Peritoneal cavity - basic anatomy of peritoneum (with notes)

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sheril kp

you can download the notes from here Anatomy of peritoneum is simple to understand if students know the basics of abdominal cavity. The peritoneal cavity is divided into lesser sac and greater sac. The connection between the two is epiploic foramen. In the anatomy of peritoneal cavity, peritoneum is divided into parietal peritoneum and visceral peritoneum. Peritoneal folds are peritoneum that hangs from abdominal wall to enclose an organ. Lesser omentum and greater omentum are examples of it. Peritoneum secretes a serous fluid called peritoneal fluid for the smooth movement of organs inside the abdominal cavity. Ligaments of peritoneum are folds of peritoneum that connects two organs like gastrosplenic ligament and gastrophrenic ligament. Retroperitoneal organs are organs not covered by peritoneum and intraperitoneal organs are organs covered by peritoneum. these are of medical important during the surgery.

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Video Transcript:

Hello students welcome to this new lecture today we are going to start abdomen in that our first topic is very prone him and peritoneum empty my name is dr. Mohammed Cheryl KP so let's get started what is peritoneum that's the first thing you need to know what is peritoneum and why you want to study it ok what's the importance of peritoneum so what is basically you know the largest body cavity in human body is Abdominal cavity okay this is it one second so this is diaphragm this is pretty big in the filter this is anterior abdominal wall this is posterior abdominal wall so all these includes the abdominal cavity so what is Pitkin peritoneum is a membrane that covers the abdominal cavity like this okay so peritoneum is a membrane that covers the abdominal cavity so why is it important why you want to study so peritoneum is a membrane that covers the Abdominal cavity okay what's the purpose of this peritoneum you know the abdominal cavity is not like what you see here this is the cavity but it has so many organs large and small organs like major part will be coming the liver then we have stroma keester the Ordnance jejunum ileum okay large intestine kidney suprarenal gland pancreas spleen all these organs will be the in this cavity abdominal cavity so Having these organs some organs has to move inside this cavity but some should be fixed for example the stomach duodenum jejunum ileum : these all are involved in peristalsis very styluses means when we eat something it has to go through our use of our stomach or this way okay absorption takes place in different parts of this GI t so peristalsis helps this food to move forward so it helps in digestion and absorption so some of These organs has to move inside but some should be fixed they don't have to inside so how it is possible okay there comes to importance of peritoneum peritoneum helps fixing some organs and helping some organs to move inside this abdominal cavity also restricting their unwanted moments also so that's the importance of that's the main importance of peritoneum okay so let's get started into the lecture so what is patronym peritoneum is a large serous membrane Lining the abdominal cavity okay that we have already mentioned so peritoneum in histologically histologically means cellular level okay how many layers are the fourth peritoneum it has outer layer and inner layer okay it has outer layer and inner layer so outer layer which is fibrous layer okay the main purpose of this fibrous layer is it gives strength to this peritoneal membrane the inner layer that's another most important layer Which contains mesothelial cells okay why miss appearances these cells can secrete serous fluid okay Sarris fluid these cells fluid lubricates the surface so it helps in the free movement of organs inside this abdominal cavity so you're getting the points the peritoneum which has two layers one is outer and other one is inner surface outer surface view it's structural strength to this peritoneum but the inner layer which is mr. Thelen Cells which secretes this service fluid okay which is called eternal food okay these fluid these fluid helps in lubricating which means as you can see here I told you up the mini is not like it like this it is compactly arranged with all the organs so if all the organs comes in that cavity it will be closely contact okay some organs will be conducted with other so if these organs if these organs call it together that creates friction which have this Friction creates loss of tissues so in order to prevent the help of peritoneal fluid which helps in this lubricating the surface so the movement of organs between this abdominal cavity becomes mode okay you understand this okay no let's get into the next point peritoneum is in the form of a close to sack what is the SEC just this is a set okay this is a set this is close to SEC okay which so here what you see is the close To sec okay invented by number of organs so see this example this is a body ball this is anterior abdominal wall this is posterior abdominal wall we know that we have peritoneum this is about peritoneum okay so peritoneum is like a closed sack okay the parts the next point inventonator by number of organs see this is one organ okay this is mr. amines Morgan so this is one organ for example let it be strong so this is tomato sauce trauma Keys imaginator into this peritoneal cavity see okay so it's a closed sac okay in resonated by number of organs your stomach history some other organs here one another okay so these all are very funny you're getting it right okay so peritoneum is divided into three parity layer visceral layer and very common force the outer layer is a little layer inner layer is visceral layer so what is the 24 volt peritoneal fold is by which organs are Suspended which means this is a this is body wall okay see this is an organ this is the wall okay body was anteater abdominal wall opposite return you'll see from this and it up in this world which is hanging like this okay the organ is hanging like this so this is called fold a very tonal fold by which organs on sustainable let's see this example so this is abdominal wall this is Victoria this is a tonal cavity okay this is over I mean this is a viscera or Or okay so from this posterior abdominal wall peritoneum is suspending stomach so this is called peritoneal a fold this one is we're coming for you are getting it right