Abdomen (digestive viscera & relationships)

cross-sectional anatomy

abdominal cavity is divided into \____ parts

2
peritoneal
retroperitoneal

double layer of peritoneum extends from posterior abdomen

mesentery

peritoneal cavity contains

-stomach
-duodenal bulb (1st portion of duodenum)
-transverse colon
-liver
-gallbladder
-spleen

retroperitoneal cavity contains

-kidneys
-aorta
-IVC
-adrenals
-ascending colon
-descending colon
-cecum
-pancreas

sections of mesentery

greater omentum
lesser omentum

where does the greater omentum extend from? then attaches to ...

extends from greater curvature of stomach down over small bowel
then comes up & attaches to inferior margin of transverse colon

where does the lesser omentum attach/extend to?

attaches to under surface of liver
& extends down to lesser curvature of stomach

what divides the peritoneal cavity into two spaces?

lesser omentum

the lesser omentum divides the peritoneal into...

two spaces:
-greater sac
-lesser sac

the greater & lesser sacs are \______________ spaces

potential spaces
for free fluid

(FF is important to note in US)

lesser sac anterior boundary

-stomach
-lesser omentum

lesser sac left boundary

-spleen
-gastrosplenic ligament
-lenio renal ligament

lesser sac right boundary

-open right area epiploic foramen

lesser sac superior boundary

liver

what is the open edge of the lesser omentum?

epiploic foramen

why is the anterior edge of the lesser sac important?

it contains the portal triad

what is the portal triad made of?

(portahepatis)
-hepatic artery
-common bile duct
-main portal vein

epiploic foramen anterior border

anterior lesser omentum

epiploic foramen posterior border

IVC

epiploic forarmen superior border

caudate lobe

epiploic foramen inferior border

first portion of duodenum

esophagus connection to stomach

gastroesophageal junction

stomach consists of what parts

-fundus
-body
-antrum (aka pre-pylorus section)

pylorus wall undistended measurement

5 mm

pylorus wall distended measurement

3 mm

pylorus max dilation

8 cm

why are pyloric wall measurements important

some babies born w/ pyloric stenosis (pylorus is closed off, need surgery)

folds/lining of stomach is called

rugae

pyloric canal measurement

less than 2-3 cm

pyloric muscle measurement

each 3.5 mm
total 10 mm

what is the first part of the small intestine?

duodenum

duodenum is \______ long

25 cm

duodenum is split into how many portions?

4

duodenum max dilation measurement

3 cm

what is the first portion of the duodenum referred to?

duodenal bulb

duodenal bulb lies ...

horizontal

is the duodenal bulb intraperitoneal or retroperitoneal?

intraperitoneal

(2nd, 3rd, & 4th portions are RETROPERITONEAL)

second portion of duodenum lies ...

vertical

third portion of duodenum lies ...

horizontal

fourth portion of duodenum lies ...

oblique

duodenum terminates at ...

fourth portion terminates at ligament of treitz

common bile duct & pancreatic duct join together & enter the duodenum at which portion?

second portion
**AMPULLA OF VATER is found here

ampulla of vater is aka

hepatopancreatic duct

second portion of small intestine

jejunum

jejunum is \____ long

2.4 m long

third portion of small intestine

ileum

ileum is \____ long

3.6 m long

ileum terminates at ...

ileocecal valve

(ileum + cecum)

large intestine consists of what parts?

cecum & colon

what quadrant & what region is the cecum in?

RLQ
right iliac

cecum wall thickness measurement

4 mm

vermiform appendix is attached to

cecum

location is variable, usually RLQ

what is the mcburney's point?

landmark associated w/ the appendix
is 1/3rd of the distance from the ASIS to the umbilicus

appendix length

varies in length
2.5-22.5 cm long
7.5 cm AVERAGE

appendix max dilation measurement

6 mm

appendix wall thickness measurement

less than 2 mm\****

parts of the colon

-ascending
-hepatic flexure
-transverse
-splenic flexure
-descending
-sigmoid
-rectum

1st portion of duodenum spatial relationship to CBD, CHA, & GDA

duodenal bulb is ANTERIOR to CBD, CHA, & GDA

2nd portion of duodenum runs \___________________ of the spine

runs parallel & right of the spine

what is anterior to the second portion of duodenum?

transverse colon

what is medial to second portion of duodenum?

pancreatic head

what enters the second portion of duodenum?

junction of CBD & pancreatic duct \= AMPULLA OF VATER

third portion of duodenum is anterior to ...

-aorta
-IVC
-crus of diaphragm

what runs anterior to third portion of duodenum?

SMA & SMV

fourth portion of duodenum ascends to ...

to the left of the aorta & left diaphragmatic crus

fourth portion of duodenum ends at

ligament of treitz \***

spaces within abdominal cavity

-suprahepatic spaces
-subhepatic space

suprahepatic spaces

left & right
????

subhepatic space is on what side?

on right

upper portion of subhepatic space is the ...

right hepatorenal pouch
(morrison's pouch\***)

where are paracolic gutters?

subhepatic space