Podcast
Questions and Answers
Which of the following describes the function of the peritoneum?
Which of the following describes the function of the peritoneum?
- Producing hormones that regulate appetite and metabolism.
- Supporting the viscera and providing pathways for vessels. (correct)
- Secreting digestive enzymes directly into the abdominal cavity.
- Filtering waste products from the blood within the abdominal cavity.
How would you describe the parietal peritoneum?
How would you describe the parietal peritoneum?
- It lines the abdominal cavity (correct)
- It suspends the small intestine from the posterior abdominal wall
- It covers the surface of the liver.
- It adheres directly to the stomach.
What is the primary role of the peritoneal cavity?
What is the primary role of the peritoneal cavity?
- To house the majority of the body's lymphoid tissue
- To store excess glucose as glycogen.
- To secrete a fluid that lubricates the surfaces of the visceral and parietal peritoneum. (correct)
- To directly absorb nutrients from digested food.
What is the clinical significance of the open peritoneal cavity in females?
What is the clinical significance of the open peritoneal cavity in females?
Which structure connects the greater and lesser sacs of the peritoneal cavity?
Which structure connects the greater and lesser sacs of the peritoneal cavity?
Which of the following is a characteristic of the lesser omentum?
Which of the following is a characteristic of the lesser omentum?
What anatomical feature defines the greater omentum?
What anatomical feature defines the greater omentum?
Which structure is located anterior to the omental foramen?
Which structure is located anterior to the omental foramen?
What is the posterior border of the omental foramen?
What is the posterior border of the omental foramen?
Which of the following is considered a supracolic recess of the peritoneal cavity?
Which of the following is considered a supracolic recess of the peritoneal cavity?
What is the primary characteristic of a mesentery?
What is the primary characteristic of a mesentery?
Which ligament is located above the umbilicus within the peritoneal cavity?
Which ligament is located above the umbilicus within the peritoneal cavity?
What is the remnant of the umbilical vein in adults?
What is the remnant of the umbilical vein in adults?
Which fold is located below the umbilicus within the parietal peritoneum?
Which fold is located below the umbilicus within the parietal peritoneum?
What is contained within the hepatoduodenal ligament?
What is contained within the hepatoduodenal ligament?
Which of the following structures is NOT a part of the anterior border of the omental bursa?
Which of the following structures is NOT a part of the anterior border of the omental bursa?
What is the name of the fold that contains the left gastric artery?
What is the name of the fold that contains the left gastric artery?
Which direction does the root of the mesentery run?
Which direction does the root of the mesentery run?
Which of the following is a structure that the root of mesentery crosses?
Which of the following is a structure that the root of mesentery crosses?
The visceral peritoneum is innervated by which nerve?
The visceral peritoneum is innervated by which nerve?
A surgeon needs to access the lesser sac to remove a growth. Which approach is most direct?
A surgeon needs to access the lesser sac to remove a growth. Which approach is most direct?
During surgery, a patient's transverse colon is inadvertently damaged. Which mesentery would be affected?
During surgery, a patient's transverse colon is inadvertently damaged. Which mesentery would be affected?
A patient presents with an infection that has spread within the peritoneal cavity. Which recess is most likely to be the initial site of infection?
A patient presents with an infection that has spread within the peritoneal cavity. Which recess is most likely to be the initial site of infection?
A surgeon ligates the hepatoduodenal ligament during a Whipple procedure (pancreaticoduodenectomy). Which structure listed is least likely to be affected?
A surgeon ligates the hepatoduodenal ligament during a Whipple procedure (pancreaticoduodenectomy). Which structure listed is least likely to be affected?
During an appendectomy, a surgeon identifies a fold that connects the appendix to the ileum. What is this structure?
During an appendectomy, a surgeon identifies a fold that connects the appendix to the ileum. What is this structure?
During a surgical procedure to remove the spleen, which ligament must be carefully divided to separate the spleen from the kidney?
During a surgical procedure to remove the spleen, which ligament must be carefully divided to separate the spleen from the kidney?
A patient has a perforated ulcer on the posterior wall of their stomach. What space is most likely to be contaminated by the gastric contents?
A patient has a perforated ulcer on the posterior wall of their stomach. What space is most likely to be contaminated by the gastric contents?
Surgical exploration of the lesser sac is often required to manage pancreatic pseudocysts. What is the most direct route to access this space?
Surgical exploration of the lesser sac is often required to manage pancreatic pseudocysts. What is the most direct route to access this space?
An ultrasound reveals fluid accumulating in the right subphrenic space. Which organ is directly inferior to this space?
An ultrasound reveals fluid accumulating in the right subphrenic space. Which organ is directly inferior to this space?
During a laparoscopic procedure, a surgeon needs to identify the lateral umbilical fold. Which vessel lies directly beneath this peritoneal fold?
During a laparoscopic procedure, a surgeon needs to identify the lateral umbilical fold. Which vessel lies directly beneath this peritoneal fold?
