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Peritoneum

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Rukiga District
Rukiga District

peritoneum, functions, peritoneal reflections, their anatomy, mesenteries, the omental cake, clinical applications

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PERITONEAL REFLECTIONS Mudoogo Edgar
quick review • Peritoneum- thin serous membrane lines the walls of the abdominal cavity • 2 KINDS – Parietal – Visceral Any functions??? 1. wall off infection & localize it 2. store fat 3. House and protect blood vessels 4. sensitive – Visceral : Stretch – Parietal : Pain, Temperature, touch & pressure
Peritoneum
Dfn:Folding back or bending of the peritoneum The peritoneal reflections include: • omenta, • mesenteries, • Ligaments- • folds and fossae. Many of them contain the blood vessels, lymphatics, and nerves that from the abdominal wall passed to viscera. Peritoneal reflections
• Greater Omentum • Connects the greater curvature of the stomach to transverse colon. • It hangs like an apron in front of the small intestine • It is folded back on itself to be attached to the transverse colon. • Largest peritoneal reflection in the body
Peritoneum
Functions of the Greater Omentum • prevents the visceral peritoneum from adhering to the parietal peritoneum • considerable mobility • forms adhesions adjacent to an inflamed organ such as the appendix • cushions the abdominal organs against injury • forms insulation against loss of body heat
Lesser Omentum • also called small omentum; gastrohepatic omentum • Connects liver to stomach attached above to porta hepatis & fissure for ligamentum venosum inferiorly to lesser curvature of the stomach,& 1st inch of duodenum. • Its free margin contains: • Portal vein: Posterior • Bile duct : Anterior & right • Hapatic artery: anterior &left • Gastrosplenic ligament • Splenicorenal or lienorenal ligament
Mesentery  large, fan-shaped, double-layered fold of peritoneum  connecting viscera to abdominal wall  provides a means for neurovascular communication between the organ and the body wall .  The mesentery (of the small intestine) It is a broad, fan-shaped fold of peritoneum connecting the coils of jejunum and ileum to the posterior abdominal wall.  Mesocolon-mesentery of the colon
Mesentery of the small intestines Arcades of arteries and veins
The radix (root) of mesentery is the portion attached to the posterior wall of the abdomen. Transverse mesocolon Sigmoid mesocolon
Peritoneum
The mesoappendix (mesentery of the appendix)
Mesoappendix-attaches the appendix to the terminal ileum. Contains the appendicular vessels
Peritoneal folds • reflection of peritoneum that is raised from the body wall by underlying blood vessels, ducts, and obliterated fetal vessels. – Median umbilical fold – 2 medial umbilical folds – 2 lateral umbilical folds
Median umbilical fold Lateral umbilical fold Medial umbilical fold Median umbilical lig. Medial umbilical lig. Inferior epigastric a.Lateral umbilical fossa Medial umbilical fossa Supravesical fossa Urinary bladder
In the clinic Two lateral umbilical folds • cover the inferior epigastric vessels and therefore bleed if cut Peritoneal cavity • Has a large s.a for administering drugs and operattions Omentectomy refers to the surgical removal of the omentum, a relatively simple procedure with no major side effects, that is performed in cases where there is concern that there may be spread of cancerous tissue into the omentum.(intestinal. Ovarian and appendix cancer) RESEARCH: affects insulin senstivity
Omental infarction • Necrosis of the greater omentum caused by an acute vascular disorder Omental cake • thickening of the greater omentum secondary to omental peritoneal metastasis due to metastatic deposits
CT SCAN
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Peritoneum

  • 2. quick review • Peritoneum- thin serous membrane lines the walls of the abdominal cavity • 2 KINDS – Parietal – Visceral Any functions??? 1. wall off infection & localize it 2. store fat 3. House and protect blood vessels 4. sensitive – Visceral : Stretch – Parietal : Pain, Temperature, touch & pressure
  • 4. Dfn:Folding back or bending of the peritoneum The peritoneal reflections include: • omenta, • mesenteries, • Ligaments- • folds and fossae. Many of them contain the blood vessels, lymphatics, and nerves that from the abdominal wall passed to viscera. Peritoneal reflections
  • 5. • Greater Omentum • Connects the greater curvature of the stomach to transverse colon. • It hangs like an apron in front of the small intestine • It is folded back on itself to be attached to the transverse colon. • Largest peritoneal reflection in the body
  • 7. Functions of the Greater Omentum • prevents the visceral peritoneum from adhering to the parietal peritoneum • considerable mobility • forms adhesions adjacent to an inflamed organ such as the appendix • cushions the abdominal organs against injury • forms insulation against loss of body heat
  • 8. Lesser Omentum • also called small omentum; gastrohepatic omentum • Connects liver to stomach attached above to porta hepatis & fissure for ligamentum venosum inferiorly to lesser curvature of the stomach,& 1st inch of duodenum. • Its free margin contains: • Portal vein: Posterior • Bile duct : Anterior & right • Hapatic artery: anterior &left • Gastrosplenic ligament • Splenicorenal or lienorenal ligament
  • 9. Mesentery  large, fan-shaped, double-layered fold of peritoneum  connecting viscera to abdominal wall  provides a means for neurovascular communication between the organ and the body wall .  The mesentery (of the small intestine) It is a broad, fan-shaped fold of peritoneum connecting the coils of jejunum and ileum to the posterior abdominal wall.  Mesocolon-mesentery of the colon
  • 10. Mesentery of the small intestines Arcades of arteries and veins
  • 11. The radix (root) of mesentery is the portion attached to the posterior wall of the abdomen. Transverse mesocolon Sigmoid mesocolon
  • 13. The mesoappendix (mesentery of the appendix)
  • 14. Mesoappendix-attaches the appendix to the terminal ileum. Contains the appendicular vessels
  • 15. Peritoneal folds • reflection of peritoneum that is raised from the body wall by underlying blood vessels, ducts, and obliterated fetal vessels. – Median umbilical fold – 2 medial umbilical folds – 2 lateral umbilical folds
  • 16. Median umbilical fold Lateral umbilical fold Medial umbilical fold Median umbilical lig. Medial umbilical lig. Inferior epigastric a.Lateral umbilical fossa Medial umbilical fossa Supravesical fossa Urinary bladder
  • 17. In the clinic Two lateral umbilical folds • cover the inferior epigastric vessels and therefore bleed if cut Peritoneal cavity • Has a large s.a for administering drugs and operattions Omentectomy refers to the surgical removal of the omentum, a relatively simple procedure with no major side effects, that is performed in cases where there is concern that there may be spread of cancerous tissue into the omentum.(intestinal. Ovarian and appendix cancer) RESEARCH: affects insulin senstivity
  • 18. Omental infarction • Necrosis of the greater omentum caused by an acute vascular disorder Omental cake • thickening of the greater omentum secondary to omental peritoneal metastasis due to metastatic deposits

Editor's Notes

  1. The median umbilical fold extends from the apex of the urinary bladder to the umbilicus and covers the median umbilical ligament, the remnant of the urachus, which joined the apex of the fetal bladder to the umbilicus. Two medial umbilical folds, lateral to the median umbilical fold, cover the medial umbilical ligaments, formed by occluded parts of the umbilical arteries. Two lateral umbilical folds, lateral to the medial umbilical folds, cover the inferior epigastric vessels and therefore bleed if cut