Peritoneum

peritoneum, functions, peritoneal reflections, their anatomy, mesenteries, the omental cake, clinical applications

1. PERITONEAL REFLECTIONS Mudoogo Edgar

2. quick review Peritoneum- thin serous membrane lines the walls of the abdominal cavity 2 KINDS Parietal Visceral Any functions??? wall off infection & localize it store fat House and protect blood vessels sensitive Visceral : Stretch Parietal : Pain, Temperature, touch & pressure

3. Dfn :Folding back or bending of the peritoneum The peritoneal reflections include: omenta , mesenteries, Ligaments- folds and fossae . Many of them contain the blood vessels, lymphatics , and nerves that from the abdominal wall passed to viscera. Peritoneal reflections

4. Greater Omentum Connects the greater curvature of the stomach to transverse colon. It hangs like an apron in front of the small intestine It is folded back on itself to be attached to the transverse colon . Largest peritoneal reflection in the body

5. Functions of the Greater Omentum prevents the visceral peritoneum from adhering to the parietal peritoneum considerable mobility forms adhesions adjacent to an inflamed organ such as the appendix cushions the abdominal organs against injury forms insulation against loss of body heat

6. Lesser Omentum also called small omentum ; gastrohepatic omentum Connects liver to stomach attached above to porta hepatis & fissure for ligamentum venosum inferiorly to lesser curvature of the stomach,& 1 st inch of duodenum. Its free margin contains: Portal vein: Posterior Bile duct : Anterior & right Hapatic artery: anterior &left Gastrosplenic ligament Splenicorenal or lienorenal ligament

7. Mesentery large, fan-shaped, double-layered fold of peritoneum connecting viscera to abdominal wall provides a means for neurovascular communication between the organ and the body wall . 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. Mesocolon -mesentery of the colon

8. Mesentery of the small intestines Arcades of arteries and veins

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

10. The mesoappendix (mesentery of the appendix)

11. Mesoappendix -attaches the appendix to the terminal ileum. Contains the appendicular vessels

12. Peritoneal folds reflection of peritoneum that is raised from the body wall by underlying blood vessels, ducts, and obliterated fetal vessels. Median umbilical fold 2 medial umbilical folds 2 lateral umbilical folds

13. Median umbilical fold Lateral umbilical fold Medial umbilical fold Median umbilical lig. Medial umbilical lig. Inferior epigastric a. Lateral umbilical fossa Medial umbilical fossa Supravesical fossa Urinary bladder

14. In the clinic Two lateral umbilical folds cover the inferior epigastric vessels and therefore bleed if cut Peritoneal cavity Has a large s.a for administering drugs and operattions Omentectomy refers to the surgical removal of the omentum , a relatively simple procedure with no major side effects, that is performed in cases where there is concern that there may be spread of cancerous tissue into the omentum .(intestinal. Ovarian and appendix cancer) RESEARCH: affects insulin senstivity

15. Omental infarction Necrosis of the greater omentum caused by an acute vascular  disorder Omental cake thickening of the greater omentum secondary to omental peritoneal metastasis due to metastatic deposits

16. CT SCAN

17. wanyala Any questions?