ABDOMINAL CAVITY. Peritoneal Cavity Greater omentum Extends from greater curvature of stomach to...

ABDOMINAL CAVITYABDOMINAL CAVITY

Peritoneal CavityPeritoneal Cavity

Greater omentumGreater omentum

Extends from greater curvature of Extends from greater curvature of stomach to posterior abdominal wall.stomach to posterior abdominal wall.

Apron-like fold covering transverse Apron-like fold covering transverse colon and small intestine.colon and small intestine.


Lesser omentumLesser omentum

Extends from lesser curvature of Extends from lesser curvature of stomach to liver.stomach to liver.

Includes:Includes:

Hepatogastric ligament.Hepatogastric ligament.

Hepatoduodenal ligament.Hepatoduodenal ligament.


MesenteriesMesenteriesMesentery proper attaches to small Mesentery proper attaches to small intestine from duodenojejunal flexure intestine from duodenojejunal flexure to to ileocecal junction.ileocecal junction.

Composed of two layers of Composed of two layers of peritoneum:peritoneum:

Enclose blood vessels and nerves Enclose blood vessels and nerves to jejunum and ileum.to jejunum and ileum.


Other mesenteries:Other mesenteries:

Transverse mesocolon.Transverse mesocolon.

Sigmoid mesocolon.Sigmoid mesocolon.

LiverLiver

Largest visceral organ in body.Largest visceral organ in body.Lies mostly in upper right portion of Lies mostly in upper right portion of

abdominal cavity.abdominal cavity.Encased in fibrous capsule and covered Encased in fibrous capsule and covered

by visceral peritoneum except:by visceral peritoneum except:Bare area:Bare area:

In contact with underside of In contact with underside of diaphragm.diaphragm.

LiverLiver

Surfaces:Surfaces:

Diaphragmatic.Diaphragmatic.

Visceral.Visceral.

Inferior.Inferior.

Lobes:Lobes:

Right:Right:

Largest.Largest.

Left.Left.

Caudate.Caudate.

Quadrate.Quadrate.

LiverLiver

Porta hepatis:Porta hepatis:Transverse fissure separating caudate and Transverse fissure separating caudate and quadrate lobes.quadrate lobes.Transmits:Transmits:

Right and left hepatic ducts.Right and left hepatic ducts.Right and left hepatic arteries.Right and left hepatic arteries.Right and left branches of portal vein.Right and left branches of portal vein.Autonomic plexus and lymphatics.Autonomic plexus and lymphatics.

GallbladderGallbladder

Relationship to liver:Relationship to liver:

Lies between quadrate and right lobe.Lies between quadrate and right lobe.

Pear-shaped organ.Pear-shaped organ.

Function:Function:

Store and concentrate bile.Store and concentrate bile.


Duct system:Duct system:

Common hepatic duct:Common hepatic duct:

From union of right and left From union of right and left hepatic ducts of liver.hepatic ducts of liver.

Accompanied by portal vein and Accompanied by portal vein and proper hepatic artery.proper hepatic artery.


Duct system:Duct system:Cystic duct:Cystic duct:

Connects common hepatic duct to Connects common hepatic duct to gall bladder.gall bladder.

Common bile duct:Common bile duct:Formed by union of common hepatic Formed by union of common hepatic duct and cystic duct.duct and cystic duct.Opens into duodenum with main Opens into duodenum with main

pancreatic duct.pancreatic duct.

StomachStomach

Located in epigastric and left hypochondriac Located in epigastric and left hypochondriac regions.regions.

Regions:Regions:Lesser curvature.Lesser curvature.

Short concave right border.Short concave right border.Attached to lesser omentum.Attached to lesser omentum.

Greater curvature:Greater curvature:Long convex left border.Long convex left border.Attached to greater omentum.Attached to greater omentum.

StomachStomach

Regions (cont.):Regions (cont.):Cardiac:Cardiac:

Adjacent to junction with Adjacent to junction with esophagus.esophagus.Fundus:Fundus:

Dome-shaped portion above entry Dome-shaped portion above entry of esophagus.of esophagus.

Often filled with gas.Often filled with gas.

StomachStomach

Regions (cont.):Regions (cont.):

Body:Body:

Pylorus:Pylorus:

With anatomical pyloric sphincter.With anatomical pyloric sphincter.

StomachStomach

Blood supply:Blood supply:

Left and right gastric arteries.Left and right gastric arteries.

Left and right gastroepiploic arteries.Left and right gastroepiploic arteries.

Short gastric arteries.Short gastric arteries.

Accompanying vein to portal vein.Accompanying vein to portal vein.

SpleenSpleen

Largest lymphatic organ:Largest lymphatic organ:

Develops in dorsal mesentery of stomach:Develops in dorsal mesentery of stomach:

Not an embryological derivative of gut tube.Not an embryological derivative of gut tube.

