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Peritoneum

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Title: Peritoneum


1
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  • Peritoneum

2
Objectives
  • Define Peritoneum.
  • Enumerate its functions.
  • Explain the general organization of the
    peritoneum.
  • Distinguish between Intraperitoneal and
    Retroperitoneal Structures.
  • Describe Peritoneal Ligaments.
  • Define lesser and greater omenta.
  • Understand the location of epiploic foramen.
  • Discuss mesentery and mesocolon.
  • Explain the Peritoneal sacs.

3
Peritoneum
  • Is a double-layer serous membrane.
  • 1.Parietal layer
  • lines abdomino pelvic wall folds
  • back on itself forming a double
  • Membrane mesentery
  • Functions of mesentery-
  • (1)Provides support
  • Intestines Mesentery Mesocolon.
  • Stomach Omenta.
  • Liver Falciform ligament.
  • (2) Prevents intestinal twisting
  • (3) Stores fat
  • (4) Pathway for vessels nerves
  • 2. Visceral Layer
  • covers the organs.
  • Peritoneal cavity
  • Potential space containing a bit of
  • serous fluid.

4
The Peritoneum
The parietal peritoneum
The visceral peritoneum
The peritoneal cavity
5
The visceral peritoneum
The peritoneal cavity
6
Peritoneum in sagittal section
7
Peritoneum in transverse section
8
Peritoneal versus Retroperitoneal (transverse
section)
  • Most of the internal organs are surrounded by
    visceral peritoneum INTRAPERITONEAL Structures.
  • Some organs (e.g. kidneys) are between peritoneum
    on one surface, and the body wall on the other
    RETROPERITONEAL Structures.

9
Peritoneal versus Retroperitoneal (sagittal
section)
10
The retroperitoneal Structures
kidneys
suprarenal glands
ureters
duodenum
pancreas
aorta
inferior vena cava
nerves
ascending colon
descending colon
11
Peritoneal ligaments, Omenta Mesenteries
  • Peritoneal ligaments
  • Two layers fold of peritoneum that connect solid
    viscera to the abdominal walls, e.g. Falciform
    ligament, Triangular ligaments Coronary
    ligaments of the liver.
  • Omenta
  • Two layers fold of peritoneum that connect the
    stomach to another viscus, e.g. greater lesser
    omenta.
  • Mesenteries
  • Two layers fold of peritoneum connecting parts
    of the intestine to the posterior abdominal wall,
    e.g. mesentery of small intestine, transverse
    mesocolon, sigmoid mesocolon.

12
Peritoneal folds related to the stomach
  • The greater omentum
  • Lies between the Stomach and the anterior
    abdominal wall.

13
Peritoneal folds related to the stomach
  • The lesser omentum
  • Passes from the lesser curvature of the
    stomach and first part of the duodenum to the
    inferior surface of the liver.

14
Greater omentum
15
Peritoneal folds related to the stomach and Kidney
  • The gastrosplenic (gastrolienal) ligament
  • Passes from the greater
  • curvature of the stomach
  • to the spleen.
  • Splenorenal (lienorenal) ligament
  • Connects the spleen to the posterior
    abdominal wall over the left kidney.

16
Peritoneal folds related to the Stomach
  • The gastrophrenic ligament
  • Connects the superior part of the greater
    curvature
  • of the stomach to the diaphragm.

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18
Peritoneal folds related to the Liver
  • The Falciform ligament Passes from the parietal
    peritoneum on the anterior abdominal wall to the
    visceral peritoneum on the surface of the liver.
  • The round ligament of the liver (ligamentum teres
    hepatis)
  • Is the obliterated umbilical vein and it is found
    in the inferior free margin of the Falciform
    ligament.

19
Peritoneal folds related to the Liver
  • Coronary ligament
  • Attaches the liver to the diaphragm. Two
    peritoneal ligaments are parts of the coronary
    ligament
  • 1. Left triangular ligament
  • Is between the left lobe of
  • the liver and the diaphragm.
  • 2. Right triangular ligament
  • Is between the right lobe of
  • the liver and the diaphragm.

20
Mesentery of the small intestine
  • The mesentery suspends the jejunum and ileum from
    the posterior abdominal wall.

21
  • Mesoappendix Attaches the appendix to the
    posterior abdominal wall and it contains the
    appendicular artery.

22
Peritoneal folds ligaments of colon
  • Transverse mesocolon Attaches the transverse
    colon to the posterior abdominal wall.
  • Phrenicocolic ligament Attaches the left
    colic flexure to the diaphragm.
  • Sigmoid mesocolon Suspends the sigmoid colon
    from the posterior abdominal wall.

23
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24
Peritoneal sacs
  • Peritoneal structures all are found within a
    subdivision of the peritoneal cavity called the
    greater peritoneal sac. Posterior to the stomach
    and lesser omentum is a smaller subdivision of
    the peritoneal cavity called the lesser
    peritoneal sac (omental bursa).
  • The omental foramen (epiploic foramen, foramen of
    Winslow) connects the greater and lesser
    peritoneal sacs.

25
The Omental foramen
  • Boundaries
  • Anterior Hepatic portal vein, hepatic artery
    and bile duct contained within the lesser
    omentum.
  • Posterior Inferior vena cava right crus of
    the diaphragm covered with parietal peritoneum.
  • Superior Caudate lobe of the liver covered
    with visceral peritoneum.
  • Inferior First part of the duodenum covered with
    visceral peritoneum.

26
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28
2. Lesser and Greater Omenta
29
Lesser and Greater Omenta
hepatogastric ligament
Lesser Omentum
hepatoduodenal ligament
the epiploic foramen (of Winslow)
30
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31
Greater Omentum
32
3. The mesenteries
33
The mesenteries
Contents ?
mesentery of the small intestine
transverse mesocolon
sigmoid mesocolon
34
Lesser Sac
35
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36
Lt. anterior subphrenic space
Rt. anterior subphrenic space
Rt. posterior subphrenic (Rt. Subhepatic)
37
left subhepatic Space (Lt. posterior subphrenic)
Morisons pouch
38
Nerve supply to the peritoneum
The parietal peritoneum
phrenic nerve
intercostal
first lumbar nerves
obturator nerve
The visceral peritoneum
autonomic
39
Thank you
39
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