Peritoneum and Peritoneal Cavity

Def: continuous, glistening and slippery transparent serous membrane lines the abdominopelvic cavity
2 continuous layers: Parietal internal surface of abd.pelvic wall, and Visceral invests viscera
Both layers: mesothelium ( simple squamous epithelium)
Parietal P:
o Same BV, lymph, nerve w/ the wall it lines
o Sensitive to pain, heat, cold and laceration localized, except at the central part diaphragm (phrenic
nerve; referred to c3-c5 dermatomes shoulder)
Visceral P:
o Same BV, lymph, nerve w/ the organs it cover
o Insensitive to touch, heat, cold and laceration
o Stimuli come from: stretching and chemical irritation poorly localized pain, referred to dermatomes
Relationships b/w viscera and peritoneum:
o Intraperitoneal organs: almost completely covered w/ visceral peritoneal invaginated into a closed sac
(punching a balloon)
o Extraperitoneal, retroperitoneal, subperitoneal organs: outside peritoneal cavity, partly covered w/
peritoneum.
Peritoneal cavity:
o Within abdominal cavity, between parietal and visceral cavity, and continues to pelvic cavity
o Content: peritoneal fluid (water, electrolytes, etc. from interstitial fluid) lubricates peritoneal surfaces
aids in movement of viscera.
o Completely closed in males; females: communication to exterior through uterine tubes, cavity and vagina
potential for infection.
Peritoneal Formations
Complex shape: greater surface area than skin highly convoluted
Mesentery:
o Double layer of peritoneum, as results of invagination of peritoneum by organ
o Constitutes a continuity of the visceral and parietal p provides neurovascular communication b/w organ
and body wall. (Fig. 2.19A & E)
o Connects intraperitoneal organ to the body wall
o Have a core of CT contains: BV, Lymph V, nerves, lymph nodes and fats
Omentum: double-layered extension or fold of peritoneum that passes from stomach and proximal duodenum
adjacent organs (fig. 2.19)
o Greater omentum: hangs like apron from greater curvature of stomach descends folds back
attaches to anterior surf. of transverse colon
o Lesser omentum: connects lesser curvature to liver; also to triad of structure that run b/w duodenum and
liver in the free edge of lesser omentum
Peritoneal ligament: double layer of peritoneum, connects organ-organ or organ-abd.wall
Liver, attached to:
o Ant. Abdominal wall falciform ligament
o Stomach Hepatoduodenal ligament ( membranous part of lesser omentum)
o Duodenum Hepatoduodenal ligament (thickened free edge of lesser omentum)
Stomach, attached to:
o Inf. Surface of diaphragm gastrophrenic lig
o Spleen gastrosplenic lig
o Transverse colon gastrocolic lig (the apron-like part of greater omentum)
o all of them are parts of greater omentum, attached to greater curve
Intraperitoneal organs must have bare areas (areas not covered by peritoneum) way for neurovascular structures
Peritoneal folds: reflection of peritoneum, raised from body wall underlying BV, ducts and obliterated fetal vessels
Peritoneal Recess/Fossa: peritoneal fold pouch of peritoneum
Subdivision of the Peritoneal Cavity
Sacs:
o Greater sac: main, larger sac (f2.21a); enter from anterolateral abd.wall
o Lesser sac (omental bursa): posterior to the stomach and lesser omentum
Compartments:
o Devided by transverse mesocolon (mesentery of transverse colon)
o Supracolic comp: stomach, liver, spleen
o Infracolic comp:
small intestine, ascending and descending colon
posterior to greater omentum
devided to R&L infracolic spaces by mesentery of small intestine (f2.21b)
o Communication b/w supra&infracolic comp. : through paracolic gutters (grooves b/w lateral
ascending/descending colon and posterolateral abd.wall)
Omental bursa
o Extensive sac-like cavity , posterior to stomach, lesser omentum (f2.21a,2.2b, 2.23)
o Smooth ant and post wall surface Permits movement of stomach on structure posterior and inferior to it
o Inferiorly, the recess sealed off from the main superior part posterior to stomach (adhere w/ greater
omentum)
o Communicates w/ greater sac through omental foramen (epiploic foramen) opening at the posterior of
free edge lesser omentum. Boundaries of omental foramen:
Ant: heaptoduodenal lig.
Post: IVC and right crus of diaphragm
Sup:liver
Inf: 1
st
part of duodenum

Reff.: Moores Clinically oriented Anatomy 5
th
ed.