MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 1
The peritoneum 
BY MUHAMMAD RAMZAN UL REHMAN 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 2
General features 
The peritoneum is a thin serous membrane that 
line the walls of the abdominal and pelvic cavities 
and cover the organs within these cavities 
Parietal peritoneum 
-lines the walls of the abdominal and pelvic 
cavities 
Visceral peritoneum 
-covers the organs 
Peritoneal cavity 
-the potential space between the parietal and 
visceral layer of peritoneum, in the mail, is a 
closed sac, but in the female, there is a 
communication with the exterior through the 
uterine tubes, the uterus, and the vagina 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 3
Function 
Secretes a lubricating serous 
fluid that continuously 
moistens the associated 
organs 
Absorb 
Support viscera 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 4
The relationship between viscera and peritoneum 
Intraperitoneal viscera 
-viscera completely surrounded by peritoneum, example, stomach, superior part of duodenum, 
jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen and ovary 
Interperitoneal viscera 
-most part of viscera surrounded by peritoneum, example, liver, gallbladder, ascending and 
descending colon, upper part of rectum, urinary bladder and uterus 
Retroperitoneal viscera 
-some organs lie on the posterior abdominal wall and are covered by peritoneum on their anterior 
surfaces only, example, kidney, suprarenal gland, pancreas, descending and horizontal parts of 
duodenum, middle and lower parts of rectum, and ureter 
Intraperitoneal viscera 
Interperitoneal viscera 
Retroperitoneal viscera 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 5
Interperitoneal viscera 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 6
Structures which are formed by peritoneum 
Omentum -two-layered fold 
of peritoneum that extends from 
stomach to adjacent organs 
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Lessor omentum 
-two-layered fold of peritoneum 
which extends from porta hepatis 
to lesser curvature of stomach and 
superior part of duodenum 
Hepatogastric ligament - 
extends from porta hepatis to 
lesser curvature of stomach 
Hepatoduodenal ligament 
◦ Extends from porta hepatis to 
superior part of duodenum 
◦ Contains common bile duct, proper 
hepatic a. and hepatic portal v. 
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Omental foramen 
Behind the right border of 
hepatoduodenal ligament 
Superior-caudate lobe of liver 
Inferior-superior part of 
duodenum 
Anterior-hepatodudenal 
ligament 
Posterior-peritoneum covering 
the inferior vena cava 
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Greater omentum 
-four-layered fold of peritoneum, 
the anterior two layers descend from 
the greater curvature of stomach 
and superior part of duodenum and 
hangs down like an apron in front of 
coils of small intestine, and then 
turns upward and attaches to the 
transverse colon. If an infection 
occurs in the intestine, plasma cells 
formed in the lymph nodes combat 
the infection and help prevent it 
from spreading to the peritoneum. 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 10
Lessor omentum 
Greater omentum 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 11
Omental bursa 
Position-situated behind the lesser omentum 
and stomach 
Walls 
Superior-peritoneum which covers the 
caudate lobe of liver and diaphragm 
Anterior-formed by lesser omentum, 
peritoneum of posterior wall of stomach, and 
anterior two layers of greater omentum 
Inferior-conjunctive area of anterior and 
posterior two layers of greater omentum 
Posterior-formed by posterior two layers 
of greater omentum, transverse colon and 
transverse mesocolon, peritoneum covering 
pancreas, left kidney and suprarenal gland 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 12
Left 
-formed by the spleen, 
gastrosplenic ligament 
and splenorenal ligament 
Right 
-formed by omental 
foramen 
The Omental bursa (lesser sac) 
communicates with the 
greater sac through the 
omental foramen. 