In a patient with cirrhosis and ascites, paracentesis (fluid drainage) is performed. Which layer must the needle penetrate to enter the peritoneal cavity?
In a patient with cirrhosis and ascites, paracentesis (fluid drainage) is performed. Which layer must the needle penetrate to enter the peritoneal cavity?
During blunt abdominal trauma, which of the following peritoneal structures is most susceptible to injury due to its relatively fixed position?
During blunt abdominal trauma, which of the following peritoneal structures is most susceptible to injury due to its relatively fixed position?
In a patient presenting with pelvic pain, a surgeon suspects pathology involving the broad ligament of the uterus. Which of the following structures is directly associated with this ligament?
In a patient presenting with pelvic pain, a surgeon suspects pathology involving the broad ligament of the uterus. Which of the following structures is directly associated with this ligament?
A CT scan reveals a collection of fluid in the infracolic region. Which of the following anatomical spaces is indicated?
A CT scan reveals a collection of fluid in the infracolic region. Which of the following anatomical spaces is indicated?
Which of the following structures in the lesser omentum might be compressed if the omental foramen becomes significantly narrowed?
Which of the following structures in the lesser omentum might be compressed if the omental foramen becomes significantly narrowed?
A surgeon is about to perform a procedure that requires them to cut the greater omentum. Which ligament of the greater omentum attaches to the stomach?
A surgeon is about to perform a procedure that requires them to cut the greater omentum. Which ligament of the greater omentum attaches to the stomach?
Which peritoneal structure is important in limiting the spread of infection around the cecum?
Which peritoneal structure is important in limiting the spread of infection around the cecum?
Where would fluid accumulate if there was a rupture in the sigmoid colon?
Where would fluid accumulate if there was a rupture in the sigmoid colon?
If a patient has developed Pelvic Peritonitis, which ligament may be affected?
If a patient has developed Pelvic Peritonitis, which ligament may be affected?
A patient has a tumor in his stomach that has spread to the Gastrophrenic ligament, which structures is that connected to?
A patient has a tumor in his stomach that has spread to the Gastrophrenic ligament, which structures is that connected to?
Flashcards
Peritoneum
Peritoneum
Two-layered transparent serous membrane in the abdomen.
Parietal peritoneum
Parietal peritoneum
Lines the abdominal cavity.
Visceral peritoneum
Visceral peritoneum
Invests the abdominal viscera.
Function of the Peritoneum
Function of the Peritoneum
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Peritoneal Cavity
Peritoneal Cavity
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Peritoneal cavity
Peritoneal cavity
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Parietal peritoneum
Parietal peritoneum
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Visceral peritoneum
Visceral peritoneum
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Omentum
Omentum
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Lesser Omentum
Lesser Omentum
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Greater Omentum
Greater Omentum
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Divisions of the Peritoneal cavity
Divisions of the Peritoneal cavity
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Greater Sac
Greater Sac
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Lesser Sac
Lesser Sac
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Males
Males
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Females
Females
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Omentum
Omentum
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Lesser Omentum
Lesser Omentum
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Greater Omentum
Greater Omentum
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Omental foramen (epiploic foramen)
Omental foramen (epiploic foramen)
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Omental foramen (epiploic foramen) superior
Omental foramen (epiploic foramen) superior
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Omental foramen (epiploic foramen) inferior
Omental foramen (epiploic foramen) inferior
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Omental foramen (epiploic foramen) anterior
Omental foramen (epiploic foramen) anterior
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Omental foramen (epiploic foramen) posterior
Omental foramen (epiploic foramen) posterior
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Supracolic recesses
Supracolic recesses
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Infracolic recesses
Infracolic recesses
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Ligament
Ligament
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Mesentery
Mesentery
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Omentum
Omentum
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Peritoneal Cavity
Peritoneal Cavity
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Lesser Omentum-Parts/Ligaments
Lesser Omentum-Parts/Ligaments
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Omental Bursa
Omental Bursa
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Omental Bursa
Omental Bursa
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Associated With
Associated With
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Parietal Nerves
Parietal Nerves
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Visceral Nerves
Visceral Nerves
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Study Notes
- The following topics are covered: Peritoneum, Lesser Omentum, Greater Omentum, and Omental Bursa.
Body Cavities
- The human body contains dorsal & ventral cavities.
- The dorsal cavity includes the cranial and spinal cavities.
- The ventral cavity includes the thoracic and abdominopelvic cavities.
- The abdominal and pelvic cavities make up the abdominopelvic cavity.
Peritoneum
- This is a two-layered, transparent serous membrane.
- The parietal peritoneum lines the abdominal cavity.
- The visceral peritoneum invests the abdominal viscera.
- It supports the viscera and provides pathways for the vessels.
- Between the two layers, there is a peritoneal cavity.
- The cavity contains a small amount of lubricating peritoneal fluid.
Peritoneal Cavity
- There are two major divisions: the greater sac, and the lesser sac.
- They are connected through the epiploic foramen.
- In males, the peritoneal cavity is a closed sac.
