Peritoneum 广西医科大学人体解剖学教研室 April 2003

peritoneum The peritoneum is a large continous sheet of serous membrane in the body, and consists of a closed sac, a part of which lines the abdominal wall is named parietal layer; the remainder is reflected over the contained visceria constitutes the visceral layer.

peritoneal cavity The parietal and visceral layer of the peritoneum are in actual contact; the potential space between them is the peritoneal cavity. Inside the peritoneal cavity, the free surface of the membrane is smooth by a thin film of serous fluid. In the male, the peritoneal cavity is a closed sac; in the female the lateral ends of the uterine tubes open into the peritoneal cavity.

I. The Relationship Between Viscera and Peritoneum The intraperitoneal viscera: Stomach, jejunum, ileum, cecum, vermiform appendix, transverse colon, sigmoid colon, spleen, ovaries, uterine tubes and superior part of the duodenum. The interperitoneal viscera: Liver, gallbladder, urinary bladder, uterus, upper part of the rectum, ascending and descending colon. The retroperitoneal viscera: Kidneys, ureters, suprarenal glands, pancreas, the lower part of the rectum, descending and inferior part of the duodenum.

The Peritoneal Reflection The peritoneal reflection include: omentum, mesenteries, ligaments, folds, recesses, pouches and fossae. Many of them contain the blood vessels, lymphatics, and nerves that from the abdominal wall passed to viscera.

I) The omentum Broad peritoneal sheet associated with stomach are termed omemta. There are two omenta, the lesser and greater. The lesser omentum The greater omentum The omental bursa

II) The mesenteries and mesocolons 1. The mesentery (of the small intestine) It is a broad, fan-shaped fold of peritoneum connecting the coils of jejunum and ileum to the posterior abdominal wall.

The radix (root) of mesentery is the portion attached to the posterior wall of the abdomen.

2. The mesoappendix (mesentery of the appendix)

3. The transverse mesocolon (mesentery of the transverse colon)

4. The sigmoid mesocolon (mesentery of the sigmoid colon)

III) The ligaments 1. The ligments of the liver Coronary ligament Left triangular ligament Right triangular ligament Falciform ligament Ligamentum teres hepatis

Ligament venosum Left triangular ligament Ligamentum teres hepatis

Posterior coronary ligament Anterior coronary ligament

Hepatogastric lig. Omentum Hepatodudenal lig.

2. The ligaments of the spleen Gastiosplenic lig. Splenorenal lig. Hepatorenal recess

3. The ligaments of the stomach Hepatogastric lig. Gastrocolic lig.

Gastrocolic lig.

4. The suspensory ligament of the duodenum Ligament of Treitz it is a fold containing the suspensory muscle of duodenum.

IV) The peritonal recesses, pouches, fossae and folds 1. The recesses (1) The duodenal recesses

(2) The cecal recesses

(3) The intersigmoid recess

(4) The hepatorenal recess

2. The pouches Rectouterine pouch Rectovesical pouch Vesicouterine pouch

3. The folds and fossa Median umbilical fold Medial umbilical fold Median umbilical lig. Lateral umbilical fold Medial umbilical lig. Lateral umbilical fossa Inferior epigastric a. Medial umbilical fossa Supravesical fossa Urinary bladder

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