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In the name of God
Abdomen 3
Dr. Zahiri
Peritoneum
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Peritoneum
It is the serous membrane(a type of loose connective tissue
and is covered by mesothelium) that lines the abdominal
cavity.
Extensions of the peritoneum form the mesenteries, omenta and
ligaments that support the abdominal contents.
Function:
To produce fluid to lubricate abdominal viscera
To enhance immune responses
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Intra pritoneal
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Retro peritoneal
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Layers of peritoneum:
The peritoneum can be regarded as a balloon into which the
organs are pressed from outside.
Due to this, two layers are formed. One layer lines the
walls of the abdominal and pelvic cavities and is called the
parietal peritoneum.
The Inner layer covers the organs is known as the visceral
peritoneum.
The space between the parietal and visceral layers, which is
the inside space of the balloon, is called the peritoneal
cavity.
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Mesentery
Ventral mesenter vs
Dorsal mesenter
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Extraperitoneal tissue:
a layer of connective tissue between the parietal peritoneum
and the fascial lining of the abdominal and pelvic walls,
It varies in amount in different regions.
In the area of the kidneys, it contains a large amount of fat,
which provides support to them.
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Classification of abdominal structures in relation
to peritoneum:
The abdominal structures, on the basis of their relation with
the peritoneum, are classified into three categories:
Intraperitoneal, Retroperitoneal and Infraperitoneal.
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Intraperitoneal organs:
An organ is almost totally covered with visceral
peritoneum(Stomach)
Retroperitoneal Organs: An organs which lie behind the
peritoneum and are only partially covered with visceral
peritoneum (Aorta)
Infraperitoneal organs: These are organs which lie
inferior to the peritoneum in the pelvis (Urinary bladder)
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Primary vs secondary
retro peritoneal
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Peritoneal development
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Peritoneal development
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Peritoneal development
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Peritoneal development
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Peritoneal ligaments, omenta and mesenteries:
Ligaments:
Peritoneal ligaments are two layered folds of peritoneum
that connect the viscera to the walls of abdomen.
Unlike other ligaments of body, they don’t possess the
dense fibrous tissue and are therefore unique.
A good example of peritoneal ligaments is found in liver, which
is connected to the diaphragm by falciform ligament, coronary
ligament, and right and left triangular ligaments.
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Peritoneal ligaments:
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Omenta:
Omenta are two layered folds of peritoneum that connect the stomach
to other viscera. There are three more obvious omenta in human body:
Greater omentum, Lesser omentum and Gastrosplenic omentum.
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• Greater omentum:
It connects the greater curvature of the stomach to the
transverse colon.
It hangs down like an apron on the coils of the small intestine
and is folded back on itself to be attached to the transverse
colon.
Lesser omentum:
It suspends the lesser curvature of the stomach from the
fissure of the ligamentum venosum (fibrous remnant of the
ductus venosus of fetal circulation) and porta hepatis.
Gastrosplenic omentum: As the name suggests, it
connects the stomach to the hilum of spleen.
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Peritoneal development
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Peritoneal development
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Mesenteries:
Mesenteries are two layered folds of peritoneum, which
connect the parts of the intestine to the posterior
abdominal wall.
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Greater and lesser sac
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The ligaments, omenta and mesenteries permit blood
vessels, lymphatics and nerves to reach the viscera
without having to pierce the peritoneum.
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Peritoneal pouches, recesses, and gutters:
The peritoneum is a highly folded membrane resulting in formation of
lots of pouches, recesses and gutters. Some of the important of them
are listed below:
Pouches:
Lesser Sac
Greater Sac
Recesses:
Duodenal recesses
Cecal recesses
Intersigmoid recesses
Spaces:
Subphrenic spaces
Gutters:
Paracolic gutters
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Pouches:
The peritoneal cavity is the largest cavity of human body
and the surface area of the parietal and visceral layers is
enormous.
Greater Sac: It is the main compartment of the peritoneal
cavity and extends from the diaphragm down into the
pelvis.
Lesser Sac: It is smaller in size and lies behind the
stomach. It is in free communication with the greater sac
through an oval window called the opening of the lesser
sac, or “epiploic foramen”.
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Greater and lesser sac
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Caudate process
of liver
IVC
Winslow foramen:
•Coledock duct(common)
• hepatic artery
•Portal vain
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1st part of
deodenum
Greater and lesser sac
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Greater omentum
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Greater sac
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Descending of Testis
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Inguinal
region
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Classification of abdominal structures in relation to peritoneum:
The abdominal structures, on the basis of their relation with the peritoneum, are classified into
three categories: Intraperitoneal, Retroperitoneal and Infraperitoneal.
Intraperitoneal organs: An organ is said to be Intraperitoneal when it is almost totally
covered with visceral peritoneum. The Intraperitoneal organs of human body are:
Stomach
First part of duodenum
Jejunum
Ileum
Cecum
Appendix
Transverse colon
Sigmoid colon
Upper 1/3 of Rectum
Liver
Spleen
Uterus (Females)
Fallopian tubes (Females)
Ovaries (Females)
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Retroperitoneal Organs: These are organs which lie behind the peritoneum and are
only partially covered with visceral peritoneum. The retroperitoneal organs of human
body are:
Second and third parts of cuodenum
Ascending colon
Descending colon
Middle 1/3 of Rectum
Pancreas
Kidneys
Adrenal glands
Proximal ureters
Renal vessels
Gonadal blood vessels
Inferior vena cave
Aorta
Infraperitoneal organs: These are organs which lie inferior to the peritoneum in the
pelvis. These include:
Lower 1/3 of rectum
Urinary bladder
Distal ureters
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