abdomen – 1 human structure and development 212 week 6 – 2005 avinash bharadwaj
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Abdomen – 1
Human Structure and Development 212Week 6 – 2005
Avinash Bharadwaj
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Regions of Abdomen Descriptive convenience Landmarks used
• Midclavicular lines (planes)• Transpyloric and
transtubercular planes Variation in descriptions Epigastrium, umbilical,
hypogastrium
Two each – hypochondrium, lumbar, iliac
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Peritoneum Highly complex cavity, especially in the
upper abdomen. Essential concepts
• Visceral and parietal layers• Mesenteries (The mesentery, mesogastrium,
mesocolon etc)• Retroperitoneal structures• Greater and lesser sacs
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Peritoneum Lesser sac Greater sac Greater omentum Lesser omentum The mesentery –
Small intestine Mesocolon –
Transverse + sigmoid
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Retroperitoneal Structures Organs which lose their mesentery
• Secondarily retroperitoneal • Duodenum, pancreas, ascending colon,
descending colon
Organs which develop posterior to the cavity• Primarily retroperitoneal• Kidneys, adrenals
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GI Tract – General Plan Four layers
• Mucosa• Lining epithelium + Lamina propria• Muscle layer – muscularis
mucosae Submucosa
• Main connective tissue layer• Major network of blood vessels• Network of nerves
Muscularis externa• Smooth muscle• Inner circular• Outer longitudinal
Serosa or adventitia
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Stomach Curvatures – variability in shape Parts
• Fundus, body, pyloric antrum and canal• Functional divisions more important!
Interior – rugae (Folds) Sphincters : “gate mechanisms”
• Functional • Anatomical – thickening of circular muscle• What type are the sphincters of the stomach?
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Small Intestine Absorptive function
• Large surface area• Circular folds of mucosa• Villi – projections of epithelium
Duodenum • Largely retroperitoneal, C-shaped• Openings of bile and pancreatic ducts
Jejunum and ileum• Long, with mesentery• Gradual transition
• Thinner wall, smaller folds and villi, pattern of blood vessels
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Colon General features
• Haustration• Taeniae coli – three bands of longitudinal
muscle Caecum + appendix
• Vermiform appendix• Importance and positions
Ascending, transverse and descending parts• Location, peritoneal covering• Flexures – hepatic and splenic• Variability
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Pattern of Blood Vessels Three major arteries
• Coeliac• Superior mesenteric• Inferior mesenteric
Branches and anastomoses• Long channels parallel to gut
tube• Short straight vessels
Submucosa – rich network
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Liver Largest gland in the body Functions
• Production of bile• Metabolic functions – carbohydrates, amino
acids• Protein synthesis• Breakdown of haemoglobin• And many others…!
Anatomical perspective
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Liver Receives venous blood from abdominal GIT
• Portal vein
Arterial blood supply – hepatic artery Hepatic veins – venous drainage to IVC
Porta hepatis – the gateway• Hepatic artery, portal vein, bile ducts• One each from right and left ‘lobes’• Functional lobes more important!• Anatomical lobes by landmarks
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Peritoneal connections• Falciform ligament• Lesser omentum
Diaphragmatic surface “Visceral” surface
Details of relations not necessary
Ligamentum teres• Obliterated umbilical vein• Umbilical vein – blood from the placenta
Ligamentum venosum• Obliterated ductus venosus• Ductus venosus – shunt between portal vein and IVC
Liver
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Portal Vein IMV Splenic SMV + Splenic
Portal vein Joined by smaller
veins from stomach etc
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Portasystemic anastomoses Junctional regions
• Oesophagus systemic veins to thorax, stomach portal vein
• Anal canal (terminal part systemic)
Other regions• “Bare area” of liver• Around the umbilicus• Around retroperitoneal organs
Liver disease especially “cirrhosis”• Portal hypertension “varicosity”.