The peritoneum 腹膜

山东大学医学院 解剖教研室李振华

General features The peritoneum is a thin serous membran

e 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

Peritoneal cavity 腹膜腔－ the potential space between the parietal and visceral layer of peritoneum, in the mail, 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 Secretes a lubricating

serous fluid that continuously moistens the associated organs

Absorb Support viscera

The relationship between viscera and peritoneum Intraperitoneal viscera 腹膜内位器官－ viscera completely surrounded by peritone

um, example, stomach, superior part of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen and ovary

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 and uterus

Retroperitoneal viscera 腹膜外位器官－ some organs lie on the posterior abdominal wall and 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, and ureter

Intraperitoneal viscera

Interperitoneal viscera

Retroperitoneal viscera

Interperitoneal viscera

Structures which are formed by peritoneum Omentum 网膜 －

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

Lessor omentum 小网膜 － two-layered fold of peritoneum which extends from porta hepatis to lesser curvature of stomach and superior part of duodenum

Hepatogastric ligament 肝胃韧带－ extends 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

Contains common bile duct, proper hepatic a. and hepatic portal v.

Omental foramen 网膜孔 Behind the right border of he

patoduodenal ligament Superior － caudate lobe of li

ver Inferior － superior part of du

odenum Anterior － hepatodudenal lig

ament Posterior － peritoneum cove

ring the inferior vena cava

Greater omentum 大网膜 － four-layered fold of peritoneum,

the anterior two layers descend from the greater curvature of stomach and superior part of duodenum and hangs down like an apron in front of coils of small intestine, and then turns upward and attaches to the transverse colon. If an infection occurs in the intestine, plasma cells formed in the lymph nodes combat the infection and help prevent it from spreading to the peritoneum.

Lessor omentum

Greater omentum

Omental bursa 网膜囊Position － situated behind the lesser oment

um and stomachWalls Superior － peritoneum which covers th

e caudate lobe of liver and diaphragm Anterior － formed by lesser omentum,

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

Inferior － conjunctive area of anterior and posterior two layers of greater omentum

Posterior － formed by posterior two layers of greater omentum, transverse colon and transverse mesocolon, peritoneum covering pancreas, left kidney and suprarenal gland

Left － formed by the spleen, gastrosplenic ligament 胃脾韧带 and splenorenal ligament 脾肾韧带

Right － formed by omental foramen

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

Mesenteries or mesocolons －two-layered fold of peritoneum that attach part of 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 Consists of two peritoneal la

yers Intestinal border － folded, 7

m long Radix of mesentery

15 cm long Directed obliquely from left

side of L2 to in front of right sacroiliac joint

Mesoappendix 阑尾系膜 Triangular mesentery － e

xtends 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－ inverted V-shaped, with apex located in front of left ureter and division of common iliac artery

Ligaments 韧带 －two-layered folds of peritoneum that attached the lesser mobile solid visera to the abdominal wall

Ligaments of liver Falciform ligament of liver

镰状韧带 Consists of double peritoneal l

ayer Extends from anterior abdomin

al wall (umbilicus) to live Free border of ligament site of l

igamentum teres

Coronary ligament 冠状韧带－ the area between upper and lower parts of the coronary ligament is the bare area of live, this area is devoid of peritoneum and lies in contract with the diaphragm

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

Hepatogastric ligament 肝胃韧带

Hepatoduodenal ligament 肝十二指肠韧带

Ligamentum teres hepatis 肝圆韧带

Ligaments of spleen Gastrosplenic ligament 胃脾韧带－ a double layer of peritoneum tha

t connects the fundus of stomach to hilum of spleen. In this double layer of peritoneum are the short gastric and left gastroepiploic vessels

Splenorenal ligament 脾肾韧带－ extends between the hilum of spleen and anterior aspect of left kidney. The splenic vessels lies within this ligament, as well as the tail of pancreas

Phrenicosplenic ligament 膈脾韧带 Splenocolic ligament 脾结肠韧带

Ligaments of stomach 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 Gastropancrestic ligament 胃胰韧

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－ formed by the inverted V attachment of 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 (median umbilical ligaments)

Medial umbilical fold 脐内侧襞－ contains remnants of the umbilical arteries (medial umbilical ligaments)

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

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 In male － rectovesical

pouch 直肠膀胱陷窝 In female

Rectouterine pouch 直肠子宫陷窝－ between rectum and uterus

Vesicouterine pouch 膀胱子宫陷窝－ between bladder and uterus

Peritoneal subdivisionsThe transverse colon and transverse

mesocolon divides the greater sac into supracolic and infracolic compartments.

Supracolic compartments 结肠上区 (subphrenic space) － lies between diaphragm and transverse colon and transverse mesocolon

Suprahepatic recess 肝上间隙 lies between the diaphragm and live－ the falciform ligament divides it into right and left suprahepatic recesses

Left suprahepatic recesses 左肝上间隙 left anterior suprahepatic

spaces left posterior suprahepati

c spaces Right suprahepatic re

cesses 右肝上间隙 right anterior suprahepati

c spaces right posterior suprahepat

ic spaces bare area of live (extrape

ritoneal space)

Infrahepatic recess 肝下间隙 lies between the live and tra

nsverse colon and transverse mesocolon － the ligamentum teres hepatic divides it into right and left infrahepatic recesses

Right infrahepatic recesses 右肝下间隙 (hepatorenal recess)

Left infrahepatic recesses 左肝下间隙 left anterior infrahepatic space left posterior infrahepatic space

Infracolic compartments 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. It provides a route for the spread of infection between the pelvic and the upper abdominal region.

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, a fold of peritoneum that passes from the colic flexure to the diaphragm.

Right mesenteric sinus 右肠系膜窦－ triangular space, lies between root of mesentery, ascending colon, right 2/3 of transverse colon and transverse mesocolon

Left mesenteric sinus 左肠系膜窦－ lies between root of mesentery, descending colon, right 1/3 of transverse colon and transverse mesocolon, its widens below where it is continuous with the cavity of the pelvis

上下流通，左沟不畅，右窦封闭，左入盆腔。