- In females that sac is open through the fallopian tubes.
Structures Formed by the Peritoneum
- These include the Omentum, Lesser Omentum & Greater Omentum.
Omentum
- This is a double layer of peritoneum.
- It extends from the stomach as well as the proximal part of the duodenum to the other abdominal organs.
Lesser Omentum
- This starts from the lesser curvature of the stomach.
- It attaches to the distal part of the duodenum and the liver.
Greater Omentum
- This contains four peritoneal layers as it descends.
- It descends from the greater curvature of the stomach and the final part of the duo to the ant surface of the transverse colon.
Omental Foramen (Epiploic Foramen)
- The superior border consists of the caudate lobe of the liver.
- The inferior border consists of the superior part of the duodenum.
- The anterior border consists of the hepatoduodenal ligament, hepatic a, portal v, and common bile duct.
- The posterior border consists of the IVC, which is covered with peritoneum in front.
Peritoneal Cavity Main Recesses
- There are supracolic and infracolic recesses.
Supracolic Recesses
- The supracolic recesses include the R and L subphrenic recesses
- Additional recesses: the R (hepato-renal), as well as the L subhepatic (omental bursa-lesser sac)
Infracolic Recesses
- The infracolic recesses include the right (supramesenteric) and left (inframesenteric).
Definitions
- Ligament: Two folds of peritoneum, supporting structures.
- Mesentery: Two folds of peritoneum, connecting to the posterior abdominal wall.
- Omentum: Connects the stomach to other organs.
Peritoneal Cavity Ligaments Above Umbilicus
- The ligaments include the falciform and the round ligament (v umbilicalis).
- Also contains the coronary, L triangular, R triangular, and hepatorenal ligaments.
- RL (remnant of umbilical v)
Peritoneal Cavity Folds and Fossae by the Parietal Peritoneum Below Umbilicus
- They include the median umbilical fold, which becomes the Urachus.
- They also include the medial umbilical fold, which becomes the Umbilical a.
- They also include the lateral umbilical fold which connects to the Inf epigastric vessels, and also the Transverse vesical fold.
- Several fossae are also present: Supravesical, Medial and Lateral inguinal fossa.
Lesser Omentum - Parts/Ligaments
- The parts comprise the Hepato-gastric and Hepato-duodenal ligaments.
- Hepato-gastric ligaments contain gastric vessels.
- Hepato-duodenal ligaments comprise of the hepatic a, portal v, and common bile duct.
Omental Bursa Exposed (Lesser Omentum Opened)
- It is composed of the Superior and Inferior Recess
- Also composed of the gastropancreatic and splenic recesses.
Greater Omentum Ligaments
- They include the Gastrophrenic, Gastrosplenic (gastrolienal), Gastrocolic, Phrenicocolic, and Splenorenal (lienorenal and phrenicosplenic) ligaments.
Peritoneal Structures - Mesentery
- This is a double-layered visceral peritoneum.
- It contains the Mesentery proper to suspend the ileum.
- It is there to suspend the jejunum to the post abd wall.
- Consist of the Mesoappendix, transverse mesocolon and Sigmoid mesocolon.
- Sigmoid mesocolon: inverted V shaped with apex located in front of the L ureter and division of the CIA.
- Sigmoid aa, vv and Sup rectal a, v are present
Root of Mesentery
- It is 15 cm long.
- It projects from the duodeno-jejunal junction (L2) to the R sacroiliac j.
- It crosses the following structures: Horizontal part of duodenum, Abdominal aorta, IVC, R ureter, R psoas major m, and Testicular OR ovarian vessels.
Pelvic Peritoneum
- Contains Broad lig of the uterus that are the mesosalpinx, mesovarium and mesometrium
- Contains the Suspensory lig of ovary
Peritoneal Cavity - Recesses Around the Duodenum
- The following are present: Inf duodenal (L3), Sup duodenal, Paraduodenal, Retroduodenal, and Mesentericoparietal.
Peritoneal Cavity - Recesses Around the Caecum
- Sup ileo-caecal, Inf ileo-caecal, and Retrocaecal are present.
Peritoneal Cavity - Recesses Around the Sigmoid Colon
- Intersigmoid recess is found here
Omental Bursa - ANT
- Contains Caudate lobe, liver, Lesser omentum, and Stomach.
Omental Bursa - POST
- Contains the Greater omentum, Left suprarenal, Left kidney, Pancreas, Transverse mesocolon, and Transverse colon.
Recesses of the Omental Bursa
- Includes the Sup omental recess, (IVC and esophagus).
- Includes the Inf omental recess (stomach as well as transverse colon).
Folds of the Omental Bursa
- L (sup) gastropancreatic fold -> L gastric a
- R gastropancreatic (hepatopancreatic) fold -> common hepatic a, hepatic a
Nerves of Peritoneum
- Parietal: Spinal nerves T7-12, Ant ramus of L1-3, Phrenic n Pudental n and the Obturator n
- Visceral: The ANS innervates sub-mesothelial tissue of VP
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