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Mesenteries or mesocolons -two-layered 
fold of peritoneum that 
attach part of the intestines to the 
posterior abdominal wall 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 14
Mesentery 
-suspends the small 
intestine from the posterior 
abdominal wall 
Broad and a fan-shaped 
Consists of two peritoneal layers 
Intestinal border-folded, 7 m 
long 
Radix of mesentery 
◦15 cm long 
◦Directed obliquely from left side of 
L2 to in front of right sacroiliac 
joint 
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Mesoappendix 
Triangular mesentery - 
extends from terminal part of 
ileum to appendix 
Appendicular artery runs in free 
margin of the mesoappendix 
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Transverse mesocolon -a 
double fold of peritoneum which 
connects the transverse colon to 
the posterior abdominal wall 
Sigmoid mesocolon - 
inverted V-shaped, with apex 
located in front of left ureter and 
division of common iliac artery 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 18
Ligaments 
-two-layered folds of 
peritoneum that attached the lesser 
mobile solid visera to the abdominal 
wall 
Ligaments of liver 
Falciform ligament of liverhl 
◦Consists of double peritoneal layer 
◦Extends from anterior abdominal wall 
(umbilicus) to live 
◦Free border of ligament site of 
ligamentum teres 
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Coronary ligament -the 
area between upper and lower 
parts of the coronary ligament is 
the bare area of live, this area is 
devoid of peritoneum and lies in 
contract with the diaphragm 
Left and right triangular ligaments 
-formed by right extremity of 
coronary ligament and left leaf of 
falciform ligament, respectively 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 20
Hepatogastric ligament 
Hepatoduodenal ligament 
Ligamentum teres hepatis 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 21
Ligaments of spleen 
Gastrosplenic ligament 
-a double layer of peritoneum that connects the fundus of stomach to hilum of spleen. In 
this double layer of peritoneum are the short gastric and left gastroepiploic vessels 
Splenorenal ligament 
-extends between the hilum of spleen and anterior aspect of left kidney. The splenic 
vessels lies within this ligament, as well as the tail of pancreas 
Phrenicosplenic ligament 
Splenocolic ligament 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 22
Ligaments of stomach 
Hepatogastric ligament 
Gastrosplenic ligament 
Gastrophrenic ligament 
Gastrocolic ligament 
Gastropancrestic ligament 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 23
Folds and recesses of posterior abdominal wall 
Superior duodenal fold and recess 
Inferior duodenal fold and recess 
Intersigmoid recess - 
formed by the inverted V attachment 
of sigmoid mesocolon 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 24
Retrocecal recess -in 
which the appendix 
frequenty lies 
Hepatorenal recess -lies 
between the right lobe of 
liver, right kidney, and right 
colic flexure, and is the 
lowest parts of the 
peritoneal cavity when the 
subject is supine 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 25
Folds and fossas of anterior abdominal wall 
Medial umbilical fold 
-contain the remnant of urachus 
(median umbilical ligaments) 
Medial umbilical fold 
-contains remnants of the 
umbilical arteries (medial umbilical 
ligaments) 
Lateral umbilical fold 
-contains the inferior epigastric 
vessels 
Supravesical fossa 
Medial inguinal fossa 
Lateral inguinal fossa 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 26
Pouches 
In male-rectovesical 
pouch 
In female 
◦Rectouterine pouch - 
between rectum and uterus 
◦Vesicouterine pouch - 
between bladder and uterus 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 27
Peritoneal subdivisions The transverse colon and transverse 
mesocolon divides the greater sac into 
supracolic and infracolic compartments. 
Supracolic compartments 
(subphrenic space)-lies between 
diaphragm and transverse colon and 
transverse mesocolon 
Suprahepatic recess 
lies between the diaphragm and live-the 
falciform ligament divides it into right and 
left suprahepatic recesses 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 28
Left suprahepatic recesses 
◦left anterior suprahepatic 
spaces 
◦left posterior suprahepatic 
spaces 
Right suprahepatic recesses 
◦right anterior suprahepatic 
spaces 
◦right posterior suprahepatic 
spaces 
◦ bare area of live 
(extraperitoneal space) 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 29
Infrahepatic recess 
lies between the live and 
transverse colon and transverse 
mesocolon-the ligamentum 
teres hepatic divides it into right 
and left infrahepatic recesses 
Right infrahepatic recesses 
(hepatorenal recess) 
Left infrahepatic recesses 
◦left anterior infrahepatic space 
◦left posterior infrahepatic space 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 30
Infracolic compartments -lies 
below the transverse colon and transverse 
mesocolon 
Right paracolic sulcus (gutter) -lies 
lateral to the ascending colon. It 
communicates with the hepatorenal 
recess and the pelvic cavity. It provides a 
route for the spread of infection between 
the pelvic and the upper abdominal 
region. 
Left paracolic sulcus (gutter) -lies 
lateral to the descending colon. It is 
separated from the area around the 
spleen by the phrenicocolic ligament, a 
fold of peritoneum that passes from the 
colic flexure to the diaphragm. 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 31
Right mesenteric sinus - 
triangular space, lies between root of 
mesentery, ascending colon, right 2/3 of 
transverse colon and transverse mesocolon 
Left mesenteric sinus - lies 
between root of mesentery, descending 
colon, right 1/3 of transverse colon and 
transverse mesocolon, its widens below 
where it is continuous with the cavity of the 
pelvis 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 32
Thank You 
MUHAMMAD RAMZAN UL REHAMN 
MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 33

Peritoneum

  • 1.
