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Peritoneum
Tough layer of elastic areolar tissue
Lined with simple squamous
epithelium
Largest of the serous sacs of the body
Has 2 layers- the parietal and visceral
Layers separated from each other by a
thin film of fluid
General features
The peritoneum is a thin
serous membrane that line
the walls of the abdominal &
pelvic cavities & cover the
organs within these cavities
Parietal peritoneum
lines the walls of the
abdominal & pelvic cavities
General features
Visceral peritoneum
covers the organs
Peritoneal cavity the
potential space between the
parietal and visceral layer of
peritoneum, , is a closed
sac, but in , there is a
communication with the
exterior through the uterine
tubes, the uterus, and the
vagina
Function
Secretes a lubricating
serous fluid that
continuously moistens
the associated organs
Absorb
Support viscera
Hepatorenal Pouch &
Rectouterine Pouch
? Superficial
view of
? the
abdominal
? organs
The peritoneum
vIs a thin serous membrane,
?Lining the wall of the
abdominal and pelvic cavities,
(the parietal peritoneum).
?Covering the existing organs,
(the visceral peritoneum).
?The potential space between
the two layers is the peritoneal
cavity.
Parietal
Visceral
The peritoneum
vThe peritoneal cavity is the
largest one in the body.
vDivisions of the peritoneal
cavity :
?Greater sac; extends from
Lesser Sac
diaphragm down to the pelvis.
?Lesser sac; lies behind the
stomach.
?Both cavities are interconnected
through the epiploic foramen.
?In male : the peritoneum is a
closed sac .
?In female : the sac is not
completely closed because it
Greater Sac
communicates with the exterior
through the uterine tubes, uterus
and vagina.
The peritoneum
qIntraperitonial and
Intraperitoneal viscera
retroperitonial; describe the
relationship between various
organs and their peritoneal
covering;
?Intraperitonial structure; which is
nearly totally covered by visceral
peritoneum.
?Retroperitonial structure; lies
behind the peritoneum, and
partially covered by visceral
peritoneum.
Retroperitoneal viscera
Intraperitoneal organ :
Is surrounded by the peritoneum and has a
supporting mesentery : stomach & 1st part of
duodenum, liver, gall bladder, spleen,
jejunum, ileum, transverse colon, sigmoid
colon, uterus, and ovaries.
Extraperitoneal or
retroperitoneal organ :
Structure that lies behind the peritoneum or
An organ, which is only partially covered by
the peritoneum and has no supporting
mesentery.
Primarily retroperitoneal organs
develop and remain outside the peritoneal
cavity: kidneys, suprarenal glands, aorta,
inferior vena cava, urinary bladder,
prostate, vagina, and rectum.
Secondarily retroperitoneal organs
develop in mesenteries, but get pushed
against the body wall (parietal peritoneum)
during growth so that only half of their
surface or less is covered by peritoneum :
pancreas, duodenum, ascending and
descending colon.
Folds of the peritoneum
qTypes of peritoneal folds
:
Omenta.
Mesenteries.
Ligaments.
Omenta
Lesser omentum
vTwo layered fold of peritoneum
connecting the stomach to another
viscus.
? The lesser omentum attaches the
lesser curvature of the stomach to
the liver.
? The greater omentum connects
the greater curvature of the
stomach to the transverse colon.
Greater omentum
Lesser
q Extends between the liver and the lesser
omentum
curvature of the stomach.
It is continuous with the two layers of
peritoneum which cover the anterior &
posterior surfaces of stomach and 1st part of
the duodenum.
Ascend as a double fold to the porta hepatis of
liver, and fissure for ligamentum venosum.
To the left of porta hepatis it is carried to the
diaphragm.
Its right border is a free margin; constitutes the
anterior boundary of the epiploic foramen.
qContents between the two layers of
the lesser omentum :
Close to the right free margin, are the hepatic
artery, the common bile duct, the portal vein,
lymphatics, and the hepatic plexus of nerves.
At the attachement to the stomach, run the
right and left gastric vessels.
Greater omentum
Greater omentum
The largest peritoneal fold, with cribriform
Greater omentum appearance, contains some adipose tissue.
It consists of a double sheet of peritoneum,
folded on itself so that it is made up of four
layers (anterior 2 layers + posterior 2 layers).
The two layers which descend from the
greater curve of the stomach and
commencement of the duodenum, pass
downward in front of the small intestines,
then turn upon themselves, and ascend to the
transverse colon, where they separate and
enclose it.
The left border of the greater omentum is
continuous with the gastrosplenic ligament.
Its right border extends as far as the
commencement of the duodenum.
Contents : the anastomosis between the
right and left gastroepiploic vessels.
Omental bursa,
(Lesser Sac)
qIt is a part of the peritonial cavity
behind the stomach.
qBoundaries of the omental bursa ;
?Anterior wall, from above downward,
by the caudate lobe of the liver, the lesser
Lesser Sac
omentum, back of the stomach, and the
anterior two layers of the greater
omentum.
?Posterior wall, from below upward, by
the posterior two layers of the greater
omentum, the transverse colon, and the
ascending layer of the transverse
mesocolon, the upper surface of the
pancreas, the left suprarenal gland, and
the upper end of the left kidney.
Epiploic foramen It is the communication between
the greater and lesser sacs .
It is bounded by;
In front by the free border of the
lesser omentum, with its contents :
hepatic artery, common bile duct,
and portal vein between its two
layers.
