Body Cavities & Membranes

Handout to Medical Students

Melaku Geletu (MSc)
Intraembryonic coelom
• Early in the fourth week, appears as a horseshoe-shaped cavity
– Curve or bend at the cranial end represents the future pericardial cavity
– Limbs indicate the future pleural and peritoneal cavities.

• Distal part of each limb is continuous with the extraembryonic coelom

– Midgut normally herniates through this communication into the umbilical cord,
where it develops

• During embryonic folding in the horizontal plane, the limbs of the

coelom are brought together on the ventral aspect of the embryo
Embryonic Body Cavity
• Develops from intraembryonic coelom
• Intraembryonic coelom is divided into three cavities during the
fourth week
– A pericardial cavity
– Two pericardioperitoneal canals
– A peritoneal cavity

• These cavities have a parietal wall lined by mesothelium and a

visceral wall covered by mesothelium
Mesenteries
• A mesentery is a double layer of peritoneum that connects the
organ to the body wall and conveys vessels and nerves to it

• There are two types: dorsal & ventral mesenteries

• Transiently, they divide the peritoneal cavity into right and left halves

• Ventral mesentery
– Soon disappears, except where it is attached to the caudal part of the
foregut (primordium of stomach and proximal part of duodenum)

– Peritoneal cavity then becomes a continuous larger space

Division of the Embryonic Body Cavity
• Pericardioperitoneal canal (right & left)

– Lies lateral to the proximal part of the foregut and dorsal to the
septum transversum

– Partitions form in each canal

• Pleuropericardial fold – separates pleural from pericardial cavities

• Pleuroperitoneal fold – between pleural & peritoneal cavities

Division of the Embryonic Body Cavity
• Pleuropericardial folds
– A pair of membranous ridges is produced in the lateral wall of each
pericardioperitoneal canal

– Forms because of the growth of the bronchial buds into the canals

– As they enlarge, they form partitions that separate the pericardial cavity from the
pleural cavities

– Contain the common cardinal veins & phrenic nerves

– Becomes thinner as a result of expansion of the pleural cavities –

pleuropericardial membrane
Pleuropericardial Membranes
• They soon grow laterally into the pericardioperitoneal canals
• As the primordial pleural cavities expand ventrally, they split the mesenchyme into:
– An outer layer that becomes the thoracic wall
– An inner layer (pleuropericardial membrane) that becomes the fibrous pericardium
• Primordial mediastinum
– Consists of a mass of mesenchyme that extends from the sternum to the vertebral column
– Pleuropericardial membranes fuse with it, separating the pericardial cavity from the pleural
cavities
• The right pleuropericardial opening closes slightly earlier than the left one and produces a
larger pleuropericardial membrane
Pleuroperitoneal Membranes
• As the pleuroperitoneal folds enlarge, they project into the pericardioperitoneal
canals.
• They become membranous, forming the pleuroperitoneal membranes
• Initially they are attached to the:
– Dorsolaterally – abdominal wall
– Crescentic free edges project into the caudal ends of the pericardioperitoneal canals.
• Extend ventromedially & fuse with the dorsal mesentery of the esophagus and
septum transversum
– Separate the pleural cavities from the peritoneal cavity

• The pleuroperitoneal opening on the right side closes slightly before the left one
Development of the Diaphragm
• Diaphragm is a dome-shaped, musculotendinous partition that
separates the thoracic and abdominal cavities

• It is a composite structure that develops from four embryonic

components:

– Septum transversum

– Pleuroperitoneal membranes

– Dorsal mesentery of esophagus

– Muscular ingrowth from lateral body walls

Septum Transversum
• Transverse septum that is composed of mesodermal tissue

• It is the primordium of the central tendon of the diaphragm

• Grows dorsally from the ventrolateral body wall and forms a semicircular shelf

• At the end of the third week, it is located cranial to the pericardial cavity

• After the head folds, it forms a thick incomplete partition between the
pericardial and abdominal cavities

• Expands and fuses with the dorsal mesentery of the esophagus and the
pleuroperitoneal membranes
Pleuroperitoneal Membranes
• Fuse with the dorsal mesoesophagus and the septum transversum
– Forms the primordial diaphragm by completing the partition

• Grow until they fuse with each other and completely cover the septum
transversum

