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Transcript of abdomen
„Selected Chapters from theCross-Sectional Anatomy
of the Human Body”
Abdominal anatomyAndrás Jakab MD, Levente István Lánczi MD
Structure of the lecture - abdomen
Bones and Muscles Abdominal aorta and its branches; veins The GIT – from esophagus to rectum Intraabdominal organs (liver, spleen, kidneys,
pancreas) Clinical cases
Bones & muscles
psoas major m.
quadratus lumborum m.
iliacus m.
diaphragm
transverse abdominal m.
intercostal mm.
transverse abdominal m.
linea alba
rectus abdominis m.
psoas major m.
quadratus lumborum m.
longissimus thoracis m.
The structure of the abdominal wall
external oblique abdominal m.
external oblique abdominal m.
Internal oblique abdominal m.
T12
L1
L2
L3
L5
Abdominal aorta and its branches
Parietal braches (paired) lumbal aa. median sacral a.
Paired, visceral branches middle suprarenal a. renal a. testicular/ovarian a.
Impaired visceral branches of abdominal aorta Impaired visceral branches
celiac tr. T12 –L1 left gastric a. splenic a.
short gastric aa. left gastro-omental artery
common hepatic a. gastroduodenal a.
right gastro-omental artery proper hepatic a.
superior mesenteric a. inferior pancreaticoduodenal a. jejunal and ileal aa. ileocolic a. right colic a. middle colic a.
Inferior mesenteric a. left colic a. sigmoid aa. superior rectal a.
a. gastrica sinistra
a. hepatica communis
tr. coeliacus
a. lienalis
Common hepatic a.
Gastroduodenal a.
Proper hepatic a.
Right gastric a.
Left gastrica a.
Superior posterior pancreaticoduodenal a.
Right and leftgastro-omental aa.
Splenic a.
Superior mesenteric arteryand its branches
Middle colic a.
Marginal artery of the colon (Drummond)
Right colic a.
Ileocolic a.
cecal & appendicular aa.
Inferior mesenteric arteryand its branches
Marginal artery of the colon (Drummond)
Left colic a.
Sigmoid aa.
Superior rectal a.
Veins
Portal vein Splenic v. Superior mesenteric v. Inferior mesenteric v.
Inferior vena cava Hepatic vv. Suprarenal v. Renal vv. Testicular/ovarian v.
T12
L1
L1
L2
L3
The Gastrointestinal Tract
Esophagus
The Stomach, Duodenum and
Pancreas
The stomach
Anatomy• cardia• fundus• body• pylorus
Arteries (celiac tr.)
• Left gastric a. (tc)
• Right gastric a. (hc)
• Left gastro-omental a. (l)• Right gastro-omental a. (gd)
• Short gastric aa. (l)
The stomach
Anatomical landmarkscardia: Th11
pylorus: L1
fundus: gastric air sac
Neighbouring structuresliver, spleen, left kidney, diaphargm, transverse colon, pancreas
DuodenumParts Superior part Superior doudenal flexure Descending part Inferior doudenal flexure Inferior part
Duodenum
Anatomical landmarkspylorus: L1
Descending part: L1-3
Neighbouring structuresliver, gall bladder, right kidney, transverse colon, pancreas head
The pancreasAnatomy parts• head
– uncinate process
• body• cauda
Ducts• major pancreatic duct• minor pancreatic duct• Vater papilla
Arteries• superior pancreatoduodenal a. (ct)
• inferior pancreatoduodenal a. (ms)
Ductsof the pancreas and the gall bladder
The abdomen
IVC
Transverse colon
Pancreas head
L5
L1
diaphragm
duodenum
jejunum, ileum
Urinary bladder
G
VP
AD
Superior mesenteric a.
R
R
Axial cross sectionTh11
A
Th11
L
G
H
VCI
LA
Axial cross sectionTh12
Th12
H
VCI
G
L
P
VP
A VL
Axial cross sectionL1
G
J
J
J
CT
CD
HVB
VCIA
AMSVP VL
P
L1
Axial cross sectionL1
HVP
VCI
L1
G
J
J
CD
CT
RD RS L
P
A
Small intestines Duodenum Jejunum Ileum Ileocoecal junction
Ileum, cecum, colon
Ileum
Colon, ascending
Appendix vermiformis
Cecum
Aperture of appendix
Ileocecal junctionIleocecal valve
Parts of Colon
appendix vermiformis
Cecum
Ascending colon
Right flexure of colon
Transverse colon
Left flexure of colon
Descending colon
Sigmoid colon
Rectum
GIT on cross sectional slices
T12
T12
L1-2
L1-2
L2
L3
L3
L4
L4
L5/S1
L5 / S1
The Liver Position
Right hypochondrium, epigastrium, left hypochondrium Upper border: 5th rib Lower border: right lower ribs
Lobes Right hepatic lobe Left hepatic lobe Quadrate lobe Caudate lobe
Ligaments: Falciform lig. Lig. teres Right and left coronal lig. Hepatorenal lig. omentum minus: lig. hepatogastricum et hepatoduodenale
Macroscopic anatomyof the liver
lobus hepatis dexter
lobus hepatis sinister
margo inferiorvesica fellea
diaphragma
lig. falciforme hepatis
lig. teres hepatis
lig. coronarium
Macroscopic anatomyof the liver
lobus hepatis sinister
lobus hepatis dexterlobus quadratus
lobus caudatuslig. coronarium
v. cava inferior
v. portae hepatis
a. hepatica propria
vesica fellea
lig. venosum
lig. teres hepatis
Vessels of the liver
Proper hepatic a.
v. portae
Choledochal duct
Vena hepatica sinistra / dextra / intermedia
VCI
Segments of the liver
Couinaud Caudate lobe: I. Left lobe
lateral: II., III. Right lobe
medial: IVa / IVb inf.: IV-V-VI sup.: VII – VIII - IX
Segments of the liver demonstrated on
IMAIOS
Gall bladder and biliary ducts
Gall bladder
Pancreatic duct
Orifice of pancreatic duct;
Major duodenal papilla
Common bile duct (biliaris)
Hepatic duct (communis)
Cystic duct
Spleen
Position: 8-11 rib;
left hypochondrium Parts:
Diaphragmatic face Gastric face Renal face Colic face hilus lienalis
Vessels Splenic a. & v.
Kidney
Parts: hilus sinus pelvis
Position: Th12-L1-2 Right kidney: lower
Vessels: Renal a. & v.
Adrenal glands: Upper pole of the kidney, inside the
adiopose capsule cortex, medulla
ureter
LeftRight VCI
AO
T12
L3
T12 – L1
L3
T12
L1
L2
Főbb képletek azonosítása
IMAIOS
L2
L3
L4
L5
S1