Abdominal Organs

7/31/2019 Abdominal Organs

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The Abdominal Organs

Functional Anatomy 212


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Overview


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Oesophagus 10 inches from pharynx to stomach

narrowat cricoid cartilage

where left bronchus crosses

oesophageal hiatus in diaphragmmucous membrane folded (normally

collapsed)

stratified squamous epithelium

striated above smooth below trachea on right,

lower aorta on left

medial to L. lung, behind left atrium


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Stomach Variable size andshape, distensible

J shaped related tobody form

Lesser and greatercurvature

gastroesophagealjunction

fundus,cardiac partbody, pyloric part

pyloric antrum andsphincter

rugae and gastricpits


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Stomach rotates and distends

Front

Back

Omentum

Dorsal

Mesentary

VentralMesentary

Splenic

tissue

Epiploic

Foramen


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Omentum


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Under the OMENTUM


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The Peritoneal cavity is divided in two

Rotation of stomach forms the greater omentum

(allows stomach distension and infection control)Omental bursa or Lesser sac is inside omentum

(a potential space)

Lesser omentum runs from stomach to liver

(note free lower border above epiploic foramen containsportal vein, hepatic artery and bile duct

Falciform ligament runs from liver to ant abd. wall


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Blood Supply of Stomach


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Superior

MesentericArtery

Territory


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Venous system

Portal Vein

Splenic vein

inferiormesenteric vein

Superiormesenteric vein

Gastric veinsHepatic Veins

Inf. Vena Cava


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Anastomoses


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Duodenum

first 12 inches of gut

four parts form C shape

duodenal cap

radiologically identified, ulcers form heremobile

descending part

pancreatic and bile ducts

horizontal partcrosses psoas, IVC and aorta

crossed by mesentery, sup mesen. art.

ascending part


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Jejunum

2/5ths of small intestine gradual transition to

ileum

many small villi

increasing numbers oflymph nodules

no submucosal glands

lacteals in each villus

columnar epithelium


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Ileum

distal 3/5ths of intestine

narrower, thinner, less vascular,

slower, more fat and arterial arcades in

mesentery than jejunum.

Peyers patches of lymphoid tissue


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Colon ascending colon

retroperitoneal

right colic or hepaticflexure

transverse colon

(mesocolon) droops towards pelvis?

left colic or splenicflexure

descending colonretroperitoneal

pelvic or sigmoid colonS shaped


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Colonoscopy

Barium

enemaoutlinesstructureson X-rays


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Appendix


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The Liver Largest Gland (one of

largest organs)

Right upper abdomenunder diaphragm

Grows as outgrowthof gut plus mesoderm

Diaphragmaticsurface

Visceral surfacedown and left

related to stomach,duodenum, r.kidney, r. colonicflexure

bears gall bladder


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Liver Largest gland (3 lbs) Location

Upper Right QuadrantMostly under ribcage

Highly vascular

Some functions produce bile

pick up glucose

detoxify poison, drugs

make blood proteinsmany others

pg 610

pg 635


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Liver: External Features

pg 635

Diaphragmatic surface

Right lobe (larger)

Left lobe

Falciform ligament

Fissure between

Visceral surface

Quadrate lobe

Caudate lobe

Both part of left lobe


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Liver:

VisceralSurface

Hepatic Vein (into inferior vena cava)

Porta HepatisHepatic Artery (from abdominal aorta )Hepatic Portal Vein

Carries nutrient-rich blood from stomach + intestines toliver

Portal system = 2 capillary beds!

He atic Ducts carr bile

pg 636


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GallbladderMuscular sac Between right +

quadrate liver lobes

Bile is stored +concentrated

Bile: breaks down fats= emulsification

Bile Produced by liver

Stored in gallbladder

pg 610


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Bile Ducts

Cystic duct carries bile from gallbladder

Hepatic duct carries bile from liver

Common Bile ductjoins cystic and hepatic

carries bile into duodenum pg 628


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Movement

of Bile

Bile secreted by livercontinuously

Hepatopancreatic

(Vater) ampulla common bile + main

pancreatic duct meetand enter duodenum

Sphincter of Oddiaround it

closed when bile notneeded for digestion

Bile then backs up into

gallbladder via cysticduct

When neededgallbladder contracts,sphincters open

pg 628


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Pancreas RetroperitonealGland

