Anatomy on the table - The three locations of organs in relation to the peritoneum

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来自 Universiteit Leiden 的课程

Anatomy of the Abdomen and Pelvis; a journey from basis to clinic.

302 个评分

Universiteit Leiden

Anatomy of the Abdomen and Pelvis; a journey from basis to clinic.

302 个评分

In this anatomy course you will explore the organs involved in our food digestion and discover the common causes of abdominal and pelvic pain. The latest graphics and animations will help you to find new insights and understanding of this part of the body, that has been the focus of anatomical research for centuries and presently arouses renewed scientific interest. You will explore the 3D anatomy of the organs from a basic level, providing thorough anatomical understanding, to its advanced application in surgical procedures. This course will challenge you to discover and help you to understand the anatomy of the abdomen and pelvis in all its aspects, ranging from its embryological underpinnings, via digital microscopy to gross topography and its clinical applications. The course is unique in that it continuously connects basic anatomical knowledge from the lab with its medical applications and current diagnostic techniques. You’ll get the chance to discuss anatomical and clinical problems with peers and experts in forum discussions and you will receive guidance in exploring the wealth of anatomical information that has been gathered over the centuries. Follow us on an exciting journey through the abdomen and pelvis where you digest your food but also where new life starts!

从本节课中

Knowing your peritoneal relationships

You have already learned that the bowels are not arranged symmetrically left and right. The rotation processes of the gut and its suppliers have important consequences for the peritoneal coverings of the gut and the abdominal wall. It determines why some structures lie easily accessible in the abdomen and others are more hidden away. In this week you will get a grip on difficult concepts as 'intraperitoneal' and 'retroperitoneal'. It is also a starter week about abdominal surgery. You will also learn a secret: The best way to mobilize the abdominal and pelvic organs is to separate what got adhered when the patient was just an embryo! Please feel free to dive into these embryonic matters and enjoy all the twists and turns!

Why bother about the peritoneum4:35

What makes understanding the peritoneum so difficult4:45

The relation of the peritoneum to the gut6:19

Locations of the intestines in relation to the peritoneum7:03

Anatomy on the table - The three locations of organs in relation to the peritoneum4:32

Peritoneal terminology: Introduction1:53

与讲师见面

Marco De Ruiter, PhD
Professor of Clinical and Experimental Anatomy
Leiden University Medical Centre
Paul Gobée, MD
Assistent professor of Anatomy
Leiden University Medical Centre
Beerend P. Hierck, PHD.
Associate professor of developmental biology
Leiden University Medical Center
Daniël Jansma, MSc
E-Learning developer
Leiden University Medical Centre
Bas Boekestijn, MD
Trainee Radiology
Leiden University Medical Centre
Friso Jansen
Drs.
Leiden University Medical Centre

The peritoneum is very complex structure.

Why should we in fact, bother about it?

Well, that's because it determines the, let's say the geography of the abdomen.

The peritoneum determines where we find the structures,

which structures you can see when you open the abdomen,

which structures you cannot see, which structures are easily accessible or

less easily accessible, and it forms a kind of compartmentation of the abdomen.

I'm going to show this in this video.

Here you see the abdomen, with the abdominal wall removed.

The first thing you will see, is very clearly visible is this large omentum.

In fact, that's already a part of the peritoneum.

If I lift that large omentum, You'll

see I'll automatically lift up the transverse colon [COUGH], sorry.

And it's mobile.

The same holds for the small bowel,

that I can hold like this and move around like this.

You see that it's connected to the back wall,

via this entry, that's a double layer of peritoneum.

It's in fact peritoneum layer, moving like this, and

surrounding the bowel and returning here.

And that causes that this bowel is very mobile, and I can rightly see it.

While this position, was peritoneum completely surrounding the bowel,

and immobile bowel is called intraperitoneal.

So that helps for the small bowel, and for the transverse colon.

Let's look at the next position.

That is, an example is here.

This is the descending colon.

You see, it looks completely different.

Nevertheless, I can see it's more or less, I can reach it.

But it's fixed to the back wall.

Well this position is named, secondary retroperitoneal.

Secondary, because it originally was intraperitoneal.

It's just adhered to the back wall.

But retroperitoneal, because it appears to be behind this

peritoneal layer, this back of the peritoneum.

So secondary retroperitoneal, it's adhered to the back wall.

But nevertheless, you can still see it.

And the third and last location of structures in relation to the peritoneum,

is primary retroperitoneal.

That are structures that have always, in the embryologic development,

were behind the peritoneal cavity.

And still remain behind the peritoneal cavity.

And these are the structures that are behind this layer that you see here.

This layer is the back of the peritoneal cavity, the back layer of the peritoneum.

And lower than that, deeper than that, you might say in the cellar,

are for instance, the large blood vessels.

The aorta, the inferior vena cava, they are hidden under this membrane,

under this peritoneum.

The kidneys, the suprarenal glands.

And I'll try to demonstrate to you where a kidney is, but you can't see it.

But I can feel it.

I can feel the kidney in here, and you might be able to see the structure

move a bit, but as you see it's really deeper down.

You might say it's in the cellar.

If I want to reach these primary retroperitoneal structures,

I have to cut the back of the peritoneum.

So there are three locations determined by the peritoneum.

It's intraperitoneal, secondary retroperitoneal,

which is attached but nevertheless visible, and

our primary retroperitoneal structures,

which are completely behind the peritoneal back whole.

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