Find study materials for any course. Check these out:
Browse by school
Make your own
To login with Google, please enable popups
To login with Google, please enable popups
Don’t have an account?
To signup with Google, please enable popups
To signup with Google, please enable popups
Sign up withor
Describe the difference between intraperitoneal, retroperitoneal, secondarily retroperitoneal, and subperitoneal organs
Anatomical location in the peritoneal compartment is differentiated by the presence of abdominal mesenteries. Abdominal organs that are covered completely by visceral peritoneum are deemed intraperitoneal. Organs that are not within the peritoneal cavity but behind it are called retroperitoneal. Organs that developed intraperitoneally, but later due to folding entered the retroperitoneal compartment and are only covered anteriorly by parietal peritoneum are called secondarily retroperitoneal. Finally, organs that are below the intraperitoneal space are called subperitoneal.
The greater omentum is the first, most visible structure in the gut. It drapes inferiorly over the small intestines and is attached via ligaments to the spleen (gastrosplenic lig), diaphragm (gastrophrenic lig), and transverse colon (gastrocolic lig).
The Coronary lig is the connection of the liver to the diaphragm and is single layered (not a mesentery). It covers the “bare area” of the liver (no visceral peritoneum) and is thickened at its lateral extents into triangular ligaments.
The Falciform lig connects the liver to the anterior wall of the abdomen and it supports the umbilical lig (ligamentum teres).
The Mesentery proper is the “true mesentery” of the abdomen and is extensive and anchors all of the small intestine to the posterior abdominal wall. It is highly vascular.
The mesenteries of the large intestine (cecum, ascending colon, descending colon, and rectum are all retroperitoneal) are the transverse mesocolon (splenic flexure anchored to the diaphragm by the phrenicocolic lig), the sigmoid mesocolon, and the mesoappendix.
The Lesser omentum is the thin mesentery that spans between the liver, duodenum, gallbladder, and lesser curvature of the stomach. It has two components: the hepatogastric lig and the hepatoduodenal lig.
What named subserous fascia is located between the peritoneum and overlying musculature.
The peritoneum is a serous membrane composed of two layers – parietal peritoneum and visceral peritoneum.
The peritoneum functions to physically support the abdominal organs as well as to supply them with neurovascular pathways via the abdominal mesenteries. The peritoneum also allows free movement of the bowels for digestion and allows the organs to move over each other without friction.
How does parietal peritoneumdiffer from visceral peritoneum in location, sensitivity?
Parietal peritoneum is served by the same blood and lymphatic vasculature and the same somatic nerve supply as the region of the abdominopelvic wall it lines. It is sensitive to pressure, pain, heat, and cold; pain from the parietal peritoneum is generally well localized.
Visceral peritoneum is served by the same blood and lymphatic vasculature and the same visceral nerve supply as the organs it covers. Insensitive to touch, heat, cold, and laceration and is stimulated primarily by stretching and chemical irritation.
Pain from the visceral peritoneum is poorly localized and is referred to the dermatomes of the spinal ganglia providing the sensory fibers. Pain from the foregut derivatives is usually experienced in the epigastric region; that from the midgut derivatives, in the umbilical region; and that from the hindgut derivatives, in the pubic region.
How many layers of peritoneum are involved in each of the following: mesentery, mesocolon, ligaments, and omentum. State one example of each.
Mesentery: two peritoneal layers, eg. Mesentery proper
Mesocolon: Two peritoneal layers, similar to mesentery, eg. Transverse mesocolon
Ligaments: Two peritoneal layers connecting organs to each other or to the abdominal wall, eg. Falciform ligament
Omentum: Two peritoneal layers connecting stomach and duodenum to adjacent organs in the lesser omentum, four peritoneal layers in the greater omentum, eg. Greater omentum
Define the location of the lesser sac. What is the remaining space within the abdominal cavity referred to as? Do the two sacs communicate? If so through what and specifically where is this communication located?
The lesser sac, aka the omental bursa, is the space posterior to the lesser omentum, and lies posterior to the stomach, lesser omentum, and adjacent structures. The omental bursa permits free movement of the stomach on adjacent structures because the anterior and posterior walls of the omental bursa slide smoothly over each other.
The remaining space in the abdominal cavity is referred to as the greater sac.
