58. Peritoneum - parietal and visceral, peritoneal cavity, omental bursa

Root of transverse mesocolon divides the peritoneal cavity into?

* Supramesocolic part - organs contained are supplied by coelic a. * Inframesocolic part - organs contained are supplied by superior and inferior mesenteric aa

Peritoneal connections of the liver

1) Falciform ligament of the liver - a peritoneal fold which extends from umbilicus to the liver and contains fibrous cord 2) Round ligament of liver - runs on the inferior surface of the liver (remnant of umbilical vein) 3) Coronary ligaments - continuation of falciform ligament on the diaphragmatic surface of the liver splitting into right and left which attached the liver to the diaphragm

Contents of the hepatoduodenal ligament

1) Portal vein - posteriorly 2) (Proper) hepatic artery - anteriorly on left 3) Bile duct - anteriorly on right

In the lesser pelvis of male the parietal peritoneum covers?

1) Upper part of urinary bladder 2) Upper part of seminal vesicles

In the lesser pelvis of female the parietal peritoneum of the anterior abdominal wall covers?

1) Upper part of urinary bladder 2) Upper part of uterus 3) Uppermost and posterior part of vagina

In female the peritoneum in lesser pelvis forms what?

1) Vesicouterine pouch between urinary bladder and uterus 2) Rectouterine pouch between uterus and rectum

What is peritoneal cavity?

A narrow space among the organs contained in the abdominal and pelvic cavities divided into: 1) Lesser sac - omental bursa: a narrow cavity behind the stomach and lesser omentum and below the liver 2) Greater sac - the rest of the peritoneal cavity

What is peritoneum and its function?

A serous membrane which covers the walls of the abdominal and pelvic cavities called the parietal peritoneum and the organs called visceral peritoneum. Free surface of the peritoneum is lubricated by small amount of serous fluid allowing the gliding movement of the viscera to the abdominal wall and upon each other.

Root of mesentery crosses

Abdominal aorta, inferior vena cava and right ureter

The contents of mesentery

Arteries: jejunal, ileal and ileocolic arteries of superior mesenteric a. of abdominal aorta Veins: superior mesenteric vein Nerve: superior mesenteric nervous plexus ( vagus and splanchnic nerves) Lymphatics: lymph nodes of the mesentery and ileocolic nodes

Root of transverse mesocolon crosses

Descending part of duodenum and pancreas

Th root of mesentery extends from/to?

Duodenojejunal junction to ileocecal junction

Name the subperitoneal organs

Empty urinary bladder In male: prostate and urethra In female: urethra and vagina

The lesser sac - omental bursa extends from/to?

From - epiploic foramen = foramen of Winslow on right To - hilum of spleen on left

Who is the policeman of the abdomen?

Greater omentum

How do we divide the organs compare to the peritoneum?

Intraperitoneal organs - abdominal organs which are completely surrounded by peritoneum and are connected to the abdominal or pelvic walls by peritoneal duplication (carrying blood vessels) Retroperitoneal organs - attached to abdominal or pelvic walls and partly covered with peritoneum. These organs are placed in front of the posterior abdominal or pelvic wall Preperitoneal organs - placed between the anterior abdominal wall and pelvic walls and the parietal peritoneum Subperitoneal organs - placed in lesser pelvis below parietal peritoneum

The parietal peritoneum of posterior abdominal wall

Is interrupted by attachment of some parts of digestive tube: 1) Root of mesentery 2) Root of transverse mesocolon 3) Root of sigmoid mesocolon

Root of sigmoid mesocolon crosses

Left iliac vessels, left gonadal vessels, left ureter

Which vessels lies between the layers of transverse mesocolon?

Middle colic arteries and veins, nerves and lymphatics supplying the transverse colon

The nerve supply of the peritoneum

Parietal: somatic nerves Visceral: visceral afferents

What is the lowest part of the peritoneal cavity in female?

Rectouterine pouch

What is the lowest part of the peritoneal cavity in male?

Rectovesical pouch

In male the peritoneum in lesser pelvis forms what?

Rectovesical pouch between urinary bladder and rectum

Contents of the hepatogastric ligament

Right and left gastric arteries

Contents of greater omentum

Right and left gastroomental vessels

Name the retroperitoneal organs

S - suprarenal glands A - abdominal aorta D - duodenum P - pancreas U - ureters C - colons (ascending + descending) K - kidneys E - esophagus R - rectum

The sigmoid mesocolon contains which vessels?

Sigmoid and superior rectal vessels, along with the nerves and lymphatics associated with sigmoid colon

The parietal peritoneum of anterior abdominal wall is folded by what?

Some embryonic remnants between the umbilicus and pubic bone: 1) Middle umbilical fold - caused by middle umbilical ligament arising from apex of urinary bladder (remnant of urachus) 2) Medial umbilical fold - is elevated by medial umbilical ligament (remnant of umbilical artery) 3) Lateral umbilical fold - elevated by inferior epigastric vessels 4) Lesser omentum - extends from the lesser curvature of stomach and 1st part of duodenum to porta hepatis on the inferior surface of the liver and is divided into several ligaments: * Hepatoduodenal ligament (lateral part) * Hepatogastric ligament (medial part) * Hepatoesophageal ligament 5) Greater omentum - descends in front of the intestines and separates them from the anterior abdominal wall. It arises from the greater curvature of the stomach. Its thicker upper part is composed of: * Gastrocolic ligament It is often referred to as the "POLICEMAN OF THE ABDOMEN" for its ability to migrate to any inflamed area and enclose around the organ to limit the spread of intraperitoneal infections

The epiploic foramen borders?

Superiorly: liver Inferiorly: duodenum Anteriorly: Hepatoduodenal lig. Posteriorly: Inferior vena cava

Borders of lesser sac - omental bursa

Superiorly: liver, diaphragm Anteriorly: lesser omentum, stomach, gastrocolic lig. (of greater omentum) Inferiorly: transverse colon and mesocolon Posteriorly: pancreas, duodenum, left kidney, left supraren

Name the intraperitoneal organs

T - transverse colon U - uterus S - sigmoid colon S - stomach I - ileum L - liver U - uterine tubes (ovaries) S - spleen J - jejunum E - abdominal part of esophagus C - caecum

Name the preperitoneal organs

Urinary bladder when full