Peritoneum - Wikipedia, the free encyclopedia Page 1 of 6

Peritoneum
From Wikipedia, the free encyclopedia

The peritoneum is the serous membrane that forms Peritoneum

the lining of the abdominal cavity or the coelom — it
covers most of the intra-abdominal (or coelomic)
organs — in higher vertebrates and some
invertebrates (annelids, for instance). It is composed
of a layer of mesothelium supported by a thin layer of
connective tissue. The peritoneum both supports the
abdominal organs and serves as a conduit for their
blood and lymph vessels and nerves.

Contents

1 Structure

1.1 Layers

1.2 Subdivisions

2 Development The peritoneum, coloured in blue

3 Clinical aspects

3.1 Peritoneal dialysis

4 Classification of abdominal structures

5 Etymology

6 Additional images

7 References

8 External links

Structure
Layers

The abdominal cavity (the space bounded by the The epiploic foramen, greater sac or general cavity
vertebrae, abdominal muscles, diaphragm and pelvic (red) and lesser sac, or omental bursa (blue). (Areas
floor) should not be confused with the intraperitoneal outlined in blue and red correspond to above
space (located within the abdominal cavity, but diagram.)
wrapped in peritoneum). For example, a kidney is
inside the abdominal cavity, but is retroperitoneal. Gray's subject #246 1149
MeSH Peritoneum
Although they ultimately form one continuous sheet,
Dorlands/Elsevier Peritoneum
two types or layers of peritoneum and a potential
space between them are referenced:

The outer layer, called the parietal peritoneum, is attached to the abdominal wall.

The inner layer, the visceral peritoneum, is wrapped around the internal organs that are located
inside the intraperitoneal cavity.

The potential space between these two layers is the peritoneal cavity; it is filled with a small
amount (about 50 ml) of slippery serous fluid that allows the two layers to slide freely over each
other.

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The term mesentery is often used to refer to a double layer of visceral peritoneum. There are often
blood vessels, nerves, and other structures between these layers. The space between these two
layers is technically outside of the peritoneal sac, and thus not in the peritoneal cavity.

Subdivisions

There are two main regions of the peritoneum, connected by the epiploic foramen (also known as the
Omental Foramen or Foramen of Winslow):

the greater sac (or general cavity of the abdomen), represented in red in the diagrams above.

the lesser sac (or omental bursa), represented in blue. The lesser sac is divided into two "omenta":

The lesser omentum (or gastrohepatic) is attached to the lesser curvature of the stomach and
the liver.

The greater omentum (or gastrocolic) hangs from the greater curve of the stomach and
loops down in front of the intestines before curving back upwards to attach to the transverse
colon. In effect it is draped in front of the intestines like an apron and may serve as an
insulating or protective layer.

The mesentery is the part of the peritoneum through which most abdominal organs are attached to the
abdominal wall and supplied with blood and lymph vessels and nerves.

Structures include:

SOURCES STRUCTURE FROM TO CONTAINS

OMENTA
greater curvature
dorsal
* greater omentum of stomach (and transverse colon
mesentery
spleen)
short gastric artery,
dorsal ** gastrosplenic
stomach spleen left gastro-omental
mesentery ligament
artery
dorsal ** gastrophrenic left inferior phrenic
stomach diaphragm
mesentery ligament artery
dorsal right gastro-omental
** gastrocolic ligament stomach transverse colon
mesentery artery -
dorsal splenic artery, tail of
** splenorenal ligament spleen kidney
mesentery pancreas
lesser curvature of
ventral
* lesser omentum the stomach (and
mesentery
duodenum)
ventral ** hepatogastric right & left gastric
stomach liver
mesentery ligament artery
hepatic artery
ventral ** hepatoduodenal
duodenum liver proper, hepatic
mesentery ligament
portal vein, bile duct
MESENTERIES

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dorsal small intestine – posterior superior mesenteric