The omental bursa communicates with the greater sac through the omental foramen (epiploic foramen), an opening situated posterior to the free edge of the lesser omentum forming the hepatoduodenal ligament.
Name the 5 peritoneal folds extending inferiorly from the umbilicus on the deep surface of the anterior abdominal wall. What does each peritoneal fold contain?
Median umbilical fold extending from the apex of the urinary bladder to the umbilicus, and covers the median umbilical ligament.
Two medial umbilical folds lateral to the median umbilical fold that cover the medial umbilical ligaments, formed by the occluded parts of the umbilical arteries.
Two lateral umbilical folds lateral to the medial umbilical folds that cover the inferior epigastric vessels.
Name the one peritoneal fold that passes superiorly. What is in the free edge of this superior peritoneal fold? What was the structure found in this free edge during embryological development?
The median umbilical fold passes superiorly from the apex of the bladder to the umbilicus.
Within the median umbilical fold, the median umbilical ligament can be found. The median umbilical ligament is a remnant of the urachus that joined the apex of the fetal bladder to the umbilicus.
From what organ does the greater omentum hang? What part of the colon is attached to deep side of the greater omentum? What is the function of the greater omentum?
The greater omentum hangs from the greater curvature of the stomach
It drapes inferiorly over the small intestines and attaches on its deep surface to the transverse colon
The greater omentum functions as an area of fat deposition, immune contribution having spots of macrophage collection, and infection and wound isolation as it attaches to sites of infection or wounds in the small intestine.
The greater omentum, large and fat-laden, prevents the visceral peritoneum from adhering to the parietal peritoneum. It has considerable mobility and moves around the peritoneal cavity with peristaltic movements of the viscera. It often forms adhesions adjacent to an inflamed organ such as the appendix, sometimes walling it off and thereby protecting other viscera from it.
Where does the lesser omentum extend? How many ligaments fuse to form the lesser omentum? Name them.
The lesser omentum connects the lesser curvature of the stomach and the proximal duodenum to the liver.
The lesser omentum contains the hepatogastric ligament between the liver and stomach, and the hepatoduodenal ligament between the liver and duodenum.
What structure can be found in the free edge of the lesser omentum? What is located under the free edge of the lesser omentum?
The hepatoduodenal ligament is found on the free edge of the lesser omentum and conducts the hepatic portal triad (portal vein, hepatic artery, and bile duct).
Anteriorly, the stomach is related to the diaphragm, the left lobe of the liver, and the anterior abdominal wall.
Posteriorly, the stomach is related to the omental bursa and pancreas; the posterior surface of the stomach forms most of the anterior wall of the omental bursa.
Superiorly, the stomach is related to the liver and diaphragm.
Inferiorly, the stomach is related to the transverse colon.
Be able to label the various surface anatomical features of the liver.
What divides the right and left lobes of the liver anatomically when viewed from its anterior aspect?
The liver is divided into right and left lobes via the falciform ligament on its anterior aspect. The falciform ligament ends inferiorly as the round ligament of the liver.
What does the anatomical arrangement between the visceral peritoneum of the liver and the diaphragm form by its reflection?
List the 3 parts of the small intestinal, in order, from proximal to distal. Which of these 3 regions is predominantly retroperitoneal? Which of these 3 regions are mesenterized?
Proximal to distal: duodenum, jejunum, ileum.
The duodenum is predominantly retroperitoneal whereas the jejunum and ileum are predominantly covered by mesentery.
In which direction does the root of the mesentery cross the posterior abdominal wall?
The root of the mesentery is directed obliquely, inferiorly, and to the right.
Where is the subphrenic recess? Why is this area important clinically?
Subphrenic recesses, superior extensions of the peritoneal cavity, are located between the anterior and the superior aspects of the liver and the diaphragm.
The hepatorenal recess is a gravity-dependent part of the peritoneal cavity when a person is in the supine position; fluid draining from the omental bursa flows into this recess. The hepatorenal recess communicates anteriorly with the right subphrenic space.
Where is the subhepatic (hepatorenal) recess, or pouch of Morrison, located?
The subhepatic recess is the space that separates the liver from the right kidney, and is significant in that fluid often collects in this space.
What are paracolic gutters and why are they important clinically?
The paracolic gutters are spaces between the colon and abdominal wall. These gutters are clinically important because they allow a passage for infectious fluids from different compartments of the abdomen.
Sign up for free and study better.
Get started today!