Abdominal Cavity 1 E-learning(1)
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Transcript of Abdominal Cavity 1 E-learning(1)
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Abdominal Cavity:
Peritoneum & GIT
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Abdominal Organs Relation to Peritoneum
Intraperitoneal:completely covered by visceral peritoneum
Retroperitoneal:posterior (behind) the peritoneum
touched anteriorly by parietal peritoneum
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Peritoneal Cavity2 parts
Greater sac:main part of peritonealcavity
Lesser sac (omental bursa):
extensional cavity behind the stomach
allows free movement of stomach
connects with greater sac through epiploic foramen
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Epiploic Foramen
Foramen of Winslow
Connects lesser sac to greater sac
Boundaries:Ant.: portal triad
(p. vein, h.a., & bile duct)
Post.: IVC
Sup.: Liver (caudate lobe)
Inf.: duodenum ( 1 st part )
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Foramen of Winslow & Lesser Sac
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Terms describing parts of peritoneum
Peritoneum has special names at specific regions:
omentum
mesentry & mesocolon
ligaments
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OmentumBroad, double layered sheet of peritoneum that connects stomach
to another abdominal organ
2 parts
1. Greater Omentum:
Greater curvature of stomach
Down (like apron)
Reflects up again
Ant. transverse colon
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2. Lesser Omentum
Lesser curvature of stomach& small part of dudenum (2cm)
Liver
Post. to it = lesser sac
* The free edge of lesser omentum is called: hepatoduodenal ligament
contains portal triad
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Hepatoduodenal Ligament
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Mesentery & Mesocolon
Mesentry:double layer of peritoneum connects small intestine to posterior abdominal wall
mesentry of small intestine
Mesocolon:double layer of peritoneum connects large intestine to posterior abdominal wall
transverse mesocolonsigmoid mesocolonmesoappendix
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Mesentery
&
Mesocolon
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LigamentsDouble layer of peritoneum that usually attached to the liver
Falciform Lig.:
Attachs the liver to ant. abdominal wall
& ends by enclosing ligamentum teres
Hepatoduodenal Lig.:
The free edge of ?
1st
2 cm of duodenum to liver
Contents?
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Gastro-Intestinal Tract (GIT) in Abdomen
Esophagus (abdominal part, 1.25cm)
Stomach
Small intestine
Large intestine
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Esophagus
Enters through esophageal opening ( T10 )
Pass about 1.25cm before entering stomach
Ends at cardiac orifice ( T11 )
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Stomach(Read your text for detailed anatomy )
*Intraperitoneal
4 regionsCardia:
surrounds esophag. opening
Fundusmost sup. Part (dome shape)
Bodycentral part, largest
Pylorus ( gate guard )antrum & canal
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Stomach
2 openings:Cardiac orifice
esophagus stomach(Physiologic sphincter )
Pyloric sphincterstomach duodenum(Anatomic & Physiologic )
Anat = thickened circular m. layer
2 curves:greater (lf.) & lesser (Rt.)
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Stomach
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Muscular Wall of Stomach
Outer ??
Middle ??
inner ??
???
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Small Intestine
(Read your text for detailed anatomy )
Duodenum (C-shaped)
Jejunum
Ileum
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Duodenum* Retroperitoneal except over omental attachment (first 2 cm)
4 parts
1. Superior (1 st ):From pylorusHorizontal (vertebral level?)
2. Descending (2 nd ):Rt. To L2 & L3Curves around head of pancreasReceives bile & main pancreatic ducts
(Major papilla)
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Duodenum
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Ampulla of Vater & Major duodenalpapilla
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3. Horizontal (3 rd ):Ant. to IVC
At level of L3
4. Ascending (4 th ):At left side of L3Ends at duodenojejunal jxn.Forms flexure (bending)
(flexure = lig. of treitz )
Small intestine enters peritoneum at the lig. of treitz
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Jejunum & Ileum
* Intraperitoneal
Jejunum: ( L, empty )upper left half
Ileum: ( G, twisted )lower right half
ends at ileocecal junction(valve)
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Large Intestine
(Read your text for detailed anatomy )
Cecum & Appendix
Ascending (retro)
Transverse (intra)
Descending (retro)
Sigmoid (intra)
Rectum (in pelvic cavity)
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Clinical Notes
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Peptic Ulcer Disease
A discontinuation (erosion) in themucosal covering in an area of theGIT (esophagus large intestine).
Most commonly in the ?
Causes:1. Bacteria: Helicobacter pylori
~80% PUDurease urea= ammonia + CO 2
2. Drugs & Irritants:NSAIDs (aspirin), smoking, alcohol
3. Hypersecretion of HCl
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Rx.:antibiotics: only when ??
Amoxi. + Mitro.
gastric acid inhibitors:histamine receptor (H2) blockers
Antacids: bufferDiet: irritantsSurgical: Vagotomy, antrum removal
(out of date )
Complications:GI-bleeding:
- erosion of a bld. Vessel - hematemesis ( ? )
Perforation:- erosion of the whole wall opening into abd. Cavity
peritonitis & inflammation of adjacent organs
* requires emergency surgical treatment
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McBurneys Point
On a straight line : 1/3 from ant. sup. iliac spine2/3 from the umbilicus
Corresponds to the base of the appendix
The incision site during appendectomy (removal of the appendix)