* Mesentery proper
mesentery jejunum and ileum abdominal wall artery
dorsal posterior
* transverse mesocolon transverse colon middle colic
mesentery abdominal wall
dorsal
* sigmoid mesocolon sigmoid colon pelvic wall sigmoid arteries
mesentery
dorsal mesentery of
* mesoappendix appendix appendicular artery
mesentery ileum
OTHER
LIGAMENTS AND
FOLDS
thoracic
round ligament of
ventral diaphragm,
* falciform ligament liver liver, paraumbilical
mesentery anterior
veins
abdominal wall
left
* round ligament of
umbilical liver umbilicus
liver
vein
ventral thoracic
* coronary ligament liver
mesentery diaphragm
ductus
* ligamentum venosum liver liver
venosus
* phrenicocolic thoracic
left colic flexure
ligament diaphragm
* left triangular
ventral
ligament, right liver
mesentery
triangular ligament
* umbilical folds urinary bladder
* ileocecal fold ileum cecum
mesovarium,
* broad ligament of the
uterus pelvic wall mesosalpinx,
uterus
mesometrium
* ovarian ligament uterus inguinal canal
* suspensory ligament
ovary pelvic wall ovarian artery
of the ovary

In addition, in the pelvic cavity there are several structures that are usually named not for the
peritoneum, but for the areas defined by the peritoneal folds:

Name Location Genders possessing structure

Rectovesical pouch between rectum and urinary bladder male only
Rectouterine pouch between rectum and uterus female only

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Vesicouterine pouch between urinary bladder and uterus female only

Pararectal fossa surrounding rectum male and female
Paravesical fossa surrounding urinary bladder male and female

Development
The peritoneum develops ultimately from the mesoderm of the trilaminar embryo. As the mesoderm
differentiates, one region known as the lateral plate mesoderm splits to form two layers separated by an
intraembryonic coelom. These two layers develop later into the visceral and parietal layers found in all
serous cavities, including the peritoneum.

As an embryo develops, the various abdominal organs grow into the abdominal cavity from structures in
the abdominal wall. In this process they become enveloped in a layer of peritoneum. The growing
organs "take their blood vessels with them" from the abdominal wall, and these blood vessels become
covered by peritoneum, forming a mesentery.

Clinical aspects
Peritoneal dialysis

In one form of dialysis, the peritoneal dialysis, a glucose solution is run through a tube into the
peritoneal cavity. The fluid is left there for a prescribed amount of time to absorb waste products, and
then removed through the tube. The reason for this effect is the high number of arteries and veins in the
peritoneal cavity. Through the mechanism of diffusion, waste products are removed from the blood.

Classification of abdominal structures

The structures in the abdomen are classified as intraperitoneal, retroperitoneal or infraperitoneal
depending on whether they are covered with visceral peritoneum and whether they are attached by
mesenteries (mensentery, mesocolon).

Infraperitoneal /
Intraperitoneal Retroperitoneal
Subperitoneal
AsAd Stomach, First part of the duodenum
The rest of the duodenum,
[5 cm], jejunum, ileum, Caecum, appendix,
ascending colon, descending Rectum (lower 1/3)
transverse colon, sigmoid colon, Rectum
colon, Rectum (middle 1/3)
(upper 1/3)
Liver, Spleen, tail of pancreas Pancreas (except tail)
Kidneys, adrenal glands, Urinary bladder,
proximal ureters, renal vessels distal ureters
In women: Uterus, Fallopian tubes, ovaries Gonadal blood vessels
Inferior vena cava, Aorta

Structures that are intraperitoneal are generally mobile, while those that are retroperitoneal are

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relatively fixed in their location.

Some structures, such as the kidneys, are "primarily retroperitoneal", while others such as the majority
of the duodenum, are "secondarily retroperitoneal", meaning that structure developed intraperitoneally
but lost its mesentery and thus became retroperitoneal.

Etymology
Peritoneum is derived from Greek via Latin. Peri- means around, while -ton- refers to stretching. Thus,
peritoneum means stretched around or stretched over.

Additional images

Sagittal section through

Horizontal disposition
Median sagittal section posterior abdominal
of the peritoneum in the
Bladder of pelvis, showing wall, showing the
lower part of the
arrangement of fasciæ. relations of the capsule
abdomen.
of the kidney.

Horizontal disposition
Topography of thoracic of the peritoneum in the
and abdominal viscera. upper part of the
abdomen

References

Tortora, Gerard J., Anagnostakos, Reginald Merryweather, Nicholas P. (1984) Principles of
Anatomy and Physiology, Harper & Row Publishers, New York ISBN 0-06-046656-1

External links

http://en.wikipedia.org/wiki/Peritoneum 2/16/2011
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SUNY Labs 37:03-0102

Overview and diagrams at colostate.edu
Retrieved from "http://en.wikipedia.org/wiki/Peritoneum"
Categories: Abdomen

This page was last modified on 4 February 2011 at 11:59.

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http://en.wikipedia.org/wiki/Peritoneum 2/16/2011