    MUHAMMAD RAMZAN ULREHMAN ..... STUDYLOVERS.COM 1
  • 2.
    The peritoneum BYMUHAMMAD RAMZAN UL REHMAN MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 2
  • 3.
    General features Theperitoneum is a thin serous membrane that line the walls of the abdominal and pelvic cavities and cover the organs within these cavities Parietal peritoneum -lines the walls of the abdominal and pelvic cavities Visceral peritoneum -covers the organs Peritoneal cavity -the potential space between the parietal and visceral layer of peritoneum, in the mail, is a closed sac, but in the female, there is a communication with the exterior through the uterine tubes, the uterus, and the vagina MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 3
  • 4.
    Function Secretes alubricating serous fluid that continuously moistens the associated organs Absorb Support viscera MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 4
  • 5.
    The relationship betweenviscera and peritoneum Intraperitoneal viscera -viscera completely surrounded by peritoneum, example, stomach, superior part of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen and ovary Interperitoneal viscera -most part of viscera surrounded by peritoneum, example, liver, gallbladder, ascending and descending colon, upper part of rectum, urinary bladder and uterus Retroperitoneal viscera -some organs lie on the posterior abdominal wall and are covered by peritoneum on their anterior surfaces only, example, kidney, suprarenal gland, pancreas, descending and horizontal parts of duodenum, middle and lower parts of rectum, and ureter Intraperitoneal viscera Interperitoneal viscera Retroperitoneal viscera MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 5
  • 6.
    Interperitoneal viscera MUHAMMADRAMZAN UL REHMAN ..... STUDYLOVERS.COM 6
  • 7.
    Structures which areformed by peritoneum Omentum -two-layered fold of peritoneum that extends from stomach to adjacent organs MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 7
  • 8.
    Lessor omentum -two-layeredfold of peritoneum which extends from porta hepatis to lesser curvature of stomach and superior part of duodenum Hepatogastric ligament - extends from porta hepatis to lesser curvature of stomach Hepatoduodenal ligament ◦ Extends from porta hepatis to superior part of duodenum ◦ Contains common bile duct, proper hepatic a. and hepatic portal v. MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 8
  • 9.
    Omental foramen Behindthe right border of hepatoduodenal ligament Superior-caudate lobe of liver Inferior-superior part of duodenum Anterior-hepatodudenal ligament Posterior-peritoneum covering the inferior vena cava MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 9
  • 10.
    Greater omentum -four-layeredfold of peritoneum, the anterior two layers descend from the greater curvature of stomach and superior part of duodenum and hangs down like an apron in front of coils of small intestine, and then turns upward and attaches to the transverse colon. If an infection occurs in the intestine, plasma cells formed in the lymph nodes combat the infection and help prevent it from spreading to the peritoneum. MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 10
  • 11.
    Lessor omentum Greateromentum MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 11
  • 12.
    Omental bursa Position-situatedbehind the lesser omentum and stomach Walls Superior-peritoneum which covers the caudate lobe of liver and diaphragm Anterior-formed by lesser omentum, peritoneum of posterior wall of stomach, and anterior two layers of greater omentum Inferior-conjunctive area of anterior and posterior two layers of greater omentum Posterior-formed by posterior two layers of greater omentum, transverse colon and transverse mesocolon, peritoneum covering pancreas, left kidney and suprarenal gland MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 12
  • 13.
    Left -formed bythe spleen, gastrosplenic ligament and splenorenal ligament Right -formed by omental foramen The Omental bursa (lesser sac) communicates with the greater sac through the omental foramen. MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 13
  • 14.
    Mesenteries or mesocolons-two-layered fold of peritoneum that attach part of the intestines to the posterior abdominal wall MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 14
  • 15.
    Mesentery -suspends thesmall intestine from the posterior abdominal wall Broad and a fan-shaped Consists of two peritoneal layers Intestinal border-folded, 7 m long Radix of mesentery ◦15 cm long ◦Directed obliquely from left side of L2 to in front of right sacroiliac joint MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 15
  • 16.
    MUHAMMAD RAMZAN ULREHMAN ..... STUDYLOVERS.COM 16
  • 17.
    Mesoappendix Triangular mesentery- extends from terminal part of ileum to appendix Appendicular artery runs in free margin of the mesoappendix MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 17
  • 18.