Behind by the peritoneum
covering the inferior vena cava.
Above (roof) by the peritoneum on
the caudate process of the liver.
Below (floor) by the peritoneum
covering the commencement of the
duodenum and the hepatic artery,
before ascending between the two
layers of the lesser omentum.
Mesenteries or mesocolons
two-layered fold of
peritoneum that attach part
of the intestines to the
posterior abdominal wall
Mesentery
suspends the small
intestine from the
posterior abdominal wall
Broad and a fan-shaped
Consists of two peritoneal
layers
Intestinal borderfolded,
7 m long
Radix of mesentery
15 cm long
Directed obliquely from
left side of L2 to in front
of right sacroiliac joint
Structure crossed by the root of mesentry
Mesoappendix
Triangular mesentery
extends from terminal
part of ileum to appendix
Appendicular artery runs
in free margin of the
mesoappendix
Transverse mesocolon
a double fold of
peritoneum which connects
the transverse colon to the
posterior abdominal wall
Sigmoid mesocolon a trianguar
fold of peritoneum.
inverted V-shaped, with apex located in
front of left ureter and division of common
iliac artery
Ligaments
two-layered folds of
peritoneum that attached the
lesser mobile solid visera to
the abdominal wall
Ligaments of liver
Falciform ligament of liver
Consists of double peritoneal
layer
Extends from anterior
abdominal wall (umbilicus)
to liver
Free border of ligament site
of ligamentum teres
Coronary ligament
the area between upper
& lower parts of the
coronary ligament is the
bare area of liver, this area
is devoid of peritoneum
and lies in contact with the
diaphragm
Left and right triangular
ligament
formed by right extremity
of coronary ligament and
left leaf of falciform
ligament, respectively
Hepatogastric ligament
Hepatoduodenal
ligament
Ligamentum teres
hepatis
Ligaments of spleen
Gastrosplenic ligament a double layer of peritoneum that
connects the fundus of stomach to hilum of spleen. In this
double layer of peritoneum are the short gastric and left
gastroepiploic vessels
Splenorenal ligament extends between the hilum of spleen
and anterior aspect of left kidney. The splenic vessels lies within
this ligament, as well as the tail of pancreas
Phrenicosplenic ligament
Splenocolic ligament
Ligaments of stomach
Hepatogastric ligament
Gastrosplenic ligament
Gastrophrenic ligament
Gastrocolic ligament
Folds and recesses of posterior abdominal
wal
Superior duodenal
fold and recess
Inferior duodenal
fold and recess
Intersigmoid recess
formed by the
inverted V attachment
of sigmoid mesocolon
Retrocecal recess
in which the
appendix frequenty lies
Hepatorenal recess
lies between the
right lobe of liver, right
kidney, and right colic
flexure, and is the
lowest parts of the
peritoneal cavity when
the subject is supine
Folds and fossas of anterior abdominal wal
Median umbilical fold
contain the remnant of
urachus (median umbilical
ligaments)
Medial umbilical fold
contains remnants of the
umbilical arteries (medial
umbilical ligaments)
Lateral umbilical fold
contains the inferior
epigastric vessels
Pouches
In malerectovesical
pouch
In female
Rectouterine pouch
between rectum and
uterus
Vesicouterine pouch
between bladder and
uterus
Peritoneal subdivisions
The transverse colon and transverse
mesocolon divides the greater sac
into supracolic and infracolic
compartments.
Supracolic
compartments
(subphrenic space)lies between
diaphragm and transverse colon
and transverse mesocolon
Suprahepatic recess lies
between the diaphragm and liver
the falciform ligament divides it
into right and left suprahepatic
recesses
Left suprahepatic
recesses
left anterior
suprahepatic spaces
left posterior
suprahepatic spaces
Right suprahepatic
recesses
right anterior
suprahepatic spaces
right posterior
suprahepatic spaces
bare area of live
(extraperitoneal space)
Infrahepatic recess
lies between the liver and
transverse colon &
transverse mesocolonthe
ligamentum teres hepatic
divides it into right and left
infrahepatic recesses
Right infrahepatic
recesses
(hepatorenal recess)
Left infrahepatic recesses
left anterior infrahepatic
space
left posterior infrahepatic
space
Infracolic
compartments
lies below the transverse
colon and transverse
mesocolon
Right paracolic sulcus
(gutter) lies lateral to the
ascending colon. It
communicates with the
hepatorenal recess and the
pelvic cavity. It provides a
route for the spread of
infection between the pelvic
& the upper abdominal
region.
Infracolic
compartments
Left paracolic sulcus
(gutter)
lies lateral to the
descending colon. It is
separated from the area
around the spleen by the
phrenicocolic ligament, a
fold of peritoneum that
passes from the colic
flexure to the diaphragm.
Right mesenteric sinus
triangular space, lies between
root of mesentery, ascending
colon, right 2/3 of transverse colon
and transverse mesocolon
Left mesenteric sinus
lies between root of mesentery,
descending colon, right 1/3 of
transverse colon and transverse
mesocolon, its widens below where
it is continuous with the cavity of
the pelvis
Applied Anatomy
Peritoneum & surgical procedures
Peritonitis & Ascites
Abdominal paracentesis
Intraperitoneal injection
peritoneal dialysis
This post was last modified on 05 April 2022