Peritoneum and peritoneal cavity

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محاضرة دكتورة نورا الطحاوى للفرقة الاولى كلية الطب البشرى
يوم الاحد 17 ابريل 2011س

Lectures of Anatomy by Dr. Noura El Tahawy for first year Faculty of Medicine, El Minia University. 17-4-211
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  • 1. The abdominal cavity, the peritoneum& the peritoneal cavity By Dr. Noura El Tahawy Faculty of Medicine El Minia University
  • 2. • Superficial view of• the abdominal• organs
  • 3. Peritoneum
  • 4. • Sagittal section through the abdominopelvic cavity
  • 5. Abdominal cavity proper• The larger part of the abdominopelvic cavity• BOUNDARIES• Superiorly: diaphragm• Inferiorly: Pelvic inlet• A large part is under the cover of the osteocartilaginous thoracic cage• Walls are lined by the parietal peritoneum
  • 6. • Thin transparent serous membrane that consists of 2 layers:• 1. PARIETAL PERITONEUM – lines the abdominal cavity• 2. VISCERAL PERITONEUM – invests the abdominal viscera
  • 7. • Composed of a single layer of squamous epithelial cells (mesothelium)• The 2 layers are separated by a capillary film of peritoneal fluid.
  • 8. PERITONEAL DERIVATIVES: Definition Peritoneal From To DerivativesLigaments Solid viscera Abdominal wallOmentum Stomach Another viscusMesentery Parts of the intestine Posterior abdominal wall
  • 9. PERITONEAL DERIVATIVES: ExamplesPeritoneal Derivative From ToLigaments Solid viscera Abdominal wall Falciform ligament liver Diaphragm and anterior abdominal wall
  • 10. Peritoneal cavity
  • 11. • DEFINITION• The potential space between the parietal and visceral layers of the peritoneum• MALES: closed cavity• FEMALES: (+) communication with the exterior through the reproductive tract (fallopian tubes, uterus, vagina)
  • 12. Divisions of the peritoneal cavity • As the fetal organs assume their adult positions, the parietal cavity is divided into the 2 peritoneal sacs: 1. the greater sac 2. the lesser sac (omental bursa)
  • 13. Peritoneal cavity• GREATER SAC • LESSER SAC• Main compartment of • Smaller the peritoneal cavity• Extends from the • Lies behind the diaphragm into the stomach pelvis The communication between the greater sac and the lesser sac is the EPIPLOIC FORAMEN
  • 14. PERITONEAL DERIVATIVES: ExamplesPeritoneal Derivative From ToOmentum Stomach Another viscus Greater omentum Greater curvature Transverse colon Lesser omentum Lesser curvature Undersurface of the liver Hepatogastric ligament Hepatoduodenal ligament Gastrosplenic Stomach Hilum of the spleen omentum (ligament)
  • 15. Greater Omentum
  • 16. Lesser Omentum & Lesser sac
  • 17. • Superficial view of• the abdominal• organs
  • 18. • Sagittal section through the abdominopelvic cavity
  • 19. Hepatogastric LigamentHepatogastric ligament Epiploic foramen
  • 20. Hepatoduodenal LigamentContents: The Portal Triad• Proper hepatic a , Portal v, Common bile duct
  • 21. Boundaries ofEpiploic foramen Proper Proper hepatic hepatic artery artery Portal vein Portal vein Common Common bile duct bile duct Contents: The Portal Triad • Proper hepatic a • Portal v • Common bile duct
  • 22. Boundaries of Epiploic foramen
  • 23. Epiploic foramen
  • 24. Epiploic foramen
  • 25. Mesentery
  • 26. PERITONEAL DERIVATIVES: ExamplesPeritoneal Derivative From ToMesentery Parts of the intestine Posterior abdominal wall Mesogastrium Stomach Posterior abdominal wall Mesentery of the small Small intestine Posterior abdominal wall intestine Transverse mesocolon Transverse colon Posterior abdominal wall Sigmoid mesocolon Sigmoid colon Posterior abdominal wall
  • 27. Transverse mesocolonMesenteryof the small intestine
  • 28. PERITONEAL ORGANSRETROPERITONEAL ORGANS INTRAPERITONEAL ORGANS When an organ is When an organ is partially covered almost entirely covered by visceral peritoneum. by visceral peritoneum The organ lies behind the peritoneum. Kidneys Suprarenal glands Pancreas Part of the duodenum Ascending colon Descending colon
  • 29. Secondary peritonealorgans Primary peritoneal PERITONEAL ORGANS organs RETROPERITONEAL ORGANS INTRAPERITONEAL ORGANS When an organ is When an organ is partially covered almost entirely covered by visceral peritoneum. by visceral peritoneum The organ lies behind the peritoneum. Kidneys Suprarenal glands Pancreas Part of the duodenum Ascending colon Descending colon
  • 30. EXTRAPERITONEAL ORGANS• Organs devoid of peritoneal lining• Rectum
  • 31. PERITONEAL RECESSES• Subphrenic recess Description and significance• Hepatorenal recess• Paracolic gutter
  • 32. SUBPHRENIC RECESS• The existence is due to the complicated arrangement of the peritoneum in the region of the liver• Right and left anterior subphrenic spaces• Right posterior subphrenic space• Right extraperitoneal space
  • 33. SUBPHRENIC RECESS• Right and left anterior subphrenic spaces• between the diaphragm and the Iiver on each side of the falciform ligament
  • 34. SUBPHRENIC RECESS• Right posterior subphrenic space• between the right lobe of the liver, the right kidney and the right colic flexure
  • 35. Anterior and Posterior Subphrenic AbscessAnterior Posterior
  • 36. SUBPHRENIC RECESS• Right extraperitoneal space• between the layers of the coronary ligament
  • 37. HEPATORENAL RECESS• Located between the inferior surface of the right lobe of the liver and the right kidney
  • 38. PARACOLIC GUTTER• Results form the arrangement of the ascending and descending colons, attachment of the transverse mesocolon, and the mesentery of the small intestine to the abdominal wall
  • 39. PARACOLIC GUTTER• 4 gutters• Lie in the lateral and medial side of the ascending and descending colons respectively
  • 40. PARACOLIC GUTTER• Right lateral paracolic gutter – In communication with the right posterior subphrenic space• Right medial paracolic gutter – Closed off from the peritoneal cavity by the mesentery of the small intestines• Left lateral paracolic gutter – Separated from the area around the spleen by the phrenicocolic ligament• Left medial paracolic gutter
  • 41. PARACOLIC GUTTER• Right lateral paracolic gutter – In communication with the right posterior subphrencicspace• Right medial paracolic gutter – Closed off from the peritoneal cavity by the mesentery of the small intestines• Left lateral paracolic gutter – Separated from the area around the spleen by the phrenicocolic ligament• Left medial paracolic gutter
  • 42. PARACOLIC GUTTER• Right lateral paracolic gutter – In communication with the right posterior subphrenic space• Right medial paracolic gutter – Closed off from the peritoneal cavity by the mesentery of the small intestines• Left lateral paracolic gutter – Separated from the area around the spleen by the phrenicocolic ligament• Left medial paracolic gutter
  • 43. The Subphrenic Spaces and the Paracolic Gutters• Clinically important !• Sites for the collection and movement of infected peritoneal fluid
  • 44. 62