The peritoneum

腹 膜

General features

The peritoneum is a thin serous membrane that line the walls of the abdominal and pelvic cavities and cover the organs within these cavities

Parietal peritoneum 壁腹膜 － lines the walls of the abdominal and pelvic cavities

Visceral peritoneum 脏腹膜 － covers the organs

General features

Peritoneal cavity 腹膜腔－

the potential space between the parietal and visceral layer of peritoneum, in the male, is a closed sac, but in the female, there is a communication with the exterior through the uterine tubes, the uterus, and the vagina.

Function Secretion 分泌 : serous

fluid that moistens the organs.

Absorption 吸收 Support and protection

abdominal organs

The relationship between viscera and peritoneum

Intraperitoneal viscera 腹膜内位器官－ viscera completely surrounded by peritoneum, such a

s ： stomach, superior part of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen 脾， ovary 卵巢 and uterine tube输卵管

Intraperitoneal viscera

Interperitoneal viscera 腹膜间位器官－ most part of viscera surrounded by peritoneum, exa

mple, liver, gallbladder, ascending and descending colon, upper part of rectum, urinary bladder 膀胱 and uterus 子宫

Interperitoneal viscera

Retroperitoneal viscera 腹膜外位器官－ some organs are covered by peritoneum on their

anterior surfaces only, example, kidney, suprarenal gland, pancreas, descending and horizontal parts of duodenum, middle and lower parts of rectum 直肠中下部 , and ureter 输尿管

Retroperitoneal viscera

Structures formed by peritoneum

Omentum 网膜 －two-layered fold of peritoneum that extends from stomach to adjacent organs

Lesser omentum

小网膜 － two-layered fold of p

eritoneum which extends from porta hepatis to lesser curvature of stomach and superior part of duodenum

Lessor omentum 小网膜 Hepatogastric ligament

肝胃韧带－ from porta hepatis to lesser curvature of stomach

Hepatoduodenal ligament 肝十二指肠韧带

extends from porta hepatis to superior part of duodenum, it contains common bile duct, proper hepatic a. hepatic portal v.

A four-layered fold of peritoneum connecting the greater curvature of stomach and superior part of duodenum to transverse colon, which hangs down like an apron( 围裙 ) in front of coils of small intestine.

Greater omentum 大网膜

Lessor omentum

Greater omentum

Omental bursa 网膜囊Position － situated behind th

e lesser omentum and stomach

Walls ： Superior － peritoneum w

hich covers the caudate lobe of liver and diaphragm

Anterior － lesser omentum, peritoneum of posterior wall of stomach, and anterior two layers of greater omentum

Omental bursa 网膜囊 Inferior － conjunctive ar

ea of anterior and posterior two layers of greater omentum

Posterior － posterior two layers of greater omentum, transverse colon and transverse mesocolon, peritoneum covering posterior abdominal wall.

Left － spleen,

gastrosplenic ligament胃脾韧带

splenorenal ligament 脾肾韧带

Right － omental foramen

Omental bursa 网膜囊

Position: lies between the liver and duodenum, behind the lesser omentum and infront of the inferior vena cava

Omental (epiploic)foramen 网膜孔

The omental bursa (lesser sac) communicates with the greater sac through the omental foramen.

Mesenteries or mesocolons 系膜

－ two-layered fold of peritoneum that attach the intestines to the posterior abdominal wall

Mesentery 肠系膜 -suspends the small intestine from the posterior abdominal wall

-Broad and a fan-shaped

Radix of mesentery

小肠系膜根 15 cm long Directed obliquely fro

m left side of L2 vertebra to right sacroiliac joint

Mesoappendix 阑尾系膜 Triangular mesentery －

extends from terminal pa

rt of ileum to appendix

Appendicular artery runs in fr

ee margin of the mesoappen

dix

Transverse mesocolon 横结肠系膜－ a double fold of peritoneum which connects the transverse colon to the posterior abdominal wall.

Sigmoid mesocolon 乙状结肠系膜－ attaches the sigmoid colon to the pelvic wall,the sigmoid.

