Anatomy (exam 2)

pelvis

pubic symphysis to sacral promontory

linea alba

most avascular band of tissue where aponeurosis of recutus meets

semilunar line

lateral border of the rectus abdominis muscle in the rectus sheath

umbilicus

T10 dermatome

L3-4 level

former umbilcal cord attachment

right hypochondriac (1)

liver, gallbladder, R kidney, small intestine

epigastric region (2)

stomache, liver, pancreas, duodenum, spleen, adreanal gland

left hypochondriac (3)

spleen, colon, L kidney, paancreas

right lumbar (4)

gallbladder, liver, R colon

umbilical region (5)

umbilicus (navel), parts of the small intestine, duodenum

left lumbar (6)

descending colon, L kidney

right iliac (7)

appendix, cecum

hypogastric region (8)

urinary bladdder, sigmoid colon, female reproductive organs

left iliac (9)

decending colon, sigmoid colon

peritoneum

sheet of smooth tissue that continuously lines you abdominopelvic cavity and surrounds your abdominal organs

pads and insulates your organs, helps hold them in place, and secretes a lubricating fluid to reduce friction when they rub against eo

parietal peritoneum

lines your abdominal and pelvic walls

viceral peritoneum

wraps around your organs

peritoneal cavity

space between peritoneum layers

peritonitis

inflammation of the peritoneal cavity

ascites

pathological accumulation of fluid

peritoneal dialysis

infusion of hypertonic solutioninto peritoneal cavity, this fluid helps absorb waste and is then drains out

malignancy

the peritoneal lining can be the site of metastasis

hydrocephalus

pts with hydrocephaly can have a VP shunt placed that drains excess cerevrospinal fluid from the brain into the abdominal cavity, where it is abs into the body

aponeuroses

elastic, thin connective tissue sheets that extend from muscles to form termination attachments to bone/fascia

rectus sheath

fascial sheath that contains the rectus abdominis and pyramidalis muscles

extends from the xiphoid process to pubic symphysis

arcuate line

seen on the peritoneal surface and is found halfway betweenthe umbilicus and pubic crest

runs along inferior margin of posterior wall of rectus sheath

external oblique muscles

most superficial of the anterolateral abdominal muscles

arises from 5th-12th ribs

flex & rotate truck

internal oblique muscles

immediately deep to external oblique

originates from lumbar fascia, iliac crest, and lateral inguinal ligament

flex & rotate truck

transverse abdominis

deepest of the anterolateral muscle of rectus sheath

arises from 7th-12th costal cartilages, lumbar fascia, iliac crest, and inguinal ligament

provides compression and support fro viscera

foregut

blood supply: celiac trunk

contains: distal esophagus to major duodenal papilla, liver, gallbladder, pancreas, and spleen

midgut

blood supply: superior mesenteric artery

contains: major duodenal papilla to proximal 2/3s of transverse colon

hindgut

blood supply: inferior mesenteric artery

contains: distal 1/3 of transverse colon to upper anal canal

mesentery

general term for peritoneal attachment anywhere along gut tube

ventral mesentery

presents only in foregut

double-layered membrane that connects the gut tube to the front wall of the abdomen

falciform ligament

divided from ventral mesentery

septum transversum/anterior body wall to liver

lesser omentum

derived from ventral mesentery

made up of the hepatogastric lig & hepatoduodenal lig

carry portal triad

dorsal mesentery

runs the entire length of the gut tube, attaching to posterior abdominal wall

stomach surfaces

left surface → becomes anterior (so L vagus n. ends anterior)

right surface → becomes posterior (so R vagus n. ends posterior)

omentum

double layer of peritoneum attached to the stomach and proximal duodenum

greater omentum

derived from dorsal mesentery

initial two-layers apron that fuses with transverse colon during development

drapes from greater curve of stomach down over transverse colon & small bown then foling back up to transverse colon

intraperitoneal

suspended by mesentery, invested by visceral peritoneum

EX: stomach, spleen, liver, 1st part of duodenum, jejunum, ileum, transverse colon, sigmoid colon, tail of pancreas

primary retroperitoneal

never suspended by mesentary ie remained posterior to parietal peritoneum from outset

EX: kidney, ureters, adreanl glands, abd aorta and IVC, lower 2/3s of rectum

secondarily retroperitoneal

iniitially intraperitoneal, suspended by dorasla mesentery ie fuses to posteriro body wall during development

fixing organ in place via a fusion facial

EX: 2nd, 3rd, and 4th parts of duodenum, pancrease, ascending & descending colon

celiac trunk

arises from abd aorta at ~T12 (aka aortic hiatus of diaphragm)

branches off L gastric artery, splenic artery, & common hepatic artery

L gastric artery

course: superiorly towards esophagogastric junction → travels along lesser curvature of stomach

supplies: abd portions of esophagus, anteror/posterior surfaces of stomach long lesser curvature, sometimes to liver

splenic artery

largest and most winding branch of celic trunk

travels laderally and slightly superiorly, posterior to stomach, running adjacent to/through pancrease en route to spleen

branches: pancreatic, splenic, short gastric, L gastro-omental

common hepatic artery

goes towards R from celiac trunk, then divides into gastroduodenal a & hepatic a. proper

gastroduodenal artery

descends posterior to first part of the duodenum → R gastro-omental a (greater curvature) → ant & post superior pancreaticoduodenal (duodenum & pancreatic head)

hepatic artery proper

ascends within hepatoduodenal ligament w portal vein & bile duct

goes off the R gastric a then divides at porta hepatis into R & L hepatic arteries

portal triad

hepatic artery proper, hepatic portal vein, and bile duct that travels within hepatoduodenal ligament

view: BAV

median arcuate ligament syndrome

compression of celiac trunk by median arcuate ligament of diaphragm can cause postprandial epigastric pain & wight loss from foregut ischemia

collateral protection

the celiac-SMA anastomoses around the pancreaticoduodenal arcades protect the foregut/midgut boundary from ischemia if one vessel is occluded

Calot’s triangle

bounded by cystic duct, common hepatic duct, & liver margin, used to safely identify and ligate cystic artery during cholecystectomy

function of liver

prod & secretes bile for emulsification of fats

regulates blood glucose [ ]

coverts ammonia into urea

stores iron, used for hemoglobin synthesis

filters blood

prod choleterol and plamsa proteins

synthesize clotting factors