• Serves as a scaffold and guide for migrating myoblasts

• Form large portions of the early fetal diaphragm & small portions of the
newborn's diaphragm
Dorsal Mesentery of the Esophagus
• Fuse with the septum transversum and pleuroperitoneal
membranes

• Constitutes the median portion of the diaphragm

• Crura of the diaphragm

– Develop from myoblasts that grow into the dorsal mesentery of the
esophagus.
Muscular Ingrowth from Lateral Body Walls
• When burrows into the lateral body walls:
– Splits body-wall tissue into two layers:
• An external layer – becomes part of the definitive abdominal wall

• An internal layer – contributes to peripheral parts of the diaphragm

– Forms the right and left costodiaphragmatic recesses

• Establishes the characteristic dome-shaped configuration of the diaphragm.
Positional Changes & Innervation of Diaphragm
• Before head fold, septum transversum lies opposite the 3rd – 5th cervical somites

– Myoblasts from C3 – C5 somites migrate into the developing diaphragm

• Differentiate into the skeletal muscle of the diaphragm

– Phrenic nerves arise from the ventral primary rami of C3 – C5 spinal nerves

• Head fold

– Diaphragm descends from the cervical level to the thoracic level

– Phrenic nerves lengthens & have a descending course

• Phrenic nerves in the embryo passes through the pleuropericardial membranes

– Phrenic nerves subsequently lie on the fibrous pericardium in adult

Positional Changes & Innervation of Diaphragm
• Innervation of diaphragm
– Motor innervation – phrenic nerve

– Sensory innervation
• Superior and inferior surfaces of the central tendon – phrenic nerve

• Peripheral part – lower thoracic intercostal nerves

– These part is derived from the lateral body wall

Ventral body wall defects
• Occur in the thorax, abdomen, and pelvis and involve the heart
• The cause is failure of the fusion of the lateral body folds
• These include:
– Heart – ectopia cordis
– Abdominal viscera – gastroschisis
– Urogenital organs – bladder or cloacal exstrophy
– Omphalocele – cause = failure of return of the mid gut after
physiological herination
Body wall defects
• Ectopia cordis
– The heart lies outside the body cavity

– Occurs when lateral body wall folds fail to close the midline in the
thoracic region

• Cantrell pentalogy
– Ectopia cordis, defects in the anterior region of the diaphragm,
absence of the pericardium, defects in the sternum, and abdominal
wall defects (omphalocele and gastroschisis)
Ventral Body wall defects
• Gastroschisis
– Occurs when body wall closure fails in the abdominal region

– Intestinal loops herniate into the amniotic cavity through the defect,
which usually lies to the right of the umbilicus

– The structures are not covered by the amnion

Ventral Body wall defects
• Bladder or cloacal exstrophy
– Results from abnormal body wall closure in the pelvic region

• Bladder exstrophy
– Only the bladder is exposed

– In males, the dorsum of the penis may split (epispadias)

• Cloacal exstrophy
– Both bladder and rectum are exposed
Ventral Body wall defects
• Omphalocele
– Causes
• Failure of return of the midgut to the abdominal cavity after physiological
umbilical herination – the main cause

• Failure in body wall closure

– Loops of bowel, and other viscera, may herniate into the defect

– The defect is covered by this epithelial layer of the amnion

Congenital diaphragmatic hernia
• Protrusion of the abdominal structures into the thoracic cavity

• Causes
– Weak area of diaphragm because of the failure of migration of the
myoblasts into the pleuroperitoneal membranes

• Failure of the fibroblasts to provide scaffolding and/or guidance cues

– Shortness of the foregut as a result of the failure to form the mesentery

• Eighty-five percent to 90% of severe defects occur on the left side

– May be because of the earlier closure of the right pleuroperitoneal canal
Congenital diaphragmatic hernia
• It may result in hypoplasia of lungs
– Because it occupies the space

– Hypoplasia of lungs results in polyhydramnios & death of the

newborn

• Less severe forms of the diaphragmatic hernia

– Retrosternal (Parasternal) Hernia

– Congenital Hiatal Hernia – because of the shortness of the foregut

Eventration of Diaphragm
• Half the diaphragm balloons into the thoracic cavity as an membranous
sheet, forming a diaphragmatic pouch

• There is superior displacement of abdominal viscera into the pocket-

like outpouching of the diaphragm

• Cause – failure of muscular tissue from the body wall to extend into the
pleuroperitoneal membrane on the affected side