retroperotenial, PERITONEAL CAVITY, PERITONEAL REFLECTIONS

• PRIMARY - not GIT

  • Kidney
  • Ureter
  • Urinary bladder
  • Uterus
  • Fallopian tube
  • Aorta
  • IVC
  • Suprarenal glands
• SECONDARY - GIT


  • Duodenum (2nd-4th)
  • Pancreas
  • Ascending / descending colon
  • Middle rectum
• RETROPERITONEAL ORGANS


  • Pancreas
  • Ureter
  • Kidney
  • Inferior vena cava
  • Duodenum
  • Ascending Colon
  • Descending Colon
  • Abdominal Aorta
• EXTRAPERITONEAL ORGAN


  No peritoneal covering at all
• Rectum


  • Superior Rectum - Peritoneal
  • Middle Rectum - Retroperitoneal
  • Inferior Rectum - Extraperitoneal
• Peritoneal cavity


  Potential space between the parietal & visceral layers of peritoneum
• Peritoneal cavity


  • Contains a thin layer of peritoneal fluid that keeps the surfaces moist
  • Lubricates enabling the viscera to move over each other without friction
• There are NO ORGANS in the peritoneal cavity
• Peritoneal cavity


  Within the abdominal cavity and continues into the pelvic cavity
• Peritoneal cavity in Males

  COMPLETELY CLOSED
• Peritoneal cavity in Females

  There is a communication pathway to the exterior of the body through the Uterine tubes, Uterine cavity and Vagina
• Subdivisions of Peritoneal Cavity

  • Greater Sac
  • Lesser Sac / Omental Bursa
• Greater Sac


  • Main and larger part of the peritoneal cavity
  • Extends from diaphragm to the pelvis
• Lesser Sac / Omental Bursa


  • Smaller part
  • Lies posterior to the stomach and lesser omentum
  • Permits free movement of the stomach on adjacent structures
  • Has two recesses: Superior recess and Inferior recess
• Foramen of Winslow


  • Boundaries:
  • A: hepatoduodenal ligament, Portal vein, Hepatic artery, Bile duct
  • P: IVC
  • S: Caudate lobe liver
  • I: Superior part of Duodenum
• Portal triad


  1. Portal vein lying posterior

  2. Common bile duct lying anterior and to the right

  3. Hepatic artery lying anterior and to the left
• Hepatoduodenal ligament


  Conducts the Portal triad
• Inflammation of the parietal peritoneum

  • Caused by an enlarged gastrointestinal structure or by escape of fluid
  • Results in sharp, localized pain over the affected area
• Inflammation of the parietal peritoneum

  • May exhibit Rebound tenderness (pain that is elicited after the pressure of palpation over the affected area is removed)
  • May exhibit Guarding (reflex spasms of abdominal muscles in response to palpation)
• Ascites


  Accumulation of fluid in the peritoneal cavity due to peritonitis from congestion of the venous drainage of the abdomen
• Paracentesis


  Surgical puncture of the peritoneal cavity for aspiration or drainage of fluid
• Paracentesis


  1. 2cm below umbilicus in the midline (through the linea alba)

  2. 5cm superior and medial to the anterior superior iliac spines on either side (in update 3cm)