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Questions and Answers
Which of the following structures is NOT formed by a double layer of visceral peritoneum?
What is the path of the two layers of peritoneum that surround the liver?
What is the name of the structure formed by the two layers of peritoneum that surround the stomach?
What is the term for the peritoneum that envelopes most of the abdominal viscera?
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What is the route taken by the lower layer of the transverse mesocolon?
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Which part of the pancreas is surrounded by the transverse mesocolon?
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What is the name of the structure formed by the two layers of peritoneum that surround the stomach at the greater curvature?
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What is the name of the passage that connects the lesser sac to the greater sac?
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What lies behind the stomach in the lesser sac?
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What continues upward as the parietal peritoneum from the upper surface of the urinary bladder?
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What is the boundary formed by the peritoneum on the caudate lobe of the liver, lesser omentum, stomach, and anterior 2 layers of the greater omentum?
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What is the main difference between the peritoneal cavity in men and women?
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What is the primary function of the peritoneal fluid in the peritoneal cavity?
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Which of the following structures connects the greater curvature of the stomach to the transverse colon?
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What is the content of the lesser omentum?
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What is the function of the gastrosplenic ligament?
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What is the blood supply to the parietal peritoneum derived from?
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What is the content of the lienorenal ligament?
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What type of pain is characterized by poor localization of the source of pain?
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What is the normal range of total peritoneal blood flow?
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How many distinct forms of pain exist?
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What is Blumberg's sign indicative of?
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What is the characteristic of visceral pain receptors?
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What is the characteristic of visceral abdominal pain?
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Which of the following is a cause of visceral abdominal pain?
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What is the characteristic of referred abdominal pain?
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What is the term for the type of pain caused by violent contraction of smooth muscles?
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In which stage of acute appendicitis is the pain localized to the right lower quadrant of the anterior abdominal wall?
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What is the reason for referred pain being felt in the midline?
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Study Notes
Peritoneum
- The peritoneum is a membrane formed of two layers: parietal peritoneum (lining the abdominal wall) and visceral peritoneum (enveloping most abdominal viscera).
- Omenta and mesenteries are double layers of visceral peritoneum.
Divisions and Relations
- The peritoneum lining the diaphragm sends two layers to surround the liver, which stop at the porta hepatis.
- The two layers descend as the lesser omentum to surround the stomach.
- At the greater curvature, the two layers descend as the anterior two layers of the greater omentum, which return to form the posterior two layers of the greater omentum.
- The posterior two layers of the greater omentum ascend to surround the transverse colon and then ascend to the anterior border of the pancreas, forming the transverse mesocolon.
Greater and Lesser Sacs
- The peritoneum is divided into the greater sac and the lesser sac.
- The greater sac is behind the anterior abdominal wall and in front of the stomach, continuing below with the pelvic cavity.
- The lesser sac lies behind the stomach, extending upward as far as the diaphragm and downward between the layers of the greater omentum.
- The lesser sac communicates with the greater sac via the epiploic foramen.
Peritoneal Cavity
- The peritoneal cavity is a potential space between the parietal peritoneum lining the abdominal wall and the visceral peritoneum enveloping the abdominal organs.
- The peritoneal cavity contains a serous fluid called peritoneal fluid, which allows motion.
- Normally, about 50-75 ml of fluid is present in the peritoneal cavity.
Omenta
- Omenta are peritoneal folds formed of two layers of visceral peritoneum that connect the stomach to another viscus.
- There are four types of omenta: lesser omentum, greater omentum, gastro-splenic ligament, and lienorenal ligament.
Blood Supply and Innervation
- The parietal peritoneum and the area of the abdominal wall it lines are supplied by the same blood vessels, lymphatics, and somatic nerve supply.
- The visceral peritoneum and the organs it envelops have the same blood vessels, lymphatics, and visceral nerve supply.
- The total peritoneal blood flow ranges from 50-150 ml/min.
Clinical Importance
- The peritoneum is important in abdominal pain, which can be classified into three types: somatic, visceral, and referred.
- Visceral pain is caused by distension of a hollow viscus, stretching of a viscus or mesentery, ischemia to a viscus, or damage to a viscus or its covering visceral peritoneum by chemicals.
- Referred pain is a feeling of pain at a place other than the site of origin of the stimulus, supplied by the same spinal segments.
- Blumberg's sign (rebound tenderness) is indicative of peritonitis.
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Description
Test your knowledge of the peritoneum, its divisions, ligaments, mesenteries, and omenta. This quiz covers the anatomy of the peritoneum, its blood supply and innervation, and its clinical importance, including abdominal paracentesis.
