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Abdomin And Superficial Structures > Peritoneum and Retroperitoneum > Flashcards

Peritoneum and Retroperitoneum Flashcards

1
Q

What structure separates the peritoneum from the retroperitoneum?

A

Peritoneal membrane

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2
Q

Describe the peritoneum

A

Thin layer of loose connective tissue which lines the abdominal cavity

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3
Q

What does the peritoneum produce?

A

Serous fluid

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4
Q

What does the peritoneum contain?

A

Fat (provides padding and support), blood vessels, lymphatics and nerves

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5
Q

Why does the peritoneum create ligaments and folds?

A

To anchor the organs

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6
Q

How does the peritoneum allow for free movement b/w the organs?

A

Serous fluid

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7
Q

What are the 2 layers of the peritoneum?

A

Parietal and Visceral

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8
Q

What does the parietal and visceral cavity create?

A

Potential space/cavity

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9
Q

What happens to the peritoneal membrane as structures move into the abdominal cavity from the posterior abdominal wall?

A

Moves anterior

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10
Q

What are the organs that become enclosed with double folds of peritoneum called?

A

Intraperitoneal organs

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11
Q

What are the organs that only have their anterior surfaces covered with peritoneal membrane called?

A

Retroperitoneum organs

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12
Q

Define mesentery

A

Peritoneal folds connecting the small and large bowel to the posterior abdominal wall

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13
Q

How is the mesentery shaped?

A

Large and fan shaped

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14
Q

Define mesocolon

A

Peritoneum attached to the colon

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15
Q

What does the mesocolon connect?

A

Connects the transverse colon and sigmoid to the posterior abdominal wall

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16
Q

Define lesser omentum

A

Double layer of mesentery

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17
Q

What does the lesser omentum connect?

A

Connects the lesser curve of the stomach and the 1st part of the duodenum to the visceral surface of the liver

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18
Q

Define greater omentum

A

Apron like fold

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19
Q

What does the greater omentum connect?

A

Connects the greater curvature of the stomach to the transverse colon

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20
Q

What is a ligament?

A

Double fold of peritoneum that connects one organ to another

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21
Q

How are ligaments named?

A

Names based on the organs they are attached to

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22
Q

What runs within a ligament?

A

Blood, lymphatic vessels and nerves to organs

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23
Q

Where is the falciform ligament located?

A

Passes over the anterior superior surface of the liver and splits

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24
Q

Where does the falciform ligament travel?

A

From the umbilicus to the liver

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25
Q

What structure runs through the falciform ligament?

A

Ligamentum teres

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26
Q

What other ligaments are formed by the splitting of the falciform ligament?

A
  1. Triangular ligament

2. Coronary ligament

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27
Q

What makes the coronary ligaments?

A

Made of parietal peritoneum

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28
Q

Where are the coronary ligaments located?

A

On the posterior aspect of the liver

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29
Q

What do the coronary ligaments define?

A

“Bare area” on the liver

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30
Q

What makes up the ligamentum teres?

A

Remanent of the fetal umbilical cord

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31
Q

Where does the ligamentum teres travel?

A

Runs in the falciform ligament and joins the LPV at the port hepatis

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32
Q

What is the ligamentum venosum?

A

Remnant of the fetal ductus venosum

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33
Q

What does the ligamentum venosum attach to?

A

Attaches to the LPV above the IVC

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34
Q

What are the triangular ligaments?

A

“Corner” of the bare area

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35
Q

What do the hepatoduodenal ligament conduct?

A

Conducts the MPV, CBD and HA

36
Q

What are other ligaments that run within the peritoneal cavity?

A

Hepatogastric
Gastrocolic
Gastrosplenic
Splenorenal (lienorenal)

37
Q

Is the peritoneal sac a closed sac?

A

Not in females (due to fallopian tubes)

38
Q

What is another name for the right sub hepatic space?

A

Morison’s pouch

39
Q

What structures is the morison’s pouch posterior to?

A

Right lobe of the liver and GB

40
Q

What structures is the morison’s pouch anterior to?

A

Upper pole of the right kidney

41
Q

What is the morison’s pouch posteriorly bound by?

A

The upper pole of the right kidney and diaphragm

42
Q

What does the right boundary of the morison’s pouch consist of?

A

Right lobe of the liver and diaphragm

43
Q

What lies interiorly to the morison’s pouch?

A

2nd part of the duodenum

44
Q

What is to the left of the morison’s pouch

A

Epiploic foramen of Windslow

45
Q

What is the most dependent portion of the subhepatic space?

A

Morison’s pouch

46
Q

Is the lesser sac part of the right or left subhepatic space?

