腹膜炎腹腔脓肿基础医学医药卫生专业资料课件.ppt

ACUTE ABSCESSE PERITONITIS  Anatomy and Physiology of the Peritoneal Cavity The peritoneal cavity is covered by a single layer of mesothelial cells on connective tissue, including collagen, elastic fibers, macrophages, and fat cells. Anatomy and Physiology of the Peritoneal Cavity The parietal peritoneum, which covers the abdominal cavity, including the anterior abdominal wall, diaphragm, and pelvis, is immediately adjacent to and reinforced by the transversalis fascia. The visceral peritoneum covers all the intraperitoneal viscera, creating a completely enclosed cavity except for the open ends of the fallopian tubes. The parietal peritoneum is innervated by both somatic and visceral afferent nerves. The peritoneum of the anterior abdominal wall is the area most sensitive to stimuli, and the pelvic peritoneum is the area least sensitive. Anatomy and Physiology of the Peritoneal Cavity Patients with abdominal pain may show tenderness to palpation of the abdomen; and if peritoneal irritation exists, they have rebound tenderness. Localized inflammation of the anterior parietal peritoneum may lead to voluntary muscle guarding. The visceral peritoneum is relatively insensitive and receives afferent innervation only from the autonomic nervous system. Stimuli from the visceral peritoneum are often poorly localized and are perceived as dull or intermittent cramping. Anatomy and Physiology of the Peritoneal Cavity The visceral afferent nerves have no receptors to mediate pain and temperature but do respond to distention, traction, and pressure. The biliary tract and mesentery have greater innervation than the small intestine. Thus, pain from the gallbladder and common duct is more accurately localized than that from the small intestine. Acute Generalized Peritonitis 1. Definition: Acute abscess peritonitis pervaded all peritoneal cavity is called acute generalized peritonitis (AGP). Peritonitis, classified as primary or spo