    Transverse mesocolon -a double fold of peritoneum which connects the transverse colon to the posterior abdominal wall Sigmoid mesocolon - inverted V-shaped, with apex located in front of left ureter and division of common iliac artery MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 18
  • 19.
    Ligaments -two-layered foldsof peritoneum that attached the lesser mobile solid visera to the abdominal wall Ligaments of liver Falciform ligament of liverhl ◦Consists of double peritoneal layer ◦Extends from anterior abdominal wall (umbilicus) to live ◦Free border of ligament site of ligamentum teres MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 19
  • 20.
    Coronary ligament -the area between upper and lower parts of the coronary ligament is the bare area of live, this area is devoid of peritoneum and lies in contract with the diaphragm Left and right triangular ligaments -formed by right extremity of coronary ligament and left leaf of falciform ligament, respectively MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 20
  • 21.
    Hepatogastric ligament Hepatoduodenalligament Ligamentum teres hepatis MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 21
  • 22.
    Ligaments of spleen Gastrosplenic ligament -a double layer of peritoneum that connects the fundus of stomach to hilum of spleen. In this double layer of peritoneum are the short gastric and left gastroepiploic vessels Splenorenal ligament -extends between the hilum of spleen and anterior aspect of left kidney. The splenic vessels lies within this ligament, as well as the tail of pancreas Phrenicosplenic ligament Splenocolic ligament MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 22
  • 23.
    Ligaments of stomach Hepatogastric ligament Gastrosplenic ligament Gastrophrenic ligament Gastrocolic ligament Gastropancrestic ligament MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 23
  • 24.
    Folds and recessesof posterior abdominal wall Superior duodenal fold and recess Inferior duodenal fold and recess Intersigmoid recess - formed by the inverted V attachment of sigmoid mesocolon MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 24
  • 25.
    Retrocecal recess -in which the appendix frequenty lies Hepatorenal recess -lies between the right lobe of liver, right kidney, and right colic flexure, and is the lowest parts of the peritoneal cavity when the subject is supine MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 25
  • 26.
    Folds and fossasof anterior abdominal wall Medial umbilical fold -contain the remnant of urachus (median umbilical ligaments) Medial umbilical fold -contains remnants of the umbilical arteries (medial umbilical ligaments) Lateral umbilical fold -contains the inferior epigastric vessels Supravesical fossa Medial inguinal fossa Lateral inguinal fossa MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 26
  • 27.
    Pouches In male-rectovesical pouch In female ◦Rectouterine pouch - between rectum and uterus ◦Vesicouterine pouch - between bladder and uterus MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 27
  • 28.
    Peritoneal subdivisions Thetransverse colon and transverse mesocolon divides the greater sac into supracolic and infracolic compartments. Supracolic compartments (subphrenic space)-lies between diaphragm and transverse colon and transverse mesocolon Suprahepatic recess lies between the diaphragm and live-the falciform ligament divides it into right and left suprahepatic recesses MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 28
  • 29.
    Left suprahepatic recesses ◦left anterior suprahepatic spaces ◦left posterior suprahepatic spaces Right suprahepatic recesses ◦right anterior suprahepatic spaces ◦right posterior suprahepatic spaces ◦ bare area of live (extraperitoneal space) MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 29
  • 30.
    Infrahepatic recess liesbetween the live and transverse colon and transverse mesocolon-the ligamentum teres hepatic divides it into right and left infrahepatic recesses Right infrahepatic recesses (hepatorenal recess) Left infrahepatic recesses ◦left anterior infrahepatic space ◦left posterior infrahepatic space MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 30
  • 31.
    Infracolic compartments -lies below the transverse colon and transverse mesocolon Right paracolic sulcus (gutter) -lies lateral to the ascending colon. It communicates with the hepatorenal recess and the pelvic cavity. It provides a route for the spread of infection between the pelvic and the upper abdominal region. Left paracolic sulcus (gutter) -lies lateral to the descending colon. It is separated from the area around the spleen by the phrenicocolic ligament, a fold of peritoneum that passes from the colic flexure to the diaphragm. MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 31
  • 32.
    Right mesenteric sinus- triangular space, lies between root of mesentery, ascending colon, right 2/3 of transverse colon and transverse mesocolon Left mesenteric sinus - lies between root of mesentery, descending colon, right 1/3 of transverse colon and transverse mesocolon, its widens below where it is continuous with the cavity of the pelvis MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 32
  • 33.
    Thank You MUHAMMADRAMZAN UL REHAMN MUHAMMAD RAMZAN UL REHMAN ..... STUDYLOVERS.COM 33