Transcript The peritoneum 腹膜

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
as： 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,
example, 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
peritoneum 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.
Greater omentum 大网膜
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.
Lessor omentum
Greater omentum
Omental bursa 网膜囊
Position－situated behind the
lesser omentum and
stomach
Walls：

Superior－peritoneum
which 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
area 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.
Omental bursa 网膜囊

Left－
spleen,
gastrosplenic ligament
胃脾韧带
splenorenal ligament
脾肾韧带

Right－omental
foramen
Omental (epiploic)foramen
网膜孔

Position: lies
between the liver and
duodenum, behind the
lesser omentum and
infront of the inferior
vena cava
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 fanshaped

Radix of mesentery
小肠系膜根


15 cm long
Directed obliquely
from left side of L2
vertebra to right
sacroiliac joint
Mesoappendix 阑尾系膜

Triangular mesentery－
extends from terminal
part of ileum to appendix

Appendicular artery runs in
free margin of the
mesoappendix
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 韧带
Ligaments of liver

Falciform ligament of
liver
镰状韧带
 Consists of double
peritoneal layer
 Extends from anterior
abdominal wall
(umbilicus) to live
 Free border of the
ligament contains
ligamentum teres

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
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Phrenicosplenic ligament 膈脾韧带
Splenocolic ligament 脾结肠韧带
Ligaments of stomach
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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
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
suprahepatic spaces
左肝上前间隙
left posterior
suprahepatic 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
infrahepatic 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