Institution Pending ­ Verify Your Institution

Access Provided by:

The Big Picture: Gross Anatomy

Chapter 8. Serous Membranes of the Abdominal Cavity

Peritoneum

Big Picture
The abdominopelvic cavity is lined with a serous membrane called the peritoneum. This membrane expands from the internal surface of the
abdominal wall to completely or partially surround organs of the abdominopelvic cavities.

Peritoneal Cavity
The peritoneum is a serous membrane that consists of two layers: parietal peritoneum and visceral peritoneum (Figure 8­1A–C). The parietal
peritoneum lines the internal walls of the abdominal cavity, forming a closed sac known as the peritoneal cavity. The peritoneal cavity is completely
closed in males. In females, the peritoneal cavity has two openings where the uterine tubes, uterus, and vagina provide a passage to the outside. The
parietal peritoneum reflects off of the posterior abdominal wall, forming a fused, double layer of peritoneum surrounding the blood vessels, nerves,
and lymphatics to abdominal organs. This double layer of peritoneum, known as the mesentery, suspends the jejunum and ileum from the posterior
abdominal wall. The peritoneum that surrounds the gut tube is called the visceral peritoneum. The peritoneal membranes produce a serous fluid
that lubricates the peritoneal surfaces, enabling the intraperitoneal organs to slide across one another with minimal friction.

Figure 8­1

Downloaded 2023­11­12 1:36 A Your IP is 152.58.3.66

Chapter 8. Serous Membranes of the Abdominal Cavity, Page 1 / 3
©2023 McGraw Hill. All Rights Reserved. Terms of Use • Privacy Policy • Notice • Accessibility
abdominal wall. The peritoneum that surrounds the gut tube is called the visceral peritoneum. The peritoneal membranes produce a serous fluid
Institution Pending ­ Verify Your Institution
that lubricates the peritoneal surfaces, enabling the intraperitoneal organs to slide across one another with minimal friction.
Access Provided by:

Figure 8­1

A. Sagittal section of the peritoneum and mesentery. B. Relationship of the mesentery and neurovascular supply to the intraperitoneal organs. C. Axial
(cross­section) of the peritoneum and mesentery.

Omentum
The omentum refers to modified mesenteries associated with the stomach and liver (Figure 8­1A).

Greater omentum. An apron­like fold of mesentery that attaches between the transverse colon to the greater curvature of the stomach.
Lesser omentum. Mesentery that attaches between the liver, stomach, and proximal portion of the duodenum. As a result, the lesser omentum
is also referred to as the hepatogastric ligament and hepatoduodenal ligament. The lesser omentum forms a sac known as the omental
bursa, which forms a subdivision of the peritoneal cavity known as the lesser sac. The greater sac is the remaining part of the peritoneal cavity.
The greater and lesser sacs communicate with each other through the epiploic foramen (of Winslow).

Innervation and Vascular Supply of the Peritoneum

The neurovascular and lymphatic supply of the peritoneum course to and from the posterior abdominal wall and gut tube through the two­layered
mesentery (Figure 8­1B). The vascular supply to the parietal peritoneum is through the same vessels that supply the abdominal body wall, mainly the
intercostal, lumbar, and epigastric vessels. The vascular supply to the visceral peritoneum is through vessels that arise from the abdominal
aorta. These vessels also supply the organs in the abdominal cavity.

The nerves supplying the parietal peritoneum are the same that supply the body wall (intercostal nerves). The parietal peritoneum receives somatic
sensory innervation. Somatic pain is sharp, focused, and specific. The visceral peritoneum and abdominal organs receive sensory innervation by the
visceral afferents
Downloaded that accompany
2023­11­12 1:36 A the
Yourautonomic nerves (sympathetic and parasympathetic). Visceral pain is dull, diffuse, and nonspecific.
IP is 152.58.3.66
Chapter 8. Serous Membranes of the Abdominal Cavity, Page 2 / 3
The McGraw
©2023 parietal and
Hill.visceral peritoneum
All Rights Reserved.areTerms
innervated
of Useby• Privacy
differentPolicy
modalities of sensory
• Notice neurons; that is, parietal peritoneum via somatic
• Accessibility
innervation and visceral peritoneum via visceral innervation. Therefore, pain experienced in the parietal peritoneum is sharp, focused, and specific.
In contrast, pain experienced in the visceral peritoneum is dull, diffuse, and nonspecific.
intercostal, lumbar, and epigastric vessels. The vascular supply to the visceral peritoneum is through vessels that arise from the abdominal
Institution Pending ­ Verify Your Institution
aorta. These vessels also supply the organs in the abdominal cavity.
Access Provided by:

The nerves supplying the parietal peritoneum are the same that supply the body wall (intercostal nerves). The parietal peritoneum receives somatic
sensory innervation. Somatic pain is sharp, focused, and specific. The visceral peritoneum and abdominal organs receive sensory innervation by the
visceral afferents that accompany the autonomic nerves (sympathetic and parasympathetic). Visceral pain is dull, diffuse, and nonspecific.

The parietal and visceral peritoneum are innervated by different modalities of sensory neurons; that is, parietal peritoneum via somatic
innervation and visceral peritoneum via visceral innervation. Therefore, pain experienced in the parietal peritoneum is sharp, focused, and specific.
In contrast, pain experienced in the visceral peritoneum is dull, diffuse, and nonspecific.

Organization of the Abdominal Viscera

Abdominal viscera are classified as either intraperitoneal or retroperitoneal (Figure 8­1A and C).

Intraperitoneal. Viscera that are suspended from the abdominal wall by mesenteries. Intraperitoneal organs are surrounded by visceral
peritoneum (e.g., stomach).
Retroperitoneal. Viscera that are not suspended from the abdominal wall by mesenteries. Retroperitoneal organs are covered on one of their
surfaces by parietal peritoneum (e.g., kidney).

Surgical procedures involving organs located in the retroperitoneal space can be accessed through the body wall, superficial to the parietal
peritoneum. For example, to access organs in the retroperitoneal space, such as the kidney, a lateral incision may be made through the muscles of
the body wall, leaving the parietal peritoneum intact. This approach reduces the risk of infection and peritonitis because the peritoneal cavity is not
entered.

Downloaded 2023­11­12 1:36 A Your IP is 152.58.3.66

Chapter 8. Serous Membranes of the Abdominal Cavity, Page 3 / 3
©2023 McGraw Hill. All Rights Reserved. Terms of Use • Privacy Policy • Notice • Accessibility