Description: The pelvis is covered internally with a thin,
translucent, serous peritoneal membrane, continuous with that of
the abdominal cavity. It is described as either parietal or visceral,
depending on the underlying structures. The vesical peritoneum anteriorly
is hardly noticeable unless the
bladder is filled, and when it is, it remains an extra-peritoneal
organ covered by parietal peritoneum. Thus, the inferior-most portion
of the vesicouterine pouch represents the anterior junction of the parietal
and visceral parts. As the membrane drapes upward anteriorly over the
uterus, round ligaments, and uterine
tubes, it invests these organs with visceral peritoneum. Posteriorly,
these organs and their ligamentous structures continue to be covered by
visceral peritoneum as it drapes abruptly medially and continues downward
to the uterine cervix. There, it becomes parietal p., covering the
sacrouterine ligaments which form as a condensation of endopelvic fascia
posterolaterally to the cervix, and between them. As it reaches the rectum,
the now visceral p. is reflected upward and circumferentially, covering
the upper half of the rectum and sigmoid colon, and forming their respective
mesentaries posterolaterally. The 'broad ligament', actually a mesentery
adjacent to the uterus laterally on either side, is comprised of anterior
and posterior parietal peritoneum, with vessels between. Only the ovaries
remain without peritoneum. The small mesentery for the uterine tube is
called the mesosalpinx, and that for the ovary, the mesoovarium. During
pregnancy, the peritoneal sac is greatly distorted as the body and fundus
grow and distend upward, carrying the adnexa and adjacent structures with
them. |