8/3/2019 Anatomy Review1

1/4

AnatomyReviewAlessandroMotta,UVVGMed.EnglishClass

***NOTICE:Icantexplainyouguystheentireanatomy,soIwillfocusonsomeargumentsIsupposetobe

moredifficultthanotherandmorespecifically,alsofrommypointofviewtheseargumentscouldbemoredangerousduringtheoralphaseofourexam,andourteacherlovestomakesometrickyquestions

PeritoneumandPeritonealCavity

Fromthebeginning:

Thearrangementoftheperitoneumandtheformationofthebursaeandofsomeligamentscanbeexplained

bytheembryologicaldevelopmentofthiscomplicatedserousmembrane

AsamatterofactinuterotheGItractisasingletubesuspendedinthecoelomicareabyventralanddorsal

mesenteries

Ittwistsandpullsthemesenterieswhileinthemeantimesomeorgans(e.g.liver,spleen)aregrowing

upfast,asaresultwegetthegreaterandlesser

omentumandtheomentalbursae. Inthispictureitis

easiertounderstand

howthemidgutwill

becometheproximal

colon,theduodenum

andthejejunum

8/3/2019 Anatomy Review1

2/4

Thesepicturesareheretoexplaintherotationoftheforegutandhowthe

peritoneumchangesBelowyoucanlookatthedevelopingphaseoftheliver

(RED)andthespleen(violet).Thearrowinthelastpictureshowstheformation

ofthelesseromentum.

Letsmoveontothecomplicatedarrangementoftheperitoneumandits

connectionsInthesepicturesbelowyoucanappreciatehowthelessersacis

formed(greenzone)andtheconnectionsofthelesseromentum(liver-

stomach)andtheformationofthegreateromentum(thegastro-colicligament,

showninthearrow).Betweenthetransversecolonandthepancreas(down

andrightpositioned)wefindalsotheformationofthetransversemesocolon,

adherenttothegreateromentum.

8/3/2019 Anatomy Review1

3/4

TheperitoneumoftheUpperAbdomengivesraisesto:*Takealooktoapictureontheatlasoryouwontbeabletorecognizethem

Falciformligament Coronaryligaments Lesseromentum(gastro-hepaticligamentandhepato-

duodenalligament)

Greateromentum,includinggastro-colicligament) Gastro-splenicligament Spleno-renalligament Phreno-colicligament

Onestepbackwardandfinalreview:

1.Theperitoneumisathinserousmembranequitesimilartothepleuralone

2.Itprovidesacontinuesliningfortheabdominalpelviccavity

3.Itisdividedinparietalandviscerallayer(theyarecontinuous!)

4.Thoseorganswhoarevirtuallyfreewithintheabdominalcavityareconnectedtothewallofthe

cavitybyadoublesheetofperitoneum(e.g.small

intestine)inwhichtheirbloodvesselsrun=

MESENTERIESforsmallintestine,MESOCOLONfor

colonofcourse!

5.WhatarethesesocalledOmentae?!Briefly:thesearedoublelayersofperitoneumseparatedbyavariable

amountofconnectivetissue

6.Thelesseromentumisderivedfromtheventralmesogastriumasabovementionedandrunsfromthe

inferiorsurfaceofthelivertothesuperiorportionsof

thestomach(lessercurvature),esophagus,pylorusand

firstduodenaltract.Therightlateralborderofthe

lesseromentumisthickenedandextendsfromthe

duodenumtotheportahepatis,givingtheonlyrealaperturetothelessersac:theEpiploicforamen

8/3/2019 Anatomy Review1

4/4

7.Thegreateromentumhangsinferiorlytothegreatercurvatureofthestomach(anteriorsheet);thissac

descendsavariabledistanceintotheperitonealcavity

andtheposteriorsheetattachestotheposterior

abdominalwall,continuouslywiththetransvers

mesocolon.(Infetallifetheselayersareseparated,they

fuseasasecondaryarrangement)

8.TheLiverisalmostcoveredbytheperitoneum,exceptedabareareamadeofareolartissue(fromthe

sub-phrenicspacetothesuprarenalgland)

9.Coronaryligament:fromthediaphragmtotheposteriorsurfacesoftherightlobeoftheliver

10.TheSpleenissuspendedintheleftupperquadrantoftheabdomenbyafewconnections

11.Thegastro-spleenligamentrunsfromthegreatercurvatureofthestomach,thensplititselfhislayersto

enclosethespleenandthenrejointoformthe

splenorenalandthephrenocolicligament

GuysImsorryifIcantsummarizemoretheargumentbuttheconnectionsoftheinternalorgansarenotsocomplicated,

theyjusthavetobestudiedonebyone,andorganbyorgan...

maytheforcebewithyouprobablyIllmakesomemore

reviewstoniteoreventomorrow

Yourbelovedcolleague,

AlessandroMotta