okay then we say two layers okay out of parity layer and in there mister layer okay suppose it's a closed set this is very funny this is also pyramid okay so this is how top which will be very cool way to me okay this is inner which will be visceral peritoneum okay in this example can you show per a Two-tier tournament visceral peritoneum this one is a little bit on you and this one it is missile peritoneum so this visceral peritoneum and / 8l peritoneum is connected by electoral fail Toni forward I'll explain to you later what is this misandry okay so I guess you understood the point okay let's get into the next job so / it will be problem which lines the inner surface of the abdomen and fill it with poor and lower surface of the referent so this is The abdominal wall this is lower surface of diaphragm this is so this is very Tanya okay so in parental petroleum the blood supply and the nerve supply ah same as those of the overlying body wall okay which means if this portion of your abdomen is even by a blood artery and it is the same artery which supplies the this portion of her a temporary problem also okay this parietal peritoneum is pain sensitive which means you can feel the pain for example if an Infection has appeared to this very tonal part you will get pain yeah because here and here the nail supply is same okay so let's discuss this diagram okay what you can see this blue line is your parietal peritoneum okay this blue line covering an organ is your whistle very cool name okay so this is particular Tanya this is a little problem can you see this this is pertinent for okay so we have multiple Organs this is liver is your stomach this is core one this is industry it's more interesting so all these organs are arranged in your peritoneal cavity plate is very preliminary okay next visceral physical in this article chromium lines the outer surface often miss around with some important so this visceral peritoneum gives blood supply and also player same as those of underling is around okay so when in organ is stretched or if quemic Ischemic means it's not getting enough blood supply and oxygen okay like you know myocardial infarction heart attack that's one kind of ischemia or if this organized distended you can feel pain okay so let us discuss the force of peer column organs are suspended by force of peritoneum okay we have discussed this before so those organs which are connected which are suspended by this false of peritoneum these organs will be mobile That can move inside this abdominal cavity on the other hand those organs which rests directly on the posterior abdominal wall which is fixed and immobile so it has no peritoneal fault it's fixed in the posterior of the mean world so it can move it can't move inside your abdominal cavity so in those organs are covered by peritoneum only on one side okay these organs are called electro very pro niall organs I'll show you one example see what is this it's the ordinal okay can you show me this is the arena see this is very funny patronum is only on the one surface what's in the opposite surface this is posterior abdominal wall so the ordinary is fixed to the posterior abdominal wall and it has electronic covering only on one side so the organ can't move inside your abdominal cavity whereas this is small indistinctly stomach this is Current so all these organs can move inside your abdominal cavity how is it that possible because of peritoneal false okay so what are the proper Khalil orphans these owners the retro means behind ok back very preliminary problem so these are organs present behind the peritoneum see this is peritoneum behind the polonium is imperium so retroperitoneal ok intraperitoneal organs means organs which are covered by peritoneum we have discussed it ok so See examples retroperitoneal organs pancreas kidney ureter Vietnam so in repair colon stomach jejunum ileum cecum appendix all these are in repertory in organs so one function of this perineum is this one for example I show you later see this is your iota okay this is your stomach this is empty so this stomach has to receive read supply so from where it receives I eternally so can do you think I oughta blood vessels can go like This if it goes like this it will be in the abdominal cavity it will be freely moving the third which can cause so many problems like a blockage can happen to this blood vessel all those problems can occur okay so what means this peritoneum is doing is anyway peritoneum is connected with these organs okay this is peritoneum so these blood vessels pass through this peritoneum okay so blood vessels pass through this peritoneum so without much of Complications these organs will receive its blood supply Nell supply and blood supply handling okay and lymphatics - okay so we are discussing patron elf old patron elf old okay so let me tell me some examples of great Connolly fault okay have you heard about recently misandry means if the patron in fault of small industry me so call on will run in full of : o Mendham patronage fault of Stomach you need to learn these names okay we will be discussing it many times so next taste ligaments of peritoneum what is ligaments of peritoneum okay ligaments of Ponemah double layer of paper tunnel fault okay that connects organ to abdominal wall or to other organs okay very clean fold we have discussed that from this abdomen it connects an organ so P ligament is double layered okay Which either connects to abdominal wall or which connects to organs okay gasps crostini recommend just from instruments please splenic mean spleen so this ligament connects stomach and spleen okay in this diagram see this one is spleen this is Strunk so the patron enfold that connecting stomach and spleen is a strong splenic ligament okay see other example is Plano Arena ligament which Connects sprain of spleen renal kidney these two okay this one is free no regional ligament okay so let's get into the next problem peritoneal cavity so what is very tunnel cavity see this is peritoneal cavity okay but we have divided this uncertainty this is a phony this one is electronic cavity we have divided this particular cavity into two okay One is lesser sac the other one is later sac okay we'll discuss little here so paternal cavities divided into two one is greater sac which is larger the other one is less subset which is smaller where is lesser sac seen which is behind stomach lesser omentum and liver okay what is lesser omentum I have told you I'm in them what is lesser omentum so