1. The peritoneum 腹膜 山东大学医学院 解剖教研室 李振华

2. 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

3. The peritoneum 腹膜 Peritoneal cavity 腹膜腔 － the potential space between the parietal and visceral layer of peritoneum. In the mail, this is a closed cavity, but in female, there is communication with the exterior through the uterine tubes, the uterus, and the vagina

4. The peritoneum 腹膜 Function  Secretes a lubricating serous fluid that continuously moistens the associated organs  Absorb  Support viscera

5. Relationship between viscera and peritoneum Intraperitoneal viscera 腹膜内位器官 Viscera are almost totally covered with visceral peritoneum Example  Stomach  Superior part of duodenum  Jejunum  Ileum  Cecum  Vermiform appendix  Transverse and sigmoid colons,  Spleen and ovary

6. Relationship between viscera and peritoneum 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

7. Relationship between viscera and peritoneum 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  Ureter

8. Interperitoneal viscera

9. Structures which are formed by peritoneum Omentum 网膜 Mesenteries 系膜 Ligaments 韧带 Folds, recesses or pouches 皱襞，隐窝和陷凹

10. Omenta 网膜 Two-layered fold of peritoneum that connect the stomach with another viscus Lessor omentum 小网膜 Greater omentum 大网膜

11. 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.  Hepatic portal v.

12. Lessor omentum 小网膜 Omental foramen 网膜孔 Behind the right border of hepatoduodenal ligament Superior － caudate lobe of liver Inferior － superior part of duodenum Anteriorly － free border of hepatodudenal ligament Posteriorly － peritoneum covering the inferior vena cava

13. Greater omentum 大网膜 Four-layered fold of peritoneum Connects the greater curvature of the stomach and superior part of duodenum with the transverse colon. It hangs down like an apron in front of coils of small intestine and is folded back on itself. 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.

14. Lessor omentum Greater omentum Lesser omentum

15. Omental bursa 网膜囊 Position － lies behind the lesser omentum and stomach Walls Superiorly － peritoneum which covers the caudate lobe of liver and diaphragm Anteriorly － formed by lesser omentum, peritoneum of posterior wall of stomach, and anterior two layers of greater omentum Inferiorly － conjunctive area of anterior and posterior two layers of greater omentum Posteriorly － formed by posterior two layers of greater omentum, transverse colon and transverse mesocolon, peritoneum covering pancreas, left kidney and suprarenal gland

16. Omental bursa 网膜囊 Left  Spleen  gastrosplenic ligament 胃脾韧带  splenorenal ligament 脾肾韧带 Right － omental foramen Communication The Omental bursa (lesser sac) communicates with the greater sac through the omental foramen.

17. Mesenteries 系膜 Two-layered fold of peritoneum connecting part of the intestines with the posterior abdominal wall

18. Mesenteries 系膜 Mesentery 肠系膜 Two-layered fold of peritoneum suspends the small intestine from the posterior abdominal wall Broad and a fan-shaped Radix of mesentery  15 cm long  Directed obliquely from left side of L2 to in front of right sacroiliac joint Intestinal border － folded, 7 m long

19. Mesenteries 系膜 Mesoappendix 阑尾系膜 Triangular mesentery － extends from terminal part of ileum to appendix Appendicular artery runs in free margin of the mesoappendix

20. Mesenteries 系膜 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

21. Ligaments 韧带 Two-layered folds of peritoneum that connect the lesser mobile solid viscera with the abdominal walls

22. 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 ligament site of ligamentum teres

23. Ligaments of liver Coronary ligament 冠状韧带 Bare area of live 肝裸区 Left and right triangular ligaments 左、右三角韧带 Hepatogastric ligament 肝胃韧带 Hepatoduodenal ligament 肝十二指肠韧带 Ligamentum teres hepatis 肝圆韧带

24. Ligaments of spleen Gastrosplenic ligament 胃脾韧带 － a double layer of peritoneum that 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

25. 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

26. 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 frequently lies

27. Folds and recesses of posterior abdominal wall 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

28. Folds and fossas of anterior abdominal wall Median 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

29. 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

30. Peritoneal cavity subdivisions The transverse colon and transverse mesocolon divides the greater sac into: Supracolic compartment 结肠上区 （ s ubphrenic space 膈下间隙 ） － lies between diaphragm and transverse colon and transverse mesocolon Infracolic compartment 结肠下区 － lies between transverse colon and transverse mesocolon and pelvic inlet

31. Supracolic compartments 结肠上区 Suprahepatic space 肝上间隙 Right suprahepatic space 右肝上间隙  Right anterior suprahepatic space 右肝上前间隙  Right posterior suprahepatic space 右肝上后间隙  Bare area of live 肝裸区 Left suprahepatic space 左肝上间隙  Left anterior suprahepatic space 左肝上前间隙  Left posterior suprahepatic space 左肝上后间隙

32. Supracolic compartments 结肠上区 Infrahepatic space 肝下间隙 Right infrahepatic spacees 右肝下间隙 (hepatorenal recess 肝肾隐窝 ) Left infrahepatic space 左肝下间隙  left anterior infrahepatic space  left posterior infrahepatic space

33. Infracolic compartments 结肠下区 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 left phrenicocolic ligament, a fold of peritoneum that passes from the colic flexure to the diaphragm.

34. Infracolic compartments 结肠下区 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。