Location:Location:

Lies against diaphragm in left Lies against diaphragm in left hypochondriac region.hypochondriac region.

Along the long axis of ribs 9-11.Along the long axis of ribs 9-11.

SpleenSpleen

Attached to stomach by:Attached to stomach by:

Gastrosplenic ligament:Gastrosplenic ligament:

Contains:Contains:

Left gastroepiploic artery and Left gastroepiploic artery and vein.vein.

Short gastric arteries and Short gastric arteries and veins.veins.

PancreasPancreas

Location:Location:

In epigastric and left hypochondriac In epigastric and left hypochondriac regions.regions.


Branches of splenic artery.Branches of splenic artery.

Superior and inferior Superior and inferior pancreaticoduodenal arteries.pancreaticoduodenal arteries.

PancreasPancreas

Four parts:Four parts:

Head.Head.

Neck.Neck.

Body.Body.

Tail.Tail.

PancreasPancreas

Head:Head:

Lies in curvature of duodenum.Lies in curvature of duodenum.

Lies anterior to inferior vena cava.Lies anterior to inferior vena cava.

Traversed by common bile duct.Traversed by common bile duct.

Neck:Neck:

Constricted where crossed posteriorly by:Constricted where crossed posteriorly by:

Superior mesenteric artery.Superior mesenteric artery.

PancreasPancreas

Body:Body:

Triangular in cross-section.Triangular in cross-section.

Extends across midline across aorta Extends across midline across aorta and left renal vein.and left renal vein.

Tail:Tail:

Ends at hilus of spleen.Ends at hilus of spleen.

Small IntestineSmall Intestine

Duodenum:Duodenum:From pylorus to jejunum.From pylorus to jejunum.Surrounds head of pancreas.Surrounds head of pancreas.Retroperitoneal.Retroperitoneal.Begins to right of midline at level of Begins to right of midline at level of lumbar vertebra 1.lumbar vertebra 1.Ends left of midline at level of lumbar Ends left of midline at level of lumbar vertebra 2.vertebra 2.


Duodenum:Duodenum:Divided into 4 parts:Divided into 4 parts:

Not discussed here.Not discussed here.Blood supply:Blood supply:

Gastroduodenal artery via smaller Gastroduodenal artery via smaller named arteries.named arteries.

Superior mesenteric artery via Superior mesenteric artery via smaller named arteries.smaller named arteries.


Jejunum and Ileum:Jejunum and Ileum:Begins at duodenojejunal flexure in upper Begins at duodenojejunal flexure in upper left quadrant.left quadrant.Ends at ileocecal junction in lower right Ends at ileocecal junction in lower right quadrant.quadrant.Approximately 20 feet in length (8/12)Approximately 20 feet in length (8/12)Attached to posterior abdominal wall by:Attached to posterior abdominal wall by:

Mesentery of small intestine.Mesentery of small intestine.15 inches long.15 inches long.


Jejunum and Ileum:Jejunum and Ileum:

Arterial supply:Arterial supply:

Superior mesenteric artery.Superior mesenteric artery.

Venous drainage:Venous drainage:

Superior mesenteric vein.Superior mesenteric vein.

Large IntestineLarge Intestine

Cecum and Appendix:Cecum and Appendix:

Ileocecal orifice with ileocecal valve.Ileocecal orifice with ileocecal valve.

McBurney’s point:McBurney’s point:

2/3 distance from umbilicus to 2/3 distance from umbilicus to ASIS.ASIS.


Transverse Colon:Transverse Colon:

From right colic flexure (hepatic) to From right colic flexure (hepatic) to left colic flexure (splenic).left colic flexure (splenic).

Suspended by transverse mesocolon.Suspended by transverse mesocolon.


Middle colic artery from superior Middle colic artery from superior mesenteric artery.mesenteric artery.


Descending Colon:Descending Colon:

From left colic flexure to pelvic brim From left colic flexure to pelvic brim (sigmoid colon).(sigmoid colon).

Mostly covered by peritoneum but Mostly covered by peritoneum but posterior wall is fused to posterior posterior wall is fused to posterior abdominal wall.abdominal wall.


Branch from inferior mesenteric artery.Branch from inferior mesenteric artery.


Sigmoid Colon:Sigmoid Colon:

Begins at pelvic brim.Begins at pelvic brim.

Becomes continuous with rectum at Becomes continuous with rectum at sacral vertebra 3.sacral vertebra 3.

Suspended by sigmoid mesocolon.Suspended by sigmoid mesocolon.


Inferior mesenteric artery.Inferior mesenteric artery.


Rectum:Rectum:

Begins at level of sacral vertebra 3.Begins at level of sacral vertebra 3.