omentum is patron in fault of stomach for X this is Strunk okay so strong it Has peritoneal food this is stomach's lesser curvature this is stomachs greater curvature the paranal fault that connecting the lesser curvature is lesser omentum so the peritoneum that covers the greater curvature is greater Amanda will discuss detail in another section okay so now this lesser omentum so let's search sack is seen behind stomach lesser omentum and liver okay so now we know that there is too Now we know that the paternal cavity is divided into two two which is lesser second greater sack so there is a communication between this lesser sac and greater sexy communicates each other through a point for a minute so ap blog foramen is just an opening that connects let's search static and greater sec okay I will show you this example so this is our abdominal cavity this is liver stomach column small intestine okay As we mentioned see all of this is electron in cavity which is divided into two later second letter sec see this one is letter stack okay behind the stomach and liver okay the other portion to big portion which is the greater set so I told you there is connection between in greater sac and lesser sexy this one this opening is called a pploi foramen okay so the connection between these two sac is a pre pro ik foramen otherwise known as Foramen of winslow or opening into lesser second okay see the other picture this is trans sectional picture means if you cut like this and see from here this is how you can see okay stomach this color is greater Zach this is Lester said see this opening this is a people wake foramen or foramen of Winslow okay so now let's discuss the functions of peritoneum okay what's the main function of this Patroni the main function is movement of mr. wrong which I have discussed before okay what the what it do is it gives a silvery surface for the moment of abdominal organs so if an abdominal organ has to move inside over the other organ there come in between them there will be a fluid called peritoneal fluid so it will reduce the friction while moving this okay so it also helps in various dances okay so what's the next function next function is protection of mr. Howle actually the peritoneum Contains phagocytic cells and paternal fluid contains lymphocytes do you know what is phagocytes and lymphocytes these are our white blood cells okay so this helps in fighting against the bacteria or any other antigen and the other mechanism by which this peritoneum helps in production is have you heard a good policeman of abdomen suppose this is your this is your abdomen okay you have an infection here for example you have appendicitis okay and infection histor Okay and appendix cot ruptured so what the greater omentum do is what is great reminder it is the peritoneum that covers the greater curvature of stomach okay greater omentum comes here and seal this place if it saves this place which means infection from this place can move to any other place okay so this place is contained like our lockdown situation now if you are not moving the infection can spread to other place so during this Time our immunity can come here like macrophages and other immune cells can come here and repair this infection also okay so that's why greater omentum is called policeman of abdomen okay what's the next function absorption and dialysis I have mentioned that miss Ophelia miss atheneum means petroleum has two days one is five plus and another one is Miss Ophelia cells so this means for fuel cells which is semi permeable you know semi permeable Solutes can so not the solute solvent can pass through it okay so fluid from this peritoneum can be absorbed to blood vessels through them which means if if this is your abdomen here you have some foods okay you have peritoneum here these fluids can be absorbed into this peritoneum okay and this peritoneum fold contains what I told you before blood vessels so this will be absorbed into this blood vessel and carry to our circulatory System so in that case see fluid can be administered through this route for example actually how we are administering food through IV only right okay in your hand you pick an IV line and fluid is injected into your body okay but in some extreme cases if you don't have any other Hays what you can do is you can view this fluid through your abdomen so when fluid enters into this Peritoneal cavity this fluid will be reabsorbed by the peritoneum into our circulatory system okay so what is peritoneum dialysis right now what we said is we can give fluid into the peritoneum so it will go to circulatory system think the other way from the circulatory system fluid will come into the peritoneum and from there you can take this fluid out from the body so when is it works for example you have you heard about in renal patients we are Doing the healthy straight so this is one way of doing dialysis because urea from our blood can be removed through this paper on your fruit okay that's how they are see system okay next function is storage of fat large amount of fat can be stored in returning next is healing power so the mesothelial cells I have discussed before they can transform into fibroblast cells okay this fibroblast cells can helps in healing so now let us Discuss the clinical Anatomy okay what is ascites SATC is the collection of fluid in the peritoneal cavity okay see this diagram this is our normal remain C fluid is accumulated in abdominal cavity this is called ascites so when does it occur the major causes is liver cirrhosis which usually occur in alcoholics then TB patients peritonitis TB peritonitis okay tuberculosis infection of peritoneum then congestive heart failure and cancer Affecting peritoneum chances are affecting better to mean no worse Paris and desist letters and SSS fluid from the peritoneal cavity is removed by puncturing the abdominal wall see this is the abdominal wall we are introducing a catheter and fluid from this abdominal cavity is taken out this procedure is called Aris and assistance later tonight is very connect this means infection or inflammation of this peritoneum pneumoperitoneum Pneumoperitoneum means peritoneal cavity contains air okay usually it's seen in stomach or intestinal perforation okay then what's laparoscopy that was copy is the examination of peritoneal cavity with laparoscope and peritoneal dialysis I have just discussed it with Camilla else is here that's all for today's lecture thank you

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