„Selected Chapters from theCross-Sectional Anatomy

of the Human Body”

Abdominal anatomyAndrás Jakab MD, Levente István Lánczi MD

Structure of the lecture - abdomen

Bones and Muscles Abdominal aorta and its branches; veins The GIT – from esophagus to rectum Intraabdominal organs (liver, spleen, kidneys,

pancreas) Clinical cases

Bones & muscles

psoas major m.

quadratus lumborum m.

iliacus m.

diaphragm

transverse abdominal m.

intercostal mm.

transverse abdominal m.

linea alba

rectus abdominis m.

psoas major m.

quadratus lumborum m.

longissimus thoracis m.

The structure of the abdominal wall

external oblique abdominal m.

external oblique abdominal m.

Internal oblique abdominal m.

T12

L1

L2

L3

L5

Abdominal aorta and its branches

Parietal braches (paired) lumbal aa. median sacral a.

Paired, visceral branches middle suprarenal a. renal a. testicular/ovarian a.

Impaired visceral branches of abdominal aorta Impaired visceral branches

celiac tr. T12 –L1 left gastric a. splenic a.

short gastric aa. left gastro-omental artery

common hepatic a. gastroduodenal a.

right gastro-omental artery proper hepatic a.

superior mesenteric a. inferior pancreaticoduodenal a. jejunal and ileal aa. ileocolic a. right colic a. middle colic a.

Inferior mesenteric a. left colic a. sigmoid aa. superior rectal a.

a. gastrica sinistra

a. hepatica communis

tr. coeliacus

a. lienalis

Common hepatic a.

Gastroduodenal a.

Proper hepatic a.

Right gastric a.

Left gastrica a.

Superior posterior pancreaticoduodenal a.

Right and leftgastro-omental aa.

Splenic a.

Superior mesenteric arteryand its branches

Middle colic a.

Marginal artery of the colon (Drummond)

Right colic a.

Ileocolic a.

cecal & appendicular aa.

Inferior mesenteric arteryand its branches

Marginal artery of the colon (Drummond)

Left colic a.

Sigmoid aa.

Superior rectal a.

Veins

Portal vein Splenic v. Superior mesenteric v. Inferior mesenteric v.

Inferior vena cava Hepatic vv. Suprarenal v. Renal vv. Testicular/ovarian v.

T12

L1

L1

L2

L3

The Gastrointestinal Tract

Esophagus

The Stomach, Duodenum and

Pancreas

The stomach

Anatomy• cardia• fundus• body• pylorus

Arteries (celiac tr.)

• Left gastric a. (tc)

• Right gastric a. (hc)

• Left gastro-omental a. (l)• Right gastro-omental a. (gd)

• Short gastric aa. (l)

The stomach

Anatomical landmarkscardia: Th11

pylorus: L1

fundus: gastric air sac

Neighbouring structuresliver, spleen, left kidney, diaphargm, transverse colon, pancreas

DuodenumParts Superior part Superior doudenal flexure Descending part Inferior doudenal flexure Inferior part

Duodenum

Anatomical landmarkspylorus: L1

Descending part: L1-3

Neighbouring structuresliver, gall bladder, right kidney, transverse colon, pancreas head

The pancreasAnatomy parts• head

– uncinate process

• body• cauda

Ducts• major pancreatic duct• minor pancreatic duct• Vater papilla

Arteries• superior pancreatoduodenal a. (ct)

• inferior pancreatoduodenal a. (ms)

Ductsof the pancreas and the gall bladder

The abdomen

IVC

Transverse colon

Pancreas head

L5

L1

diaphragm

duodenum

jejunum, ileum

Urinary bladder

G

VP

AD

Superior mesenteric a.

R

R

Axial cross sectionTh11

A

Th11

L

G

H

VCI

LA

Axial cross sectionTh12

Th12

H

VCI

G

L

P

VP

A VL

Axial cross sectionL1

G

J

J

J

CT

CD

HVB

VCIA

AMSVP VL

P

L1

Axial cross sectionL1

HVP

VCI

L1

G

J

J

CD

CT

RD RS L

P

A

Small intestines Duodenum Jejunum Ileum Ileocoecal junction

Ileum, cecum, colon

Ileum

Colon, ascending

Appendix vermiformis

Cecum

Aperture of appendix

Ileocecal junctionIleocecal valve

Parts of Colon

appendix vermiformis

Cecum

Ascending colon

Right flexure of colon

Transverse colon

Left flexure of colon

Descending colon

Sigmoid colon

Rectum

GIT on cross sectional slices

T12

T12

L1-2

L1-2

L2

L3

L3

L4

L4

L5/S1

L5 / S1

The Liver Position

Right hypochondrium, epigastrium, left hypochondrium Upper border: 5th rib Lower border: right lower ribs

Lobes Right hepatic lobe Left hepatic lobe Quadrate lobe Caudate lobe

Ligaments: Falciform lig. Lig. teres Right and left coronal lig. Hepatorenal lig. omentum minus: lig. hepatogastricum et hepatoduodenale

Macroscopic anatomyof the liver

lobus hepatis dexter

lobus hepatis sinister

margo inferiorvesica fellea

diaphragma

lig. falciforme hepatis

lig. teres hepatis

lig. coronarium

Macroscopic anatomyof the liver

lobus hepatis sinister

lobus hepatis dexterlobus quadratus

lobus caudatuslig. coronarium

v. cava inferior

v. portae hepatis

a. hepatica propria

vesica fellea

lig. venosum

lig. teres hepatis

Vessels of the liver

Proper hepatic a.

v. portae

Choledochal duct

Vena hepatica sinistra / dextra / intermedia

VCI

Segments of the liver

Couinaud Caudate lobe: I. Left lobe

lateral: II., III. Right lobe

medial: IVa / IVb inf.: IV-V-VI sup.: VII – VIII - IX

Segments of the liver demonstrated on

IMAIOS

Gall bladder and biliary ducts

Gall bladder

Pancreatic duct

Orifice of pancreatic duct;

Major duodenal papilla

Common bile duct (biliaris)

Hepatic duct (communis)

Cystic duct

Spleen

Position: 8-11 rib;

left hypochondrium Parts:

Diaphragmatic face Gastric face Renal face Colic face hilus lienalis

Vessels Splenic a. & v.

Kidney

Parts: hilus sinus pelvis

Position: Th12-L1-2 Right kidney: lower

Vessels: Renal a. & v.

Adrenal glands: Upper pole of the kidney, inside the

adiopose capsule cortex, medulla

ureter

LeftRight VCI

AO

T12

L3

T12 – L1

L3

T12

L1

L2

Főbb képletek azonosítása

IMAIOS

L2

L3

L4

L5

S1