Peritoneum and Stomach Anatomy - Prof. Dr. Maha, Cheat Sheet of Anatomy

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Peritoneum & Stomach

Presented By :

miss Maha

Introduction

• (^) According to this reflections the abdominal organs may:
• (^) Completely covers by peritoneum ( Intraperitoneal ) or
• (^) Coverd by peritoneum anteriorly ( retroperitoneal )
• (^) Coverd by peritoneum anteriorly ( subperitoneal )
• (^) Have no peritoneal covering ( extraperitoneal ).

Peritoneum

Peritoneal

Reflections

 Functions :

o Support the

viscera.

o Provide pathways

for associated

neurovascular

structures.

A. Omentum

2. Greater Omentum

 (^) It is derived from the embryonic dorsal mesentery.  (^) Hangs down like an apron from the greater curvature of the stomach, covering the transverse colon and other abdominal viscera.  (^) Transmits the right and left gastroepiploic vessels along the greater curvature.

2. Greater Omentum

• (^) It Consists of the

gastrolienal ,

lienorenal ,

gastrophrenic , and

gastrocolic ligaments.

a. Gastrolienal

(Gastrosplenic)

Ligament.

• (^) Extends from the left portion of the greater curvature of the stomach to the hilus of the spleen and contains the short gastric and left gastroepiploic vessels.

B. Mesenteries 1- Mesentery of the Small Intestine (Mesentery Proper).  (^) Is a fan-shaped double fold of peritoneum that suspends the jejunum and the ileum from the posterior abdominal wall and transmits nerves and blood vessels to and from the small intestine.  (^) Forms a root that extends from the duodenojejunal flexure to the right iliac fossa.  (^) Has a free border that

B. Mesenteries

1- Mesentery of the

Small Intestine

(Mesentery Proper).

Forms a root that

extends from the

duodenojejunal flexure

to the right iliac fossa.

Has a free border that

encloses the small

intestine.

 Contains the superior

mesenteric and

C. Other Peritoneal Ligaments

1. Phrenicocolic Ligament o (^) Runs from the left colic flexure to the diaphragm. 2. Falciform Ligament  (^) Is a sickle-shaped peritoneal fold connecting the liver to the diaphragm and the anterior abdominal wall. o (^) Contains the ligamentum teres, hepatis and the paraumbilical vein, which connects the left branch of the portal vein with the subcutaneous veins in the region of the umbilicus.

3. Ligamentum Teres Hepatis ( Round Ligament of the Liver ) 

C. Other Peritoneal Ligaments

4. Coronary Ligament

 (^) Is a peritoneal reflection from the diaphragmatic surface of the liver onto the diaphragm and encloses a triangular area of the right lobe, the bare area of the liver.  (^) Has right and left extensions that form the right and left triangular ligaments.

A. Lesser Sac (Omental Bursa)

• (^) Is an irregular space that lies behind the liver , lesser omentum , stomach , and upper anterior part of the greater omentum.
• (^) Is a closed sac , except for its communication with the greater sac through the Epiploic (Omental) Foramen.
• (^) Presents 3 recesses: (a)Superior recess, which lies behind the stomach, lesser omentum, and left lobe of the liver; (b)Inferior recess, which lies behind the stomach, extending into the layers of the greater omentum; and

B. Greater Sac

1. Subphrenic ( Suprahepatic ) Recess  (^) Is a peritoneal pocket between the diaphragm and the anterior and superior part of the liver and is separated into right and left recesses by the falciform ligament.

2. Subhepatic Recess or

Hepatorenal Recess (Morrison’s Pouch)  (^) Is a deep peritoneal pocket between the liver anteriorly and the kidney and

C. Epiploic or Omental (Winslow’s) Foramen

• (^) It is a natural opening between the lesser and greater sacs.
• (^) Is bounded o (^) Superiorly by: peritoneum on the caudate lobe of the liver, o (^) Inferiorly by: peritoneum on the 1 st part of the duodenum, o (^) Anteriorly by: the free edge of the lesser omentum, o (^) Posteriorly by: peritoneum covering the IVC.

Nerve Supply  The Parietal Peritoneum

o The parietal peritoneum associated with

the abdominal wall is innervated by

somatic afferents carried in branches of

the associated spinal nerves and is

therefore sensitive to well-localized pain.

 The visceral peritoneum

• (^) It is innervated by visceral afferents that

accompany autonomic nerves

(sympathetic and parasympathetic) back to

the central nervous system..

 Activation of these fibers can lead to

referred and poorly localized sensations