Exocrine digestive enzymes

Endocrine hormone insulin

hormone glucagon

Location

curve of duodenum extends to spleen

pg 639

Main Pancreatic


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Ducts of Pancreas

Main Pancreaticduct

joins common

bile ductenters

duodenum

Hepatopancreatic (Vater)ampulla

AccessoryPancreatic duct

entersduodenum in

other locationpg 628


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Biliary System R and L Hepatic ducts

Common hepatic duct

Joined by cystic duct (togall bladder)

Forms bile duct

(common bile duct) Gall Bladder

body and fundus,salts and water

absorbed store for bile,

released in responseto cholecystokinin


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Pancreas


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Pancreas

Head in concavity of duodenum

body across vertebrae

tail reaches the spleenpancreatic duct (+ accessory?)

ampulladuodenal papilla


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Spleen


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Spleen Largest lymphorgan

Highly vascular

Function

remove blood-borneantigens (immune)

remove and destroyold/damaged bloodcells

stores blood platelets

In fetus: site ofhematopoiesis

pg 639


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The Spleen

Lies in left hypochondriac regionbetween gastric fundus and diaphragmat level of 9th-10th rib (not normallypalpable)

Soft, friable, highly vascular, darkpurple

Diaphragmatic surface

convex and smooth facing diaphragmVisceral surface

gastric, renal, pancreatic and colic

impressions


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The Spleen (2)

Hilum of spleen long fissure throughwhich vessels and nerves pass

Suspended from stomach by

gastrolienal ligament (contains shortgastric and left gastro-epiploic branchesof spenic artery)

Suspended from posterior abdominalwall by lienorenal ligament

Covered by adherent peritoneum


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Relationship to the Spleen


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Urinary System

KidneysPurify blood

Ureters

Drain urine fromkidney to bladder

Urinary Bladder

Store urineUrethra

Drain urine frombladder to outside body pg 5


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Kidneys: major excretory organs

Remove toxins, metabolic waste, excess H2O,ions

Urea, uric acid, creatinin

Regulates volume + makeup of blood

Maintains balance between Salts and water

Acids and bases


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Kidneys

In fat capsule

Suprarenalglandssuperiorly

Direct Arterialand venoussupply


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Kidneys: Gross Anatomy

Located superiorlumbar region

Posterior abdominal

wall (T12-L3) Retroperitoneal

Hilus

Adrenal Gland:

superomedial to kidney Renal Artery + Vein

Innervation: branchesof renal plexus

pg 648


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Kidneys External View

Artery - Vein - Ureter


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Kidney Internal Structure Renal

pyramidsbetween renalcolumns

Renal Cortex

Renalpapillae draininto minorcalix

Major calixjoin to formrenal pelvis

Ureter as

outlet


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Relationships of the Kidneys


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CLINICAL ANATOMY

Peritonitis: Inflammation of the covering of

the abdominal structures, causing rigidityand severe pain.

Acute abdomen:

Appendicitis: Inflammation of theappendix, in the lower right colon.

Cholecystitis: Inflammation of thegallbladder, causing severe right-sidedabdominal ain.


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Dyspepsia: The feeling of an upset stomachor indigestion.

Constipation: Having fewer than threebowel movements per week.

Gastritis: Inflammation of the stomach,

often causing nausea and/or pain.Peptic ulcer disease: Ulcers are erosions and

peptic refers to acid.

Intestinal obstruction: A single area of thesmall or large intestine can become blockedVomiting and abdominal distension are

symptoms.

G i Th h i l l


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Gastroparesis: The stomach empties slowlydue to nerve damage from diabetes or other

conditions. Nausea and vomiting aresymptoms.

Pancreatitis: Inflammation of the pancreas.Alcohol and gallstones are the most commoncauses of pancreatitis. Other causes includedrugs and trauma; about 10% to 15% of casesare from unknown causes.

Hepatitis: Inflammation of the liver, usuallydue to viral infection. Drugs or immunesystem problems can also cause hepatitis.


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Cirrhosis: Scarring of the liver caused bychronic inflammation. Heavy drinking or

chronic hepatitis are the most common causes.Ascites: Abdominal fluid buildup often

caused by cirrhosis.

Abdominal hernia: A weakening or gap in theabdominal fascia allows a section of theintestine to protrude.

Abdominal aortic aneurysm: A weakening ofthe aorta's wall creates a balloon-likeexpansion of the vessel that grows over years.

Abdominal Organs

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