, with cribriform appearance, contains some adipose tissue

42
Q

The greater omentum is consisted of

A

a double sheet of peritoneum, folded on itself so that it is made up of four layers (anterior 2 layers
+ posterior 2 layers).

43
Q

The two layers which descend from the greater curve pass ……… ?

A

downward in front of the small intestines, then
turn upon themselves, and ascend to the transverse colon, where they separate and enclose it

44
Q

Greater omentum contents

A

the anastomosis between the right and left gastroepiploic

45
Q

Mesentery structure and attachments

A

Mesentery is double layer of visceral peritoneum
It connects an intraperitoneal organ to the posterior abdominal wall

46
Q

Mesentry provides what?

A

provides a pathway for nerves, blood vessels and lymphatics to travel from the body wall to the viscera

47
Q

Examples of mesentry

A

o Mesentery of small intestine
o transverse mesocolon
o sigmoid mesocolons
o the mesoappendix

48
Q

The root mesentery of the small intestine is known to be? (Length and width wise)

A

The root is narrow, about 15 cm long, 20 cm in width

49
Q

The root of the mesentery of the small intestine is directed obliquely from, to?

A

directed obliquely from the duodenojejunal flexure at the left side of the second lumbar vertebra to the right sacroiliac joint

50
Q

Define ligaments

A

It is a double fold of peritoneum that connects viscera together or connects viscera to the abdominal wall and diaphragm

51
Q

Name 6 examples of ligaments

A

• Hepatogastric ligament, a portion of the lesser
omentum, which connects the liver to the stomach
• Falciform ligament ,connecting the liver to the anterior abdominal wall
• Coronary and triangular ligaments connecting the liver to the diaphragm
• Gastro phrenic ligament connecting the stomach to
the diaphragm
• Gastro splenic ligament connecting the stomach to
the spleen
• Lienorenal ligament connecting the spleen to the left kidne

52
Q

Which kind of peritoneum is sensitive to
pain, temperature, touch, and pressure

A

parietal peritoneum

53
Q

The parietal peritoneum is supplied by?

A

lower six thoracic (lower 6 intercostal ) and first lumbar nerves

54
Q

The visceral peritoneum is supplied by?

A

Autonomic nerves that supply the viscera or traveling in the mesenteries

55
Q

The visceral peritoneum is only sensitive only to?

A

Stretch and tearing

56
Q

The central part of the diaphragmatic peritoneum (parietal. P) is supplied by?

A

the phrenic nerves

57
Q

Peritoneal Pain (as in Peritonitis) symptoms from the Parietal Peritoneum?

A

Abdominal pain originating from the parietal peritoneum is therefore of the somatic type
It is usually severe, and can be accurately localized

58
Q

Peritoneal Pain (as in Peritonitis) causes and symptoms from the visceral Peritoneum?

A

Including the mesenteries, is innervated by autonomic nerves.
It is due to Stretch caused by over distension of a viscus and pulling on a mesentery That gives rise to the sensation of pain leading to abdominal pain; poorly localized, poorly characterized pain. (dull, unclear, cramping )]

59
Q

The peritoneum is a semi permeable membrane which allows? Used in patients with?

A
  • allows transfer of substances (glucose solution) across itself to remove the waste products.
  • It has been used of in patients with acute renal insufficiency
60
Q

Ascites is

A

an abnormal accumulation of fluid,more than 25 ml of fluid in the peritoneal cavity of the abdomen

61
Q

Ascites symptoms

A

The symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath.