Download Horizontal Disposition of the Peritoneum

PERITONEUM
(HORIZONTAL DISPOSITION)
Learning objectives
At the end of the lecture, students should be able to know:
• What is peritoneum?
• Arrangement of peritoneum?
• In transverse section of abdomen?
• In transverse section of male pelvis?
• In transverse section of female pelvis?
HORIZONTAL TRACING OF PERITONEUM
PARIETAL PERITONEUM
•
Peritoneum is a thin serous membrane that lines wall of
abdominal and pelvic cavities and clothing the abdominal and
pelvic viscera.
•
It can be regarded as a balloon into which the organs are
pressed into from outside.
•
The parietal peritoneum lines the wall of abdominal and pelvic cavities.
The visceral peritoneum covers the organs.
•
The potential space between the parietal and visceral layer
which is in effect the inside space of the balloon is called
peritoneal cavity.
•
In males it is close cavity but in females there is a
communication with the exterior through uterine tubes, the
uterus and the vagina.
•
The best way to try to visualize the peritoneum and its reflections is to examine sagittal
and cross sections through the abdomen. After looking at images of these sections.
Horizontal Disposition of the Peritoneum
• Below the transverse colon the arrangement is simple, as it includes
only the main cavity.
• above the level of the transverse colon it is more complicated on
account of the existence of the omental bursa. Below the transverse
colon it may be considered in the two regions, viz., in the pelvis and in
the abdomen proper.
HORIZONTAL TRACING OF THE
PERITONIUM
•
Horizontal disposition of peritoneum below the transverse colon the arrangement is
simple but differ at the:
– *Pelvis
– *Lower abdominal level
– *Upper abdominal level
HORIZONTAL TRACING ABOVE THE LEVEL OF
TRANVERSE COLON
•
Starting on the anterior abdominal wall to the left of falciform ligament the peritoneum
can be traced in sequence:
1) Left layer of falciform ligament
2) Over the liver to the porta hepatis
3) Anterior layer of lesser Omentum
4) Front of stomach
HORIZONTAL TRACING ABOVE THE LEVEL OF
TRANVERSE COLON
5) Left layer of Gastro Splenic Ligament
6) Over the surface of Spleen
7) Left layer of Lienorenal Ligament
8) Posterior abdominal wall, infront of Left kidney, thus
back to Anterior Abdominal Wall.
•
The peritoneum of right layer of falciform ligament passes on to the liver and form there
to:
1) Posterior layer of lesser omentum
2) Posterior wall of stomach
3) Right layer of gastrosplenic and Lienorenal Ligaments
4) Posterior abdominal
wall, and back across
the midline to reach
the anterior abdominal
wall.
HORIZONTAL TRACING BELOW THE LEVEL OF
TRANVERSE COLON
•
On the back of anterior abdominal wall, we see number of peritoneal fold and fossae,
starting from median plane these are as follows.
1) Median Umbilical fold, raised by
Median Umbilical Ligament
remanant of Urachus.
2) Medial inguinal fossa
3) Medial umbilical fold, raised
by obliterated umbilical artery.
HORIZONTAL TRACING BELOW THE LEVEL OF
TRANVERSE COLON
4) Lateral inguinal fossa
5) Lateral Inguinal fold raised
by inferior epigastric vessels.
6) The femoral fossa, overlying
femoral septum.
•
•
•
Further laterally the peritoneum passes over the lateral part of abdominal wall to reach
the posterior abdominal wall.
Near the midline, the peritoneum becomes continuous with the two layer Mensentery and
thus reaches the small intestine.
At this level we also see the greater omentum made up of 4 layers. It lies between the
intestine and anterior abdominal wall.
HORIZONTAL TRACING OF PERITONEUM IN LESSER
PELVIS
( MALE)
•
•
•
•
•
•
Note the following:
1) The recto vessical pouch
2) The para rectal fossae
3) The sacrogenital folds forming the lateral limit of recto vesical pouch.
4) The pararectal fossae
5) Paravesical fossae
Peritoneum of Male Pelvis
HORIZONTAL TRACING OF PERITONEUM IN LESSER
PELVIS (FEMALE)
1) The uterus and broad ligament form transverse partition across the pelvis.
2) The pararectal and paravesical fossae
3) The recto uterine pouch.
REFERENCES
•
Textbook of anatomy by Gray’s.
•
Textbook of Anatomy by Keith.L.Moore.