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Peritoneum

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1What is the foregut?The anterior part of the embryological alimentary tract containing the oesophagus, pharynx, stomach and proximal part of duodenum.
2What is the midgut?Portion of alimentary tract comprising of distal duodenum, jejunum, ileum, proximal caecum, ascending colon, 2/3rd of transverse colon.
3What is the hindgut?Last 1/3 of transverse colon down to half way down the anal canal.
4What is a mesentry?a fold of membranous tissue that arises from the part of the anterior wall and the whole of the posterior wall of the peritoneal cavity and attaches to the intestinal tract.
5What is the peritoneal cavity, and does it contain organs? If so, which ones?Serosal sac formed between the folds of the peritoneal membrane; i.e between the visceral and parietal peritoneum. It does not contain any organs, just fluid.
6What is the histological epithelium of the visceral peritoneum?Simple squamous epithelium = mesothelium
7Does the abdominal cavity contain organs?Yes - stomach, liver, gallbladder, spleen, pancreas, small intestine, kidneys, large intestine, and adrenal glands.
8What are intra-peritoneal organs?Organs still WITH a mesentery after the alimentary tract has enlarged and twisted in development.
9What are retro-peritoneal organs?Organs that no longer have a mesentery after the development of the alimentary tract as the mesenteries have blended into the parietal peritoneum of the posterior abdominal wall.
10Name the retro-peritoneal organs. (HINT: SAD PUCKER)S: suprarenal (adrenal) gland
A: aorta/IVC
D: duodenum (second and third part)
P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: (o)esophagus
R: rectum
11What is a primary retroperitoneal organ. Give an example.Organs which developed without a mesentery; e.g. kidney.
12What is a secondary retroperitoneal organ? Give an example.Organs which developed in the mesentery which is subsequently reabsorbed. E.g. pancreas, duodenum, asc/desc colon.
13What causes the ascending and descending colon to be pushed against the back wall of the peritoneum and thus lose its mesentery?Gut rotation
14What is the stomach (suspended in the mesentery) in the embryo called?Mesogastrium
15Which ligament attaches the liver to the anterior wall (via its double fold of mesogastrium) during development?The falciform ligament
16Name the ligament connecting the posterior liver (which is now medial due to rotation) to the stomach?Gastrohepatic ligament
17The gastrohepatic ligament is also known as the greater omentum. True or false?False ; it is known as the LESSER omentum
18Which ligament connects the greater curvature of stomach with the hilum of the spleen?Gastro-splenic / gastro-lineal ligament.
19Name the ligament connecting the spleen to the kidneys.Spleno-renal / lieno-renal ligament
20What is the greater omentum?The layer of peritoneum that surrounds abdominal organs BELOW stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and reflects on itself to ascend to the transverse colon before reaching to the posterior abdominal wall
21What is the lesser omentum?The double layer of peritoneum that extends from the liver to the lesser curvature of the stomach and the start of the duodenum
22The stomach grows symmetrically. True or false?False; it grows asymmetrically and this leads to the greater and lesser curvature.
23Describe how the stomach rotates during development.1 - Rotates 90° clockwise = right side of the stomach becomes posteriorly orientated and the left side anteriorly orientated.
2- The upper side grows faster than the lower side = greater and lesser curvature.
3- The stomach then rocks on its longitudinal axis = distal end of stomach shifts to right and proximal end (cardiac orifice) shifts to the left.
24What is the omental bursa?The lesser sac; peritoneal cavity BEHIND the stomach
25What is the greater omentum?large apron-like fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines
26How is the greater omentum formed?Originally formed from 4 layers, the inner two of which fuse. Before fusion, the space between these inner layers is part of the lesser sac, and is called the omentum bursa = fluid-filled space. When 2 membranes fuse, space disappears and so does bursa.
27What are the important functions of the greater omentum?Localises infections by sticking to any infected region; traps infection and prevents spreading. This is why the G.O is often called the 'abdominal policeman'.
28Which mesentery is the greater omentum derived from?Dorsal mesentery
29Which mesentery is the lesser omentum derived from?Ventral mesentery of the embryo
30Name the opening connecting the lesser and greater sacs.Epiploic foramen
31Which three structures pass to or from the liver via the free edge of the lesser omentum?Proper hepatic artery
Hepatic portal vein
Common bile duct
32What is the Pringle's manoeuvre?Using the thumb to pinch the free edge of the lesser omentum to occlude blood supply to liver and gall bladder; method to control liver bleeding.
33What is 'The Mesentery'?The mesentery of the ileum and jejenum
34The caecum is not always a retroperitoneal organ in every individual. True or false?True; it is variable in its covering of peritoneum. If it loses its mesentery it becomes retroperitoneal. If the peritoneum remains, it becomes intraperitoneal.
35Name the mesentery in which the transverse coon is suspended. What happens to this mesentery eventually?Transverse mesocolon, fuses with the greater omentum
36Name the mesentery in which the sigmoid colon is suspendedSigmoid mesocolon.
37Define the supracolic compartmentSupracolic compartment is that part of the main peritoneal cavity which extends from the transverse mesocolon upwards. It contains liver, spleen, stomach, abdominal esophagus and first part of duodenum
38Define the infracolic compartment.The infracolic compartment of the greater sac lies below the transverse mesocolon and contains the main mass of intestinal coils. $Define the infracolic compartment.$
39Name the structures connecting the supracolic compartment with the pelvic cavity.Right and left paracolic gutters.
40Name the structures connecting the infracolic compartment with the sub phrenic spaces.Right and left paracolic gutters. $Name the structures connecting the infracolic compartment with the sub phrenic spaces.$
41What is the name of this space between the right lobe of the liver and the right kidney? What is the significance of this space?Hepato-renal pouch; potential receptacle for fluid from the gall bladder, proximal duodenum and right paracolic gutter.
42Fluid from the hepato-renal pouch can reach the right sub-phrenic space. Where would pain be felt in this condition?Right shoulder; referred pain.
43Fluid from which perforated viscera can enter either infra- or supracolic compartments depending on the site of perforation on the organ.Fluid from perforated duodenum
44Fluid from a perforated duodenum can affect with 5 structures?1 - right kidney and (2) its pelvis
3 - head of pancreas
4 - hepato-duodeno-pacreatic blood supply
5 - right psoas major
45Name the space formed by the peritoneum hanging over the pelvic organs, between the bladder and rectum in males?Recto-vesical pouch
46Name the space formed by the hanging over of the peritoneum between the bladder and uterus in females?Vesicouterine pouch
47Name the space formed by the hanging over of the peritoneum between the rectum and uterus in females?Rectouterine pouch
48What do the spaces formed by the peritoneal folds over the pelvic organs mean?Pus can collect there