Follows curvature of sacrum and Follows curvature of sacrum and coccyx.coccyx.


Anal Canal:Anal Canal:Internal anal sphincter:Internal anal sphincter:

Thick ring of circular smooth muscle.Thick ring of circular smooth muscle.Surrounds upper part of anal canal.Surrounds upper part of anal canal.Controlled reflexively and involuntarily Controlled reflexively and involuntarily

by ANS:by ANS:Parasympathetic system Parasympathetic system

promotes relaxation.promotes relaxation.Sympathetic system Sympathetic system

promotes contraction.promotes contraction.


Anal Canal:Anal Canal:

External anal sphincter:External anal sphincter:

Three rings of skeletal muscle.Three rings of skeletal muscle.

Extends entire length of anal Extends entire length of anal canal.canal.

Controlled voluntarily via Controlled voluntarily via branches of pudendal nerve.branches of pudendal nerve.


Anal Canal:Anal Canal:Anal columns:Anal columns:

5-10 longitudinal folds of mucosa in upper 5-10 longitudinal folds of mucosa in upper half of canal.half of canal.

Pectinate line:Pectinate line:Marks junction between endoderm Marks junction between endoderm

portion of anal canal and portion of anal canal and ectoderm portion of anal canal ectoderm portion of anal canal (proctodeum).(proctodeum).

Marks division between visceral and somatic Marks division between visceral and somatic arterial, venous, lymphatic, and nerve arterial, venous, lymphatic, and nerve supply.supply.

Urinary SystemUrinary System

Kidneys and ureters:Kidneys and ureters:Kidneys are retroperitoneal.Kidneys are retroperitoneal.Lie against posterior abdominal wall Lie against posterior abdominal wall on either side of vertebral column.on either side of vertebral column.Generally lie adjacent to upper three Generally lie adjacent to upper three lumbar vertebrae.lumbar vertebrae.Move with movements of the Move with movements of the diaphragm.diaphragm.


Kidneys and ureters:Kidneys and ureters:

Subdivisions:Subdivisions:

Cortex.Cortex.

Medulla Medulla

with renal pyramidswith renal pyramids

PelvisPelvis

major and minor calyces (sing. major and minor calyces (sing. calyx)calyx)


Kidneys and ureters:Kidneys and ureters:Ureter is a continuation of the pelvis.Ureter is a continuation of the pelvis.

Descends retroperitoneally on the Descends retroperitoneally on the anterior surface of the psoas anterior surface of the psoas major.major.

Passes anterior to bifurcation of Passes anterior to bifurcation of common iliac.common iliac.

Renal fat.Renal fat.


Suprarenal (adrenal) glands:Suprarenal (adrenal) glands:


Right and left renal arteries:Right and left renal arteries:

Right is longer than the left.Right is longer than the left.

Right and left renal veins:Right and left renal veins:

Left is longer than the right.Left is longer than the right.


Urinary bladder:Urinary bladder:ApexApex

points anteriorly.points anteriorly.attached to umbilicus via median attached to umbilicus via median

umbilical ligament.umbilical ligament.Base:Base:

faces posteriorly.faces posteriorly.receives ureters.receives ureters.opens into urethra.opens into urethra.


Urinary bladder:Urinary bladder:

Superior surface:Superior surface:

Completely covered by Completely covered by peritoneum.peritoneum.

Muscle:Muscle:

= detrusor muscle.= detrusor muscle.




Superior and inferior vesical Superior and inferior vesical arteries from internal iliac arteries.arteries from internal iliac arteries.


Urinary bladder:Urinary bladder:Trigone:Trigone:

Smooth internal surface of Smooth internal surface of triangular base:triangular base:

Does not contract or stretch Does not contract or stretch when bladder empties and when bladder empties and fills.fills.



Trigone:Trigone:

Three openings:Three openings:

Paired ureteric orifices.Paired ureteric orifices.

Internal urethral orifice.Internal urethral orifice.


Suprarenal glands:Suprarenal glands:Lie against posterior abdominal wall on Lie against posterior abdominal wall on superior superior poles of kidneys.poles of kidneys.Arterial supply:Arterial supply:

Superior suprarenal arteries:Superior suprarenal arteries:From inferior phrenic artery.From inferior phrenic artery.

Middle suprarenal artery:Middle suprarenal artery:From abdominal aorta.From abdominal aorta.

Inferior suprarenal arteries:Inferior suprarenal arteries:From renal arteryFrom renal artery


Suprarenal glands:Suprarenal glands:Venous drainage:Venous drainage:

Right suprarenal vein to inferior Right suprarenal vein to inferior vena cava.vena cava.

Left suprarenal vein to renal vein.Left suprarenal vein to renal vein.

ABDOMINAL CAVITY. Peritoneal Cavity Greater omentum Extends from greater curvature of stomach to...

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