A

Left subhepatic space

47
Q

What is contained within the left subhepatic space?

A

Anterior and posterior recesses

48
Q

Describe the subphrenic space

A

Anterior and posterior portions

49
Q

What does the posterior right subphrenic space communicate with?

A

Right subhepatic space

50
Q

What structure defines the subphrenic space?

A

Liver and diaphragm

51
Q

What ligament divides the subphrenic space into right and left?

A

Falciform ligament

52
Q

Does the lesser sac communicate with the greater sac?

A

Yes

53
Q

What is the alternate name for the lesser sac?

A

Omental bursa

54
Q

What are the 3 terms for the opening of the lesser sac?

A
  1. Epiploic foramen
  2. Foramen of Winslow
  3. Omental foramen/neck
55
Q

What structure lies posterior to the opening of the lesser sac?

A

IVC

56
Q

What structure lies superior to the opening of the lesser sac?

A

Caudate lobe

57
Q

What structure lies directly anterior to the lesser sac?

A

Stomach

58
Q

What retroperitoneal structure lies directly posterior to the lesser sac?

A

Pancreas

59
Q

Which sac accounts for the most space in the peritoneal cavity?

A

Greater sac

60
Q

What is the relation of the greater sac to the lesser sac?

A

Anterior to the lesser sac superiorly

Posterior to the lesser sac inferiorly

61
Q

What structure divides the greater sac to into supramesocolic and inframesocolic compartments?

A

Transverse mesocolon

62
Q

What structure are included in the Supramesocolon space?

A

Subphrenic and subhepatic spaces

63
Q

What structures are included in the Inframesocolic space?

A

Paracolic gutters and pelvic reflections

64
Q

What structure divides the inframesocolic into right and left compartments?

A

Root of mesentery

65
Q

The right and left inframesocolic compartments are further divided into medial and lateral compartments by what structures?

A

The ascending colon (right)

The descending colon (left)

66
Q

What is the right paracolic gutter?

A

Space b/w the ascending colon and the right lateral abdomen wall

67
Q

What is the left paracolic gutter?

A

Space b/w the descending colon and the left lateral abdomen wall

68
Q

Which portion of the inframesocolic compartment does not communicate with the pelvic cavity directly?

A

Right medial compartment because the root of the mesentery blocks any fluid

69
Q

Which ligament prevents the left lateral gutter from communicating with the left supramesocolic area?

A

Phrenocolic ligament

70
Q

What is the appearance of the parietal peritoneum?

A

Thin smooth echogenic line deep to the abdominal wall muscles- peritoneal line

71
Q

What is the scanning technique used for the peritoneum and retroperitoneum?

A
  • Should fast overnight to reduce bowel gas
  • 3.5 to 5 MHz probe
  • Pt scanned in supine
  • Apply graded compression
72
Q

When is the mesentery viewed on US?

A

When there is ascitis in the abdomen- appears as a free floating smooth leaves directed towards the centre of the abdomen

73
Q

The retroperitoneum is posterior to what structure?

A

Peritoneum

74
Q

The retroperitoneum is anterior to what structure?

A

Transversalis fascia

75
Q

What forms the inferior boundary of the retroperitoneum?

A

Pelvic brim (pelvic diaphragm)

76
Q

How many compartments/spaces make up the retroperitoneum?

A

3

77
Q

How many layers of fascia is the retroperitoneum made of?

A

2

78
Q

What structures define the boundary of the anterior pararenal space?

A

Anterior- gerotas fascia

Posterior- peritoneum

79
Q

What are the major structures within the anterior pararenal space?

A

Ascending and descending colon, duodenum (besides the first part) and the pancreas

80
Q

Does the anterior pararenal space potentially communicate with the posterior pararenal space and pelvis?

A

Yes - potential midline communication

81
Q

What structures enclose the perirenal space?

A

Renal fascia or gerotas fascia

82
Q

What are the major structures within the perirenal space?

A

Kidneys, adrenals, ureters and great vessels

83
Q

Does the perirenal space communicate with the pelvic area?

A

No- no communication across midline due to the great vessels blocking flow

84
Q

Describe the posterior pararenal space

A
  • Extends from the posterior renal fascia anteriorly to the transversalis fascia
  • No solid organs
  • Contains fat
85
Q

What are the 3 spaces that communicate with the posterior pararenal space?

A
  1. Anterior pararenal space
  2. Pelvis
  3. Peritoneal space- potential space b/w peritoneum and transversalis fascia
86
Q

What is the role of US when examining the peritoneum and retroperitoneum?

A
  • Characterize lesions
  • Assess aortic aneurysms
  • Provide guidance for interventional procedures

Abdomin And Superficial Structures (12 decks)

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