Peritoneum and

Peritoneal Cavity
Dr. Aldwin A. Yaneza
Dept of Anatomy
 Terminology
Greek
 Liver – hepar ex. hepatitis
 Stomach – gaster ex gastric ulcer
 Spleen - splen ex splenic artery
 Diaphragm – phren ex phrenic nerve
 Kidney – renes ex renal vein
 Terminology
 1. Peritoneum
 2. Mesentery
 3. Omentum
 4. Peritoneal ligament
 5. Peritoneal folds
 6. Peritoneal recess
 7. Omental bursa
 1. PERITONEUM
 Thin transparent serous
membrane
 2 layers
1. Parietal - lining of abd.
wall
2. Visceral – covers the
viscera
 Peritoneal fluid –
separates parietal &
visceral periton.
 Lubricates peritoneal
surfaces, enables
viscera to move on
each other without
friction
Parietal

Visceral
 2. MESENTERY
 Double layer of peritoneum w/c encloses an organ and
connects it to abdominal wall
 Contains fat, lymph nodes, BV, nerves going to viscus
 Named after viscus it attaches
 Stomach – mesogastrium
 Transverse colon – transverse mesocolon
 Sigmoid colon – mesosigmoid
 Appendix – mesoappendix
 Most mobile parts of intestine
 Transverse colon, small intestine
 None in retroperitoneal viscus
 Ascending colon , kidney, parts of duodenum
Transverse mesocolon

mesosigmoid
 3. OMENTUM
 Double layered sheet or
fold of peritoneum
 Attach the stomach to the
body wall or to other
abdominal organs
 2 forms
 Greater omentum

 Lesser omentum
 3a. Greater Omentum [ plt 252]
 Fatty fold of peritoneum
 Hangs fr stomach
 Connects stomach w/
diaphragm, spleen and
transverse colon
 Thin as paper in thin
persons
 Thick and fat laden in
obese persons
 Long enough to cover
whole abdomen [apron]
 3b. Lesser Omentum
 Plate 258
 Connects lesser curve of
stomach and proximal
duodenum to liver
 2 portions
 1.Hepatogastric ligament
- Connects liver to stomach
 2. Hepatoduodenal
- Connects liver to duodenum
 4. Peritoneal Ligament [plt 255]
 Double layer of peritoneum that
connects an organ with another
organ or with abdominal wall
 May contain BV or remnants of
BV
 Examples:
 Splenocolic ligament- att
spleen to colon
 Gastrosplenic ligament-
att stomach to spleen
 5. Peritoneal folds
 Reflection of peritoneum
w/ sharp borders
 Often formed by
peritoneum that covers
blood vessels, ducts, and
obliterated BV
 Ex. Umbilical folds
 6. Peritoneal Recesses [plt 264]
 Peritoneum folds to form a
blind pouches [cul de sacs]
or tubular cavities that are
closed at one end with an
opening into the peritoneal
cavity
Ex.
 Retrocecal recess –
posterior to cecum
 Ileocecal recess – anterior
to cecum
 Subdivisions
 Upon lifting the greater
omentum
 Divides peritoneal cavity
into 2 compartments
1. Supracolic
2. Infracolic
 Supracolic compartment
 Divided into smaller
spaces by falciform lig
1. Subphrenic recess
 R and L
 Bet diaphragm and liver
2. Hepatorenal recess
 Bet R liver lobe and R
kidney
 Infracolic Compartment, plt 264
 Divided into R and L by
mesentery of small intestine
1. Paracolic gutters
 R – assoc w/ ascending colon
 L – assoc w/ descending
colon
2. Paravetebral gutter
 On each side of vertebra
 Cont kidney,ureter,part of
colon
 7. Omental Bursa, plt 255
 Large compartment
 Bet stomach and posterior
abd wall
 Posterior to lesser
omentum and stomach
 Extension of the main PC
into the invaginated R side
of the dorsal mesentery of
the stomach
 Omental Bursa
 Extension of omental bursa
 1. Superior recess
 Limited superiorly by
diaphragm
 2. Inferior recess
 Potential space
 Omental Bursa, plt 258
 Foramen of Winslow
 Communic of OB w/ main peritoneal
cavity
 Posterior to lesser omentum
 Admits 2 digits
 Boundaries
 Anterior – portal v, hepatic artery and
bile duct or portal triad
 Posterior – IVC and R crus diaphragm
 Superior – caudate lobe,liver
 Inferior – superior part of duodenum
and portal triad
 Peritoneal [abdominal] cavity
 Larger part of abdominopelvic
cavity
 Contains viscera
 Located superior to the pelvic inlet
 Lined by parietal peritoneum
 Boundaries
 Superior – diaphragm
 Inferior – contin. w/ pelvic cavity
 Posterior – vertebral column
 Anterior – abdominal wall
IDENTIFY?
Greater omentum
 Peritonitis
 Inflammation of peritoneum
 Underlying causes:
 Inflammed viscus
 Abscess in peritoneal cavity
 Spillage of intestinal contents
into peritoneal cavity
 Trauma of abdomen[SW,GSW]
 Pain in overlying area
 Rebound tenderness
 Reflex increase in tone of ant
abd wall [ AAW ]muscles
 Spasm of AAW muscles
 Muscle guarding