Ligaments of liver Falciform ligament of li

ver 镰状韧带 Consists of double per

itoneal layer Extends from anterior

abdominal wall (umbilicus) to live

Free border of the ligament contains ligamentum teres

Ligaments 韧带

Coronary ligament 冠状韧带－ the area between upper and lower layer of the coronary ligament is the bare area of liverwhich contract with the diaphragm;

Left and right triangular ligaments 左、右三角韧带－ formed by left and right extremity of coronary ligament

Hepatogastric ligament 肝胃韧带

Hepatoduodenal ligament 肝十二指肠韧带

Ligaments of spleen

Gastrosplenic ligament 胃脾韧带－ connects the fundus of stomach to hilum of spleen. the short gastric and left gastroepiploic vessels pass through it.

Splenorenal ligament 脾肾韧带－ extends between the hilum of spleen and left kidney.

The splenic vessels lies within this ligament, as well as the tail of pancreas

Ligaments of spleen

Phrenicosplenic ligament 膈脾韧带 Splenocolic ligament 脾结肠韧带

Hepatogastric ligament 肝胃韧带 Gastrosplenic ligament 胃脾韧带 Gastrophrenic ligament 胃膈韧带 Gastrocolic ligament 胃结肠韧带

Ligaments of stomach

Folds and recesses of posterior abdominal wall

Superior duodenal fold and recess 十二指肠上襞和上隐窝

Inferior duodenal fold and recess 十二指肠下襞和下隐窝

Intersigmoid recess 乙状结肠间隐窝－ between posterior wall of abdomen and sigmoid mesocolon

Retrocecal recess 盲肠后隐窝－ in which the appendix frequenty lies

Hepatorenal recess 肝肾隐窝－ lies between the right lobe of liver, right kidney, and right colic flexure, and is the lowest parts of the peritoneal cavity when the subject is supine

Folds and fossas of anterior abdominal wall

Medial umbilical fold 脐正中襞－ contain the remnant of urachus 脐尿管 (median umbilical ligaments)

Medial umbilical fold 脐内侧襞－ contains remnants of the umbilical arteries

Lateral umbilical fold 脐外侧襞－ contains the inferior epigastric vessels

Folds and fossas of anterior abdominal wall

Supravesical fossa 膀胱上窝

Medial inguinal fossa 腹股沟内侧窝

Lateral inguinal fossa 腹股沟外侧窝

★ Pouches 陷凹

In male － rectovesical pouch 直肠膀胱陷凹

In female

Rectouterine pouch 直肠子宫陷凹

－ between rectum and uterus

Vesicouterine pouch 膀胱子宫陷凹

－ between bladder and uterus

Peritoneal subdivisions

The transverse colon and transverse mesocolon divides the greater sac into supracolic and infracolic compartments 结肠上区和结肠下区 .

Supracolic compartment 结肠上区 (subphrenic space) － may be divided into Suprahepatic space and Infrahepatic space by the liver.

Peritoneal subdivisions

Suprahepatic space 肝上间隙 lies between the diaphragm and liver;It is divided into

right and left suprahepatic spaces by the falciform ligament

Left suprahepatic space 左肝上间隙 left anterior suprahepati

c spaces 左肝上前间隙 left posterior suprahepat

ic spaces 左肝上后间隙

Right suprahepatic space 右肝上间隙

right anterior suprahepatic spaces

bare area of live (extraperitoneal space)

Infrahepatic space 肝下间隙

- lies between the live and transverse colon and transverse mesocolon;

-the ligamentum teres hepatic divides it into

Right infrahepatic space 右肝下间隙 (hepatorenal recess)

Left infrahepatic space 左肝下间隙

Infrahepatic space 肝下间隙

Left infrahepatic space 左肝下间隙 divieded into(by the leser omentum and stomach) left anterior infrahepatic

space 左肝下前间隙 left posterior infrahepati

c space 左肝下后间隙 (omental bursa)

Infracolic compartment 结肠下区 － lies below the transverse colon and transverse mesocolon

Right paracolic sulcus (gutter) 右结肠旁沟－

lies lateral to the ascending colon. It communicates with the hepatorenal recess and the pelvic cavity.

Infracolic compartment 结肠下区

Left paracolic sulcus (gutter) 左结肠旁沟 － lies lateral to the descending colon. It is separated from the area around the spleen by the phrenicocolic ligament.

Infracolic compartment 结肠下区 Left mesenteric sinus

左肠系膜窦－ triangular space, lies between root of mesentery, ascending colon, right 2/3 of transverse colon

Right mesenteric sinus 右肠系膜窦－ lies between root of mesentery, descending colon, right 1/3 of transverse colon, and is continuous with the cavity of the pelvis