Peritoneum Assignment Help

What is peritoneum?

The smooth and serous membrane that forms the lining of abdomen is termed as peritoneum. It allows nerves, blood vessels or any other organs pass through the abdominal organs. Peritoneum is made up of two important layers, called parietal peritoneum and visceral peritoneum.

Parietal peritoneum: It forms the lining of abdominal wall and is supplied by somatic blood vessel in abdomen and pelvic walls. This layer is sensitive, thus the receptor of pain, temperature, touch and pressure is present in parietal peritoneum. Lower six thoracic and first lumbar nerves is present in the parietal peritoneum lining anterior abdominal wall whereas the central part of diaphragmatic peritoneum is supplied by phrenic nerve. Likewise in the pelvic part, the layer of parietal peritoneum is supplied by obturator nerve.

Visceral peritoneum: It forms the lining of abdominal organs and is sensitive to tearing and stretch only. It receives nerves supply form autonomic afferent nerves.

Between both these membrane is present peritoneal cavity that is thin layer liquid that lubricates the surface of peritoneum. In male, peritoneal cavity is closed completely, whereas in female this cavity connects with uterine tube and hence exterior of the body.

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Peritoneal fold, mesentery and peritoneal ligament

The double layer of peritoneum along with connective tissue called mesentery anchors organs of abdomen to the posterior abdominal wall, therefore holding those organs in place and allowing some movement. The portion that is raised from abdominal wall by the vessels and ducts that lies underneath it is called peritoneal fold. Each of this fold forms a pouch like structure called peritoneal recess. Likewise, the two layer folds of peritoneum that connect viscera to the abdominal wall are called peritoneal ligaments. Therefore peritoneal mesentery, ligaments and folds connect one abdominal organ to the other and also with the wall of abdomen.

Peritoneal Pouches, Recesses, Spaces And Gutters

1. Lesser SAC : lies behind the stomach and the lesser omentum
2. Duodenal recesses lies close to duodenojejunal junction.
3. Cecal Recesses is fold of peritoneum close to the cecum produce three peritoneal recess
4. Subphrenic Space is situated between the diaphragm and the liver, on each side of the falciform ligament.
5. Paracolic Gutters lies on the lateral and medial side of the ascending and descending colons

Greater and lesser omentums

The fatty apron that hangs down the intestine helping to pillow them is termed as omentum.

Greater omentum: Greater curvature of stomach is associated to the transverse colon by greater omentum. It is made of three important ligaments; gastrophrenic ligament (runs from greater curvature of stomach to diaphragm), gastrosplenic ligament (runs from greater curvature of stomach to spleen), gastrocolic ligament (runs from greater curvature of stomach and first duodenal part to transverse colon).

Lesser omentum: Lesser curvature of stomach is suspended from fissure of ligamentum venosum and porta hepatis by lesser omentum. The ligaments that makes lesser omentum are: Hepatogastric ligament (runs from lesser curvature of stomach to liver) and hepatoduodenal ligament (runs from liver to the duodenum).

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Abdominal structures in relation to peritoneum

Intraperitoneal: When the organ is completely covered with visceral peritoneum, it is termed as intraperitoneal. Example: stomach, appendix, cecum, liver, spleen, ovaries, etc.

Retroperitoneal: When the organ is partly covered with visceral peritoneum, it is termed as retroperitoneal. Also these organs lies behind the peritoneum. Example: Colon, kidneys, aorta, pancreas, renal vessels, adrenal glands etc.

Infraperitoneal: The organ lying inferior to the peritoneum in the pelvis are infraperitoneal organs. Example: Urinary bladder, ureter etc.

Function of peritoneum

• Peritoneal fluid allows easy sliding of visceral organs.
• Localizes intraperitoneal infections.
• Peritoneal folds helps to adhere one visceral organ with other and also visceral organ with wall of abdomen.
• The fats deposited in peritoneal ligaments and mesentery provide possible advantages to human body.

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