Abdominal Cavity 1 (Slides)

8/8/2019 Abdominal Cavity 1 (Slides)

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Abdominal Cavity:Abdominal Cavity:

Peritoneum & GITPeritoneum & GIT


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PeritoneumPeritoneum

A serous membrane of 2 continuous layers that covers the

abdominal organs

(G, To stretch or cover around)

Parietal: lining internal abdominal wall

Visceral: lining abdominal organs (viscera)

Peritoneal cavity: space between parietal & visceral layersfluid filled reduce friction

* NO organs in peritoneal cavity


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Abdominal Organs Relation to PeritoneumAbdominal Organs Relation to Peritoneum

Intraperitoneal:

completely covered by visceral peritoneum

e.g. stomach, spleen, jejunum, ileum

Retroperitoneal:

posterior (behind) the peritoneum

only partially covered with visceral peritoneum

e.g. pancrease, kidneys, ascending and descending colons


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Peritoneal CavityPeritoneal Cavity

2 parts

Greater sac:

main part of peritoneal

cavity

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 ForamenEpiploic Foramen

Foramen ofWinslow

Connects lesser sac to greater sac

Boundaries:Ant.: portal triad

(p. vein, h.a., & bile duct)

Post.: IVC

Sup.: Liver (caudate lobe)

Inf.: duodenum (1st part)


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Foramen of Winslow & Lesser SacForamen of Winslow & Lesser Sac


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Terms describing parts of peritoneumTerms describing parts of peritoneum

Peritoneum has special names at specific regions:

omentum

mesentry & mesocolon

ligaments


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OmentumOmentum

Broad, double layered sheet of peritoneum that connectsstomach

to another abdominal organ

2 parts

1. Greater Omentum:

Greater curvature of stomach

Down (like apron)

Ant. to S. intestine

Reflects up again

Ant. transverse colon


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2. Lesser Omentum2. 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 LigamentHepatoduodenal Ligament


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Mesentery & MesocolonMesentery & 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 mesocolon

sigmoid mesocolon

mesoappendix

what about ascending and descendingmesocolon !!??


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MesenteryMesentery

&&

Mesocolon

Mesocolon


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LigamentsLigaments

Double layer of peritoneum that usually attached to the liver

Falciform Lig.:

Attaches the liver to ant. abdominal

wall and diaphragm

& ends by enclosing ligamentum teres

Hepatoduodenal Lig.:

The free edge of ?

1st 2 cm of duodenum to liver

Contents?


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GastroGastro--Intestinal Tract (GIT) in AbdomenIntestinal Tract (GIT) in Abdomen

Esophagus (abdominal part, 1.25cm)

Stomach

Small intestine

Large intestine


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EsophagusEsophagus

Enters through esophageal opening (T10)

Pass about 1.25cm before entering stomach

Ends at cardiac orifice (T11)


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StomachStomach

*Intraperitoneal

4 regions

Cardia:

surrounds esophag. opening

Fundus

most sup. Part (dome shape)

Bodycentral part, largest

Pylorus (gate guard)

antrum & canal


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StomachStomach

2 openings:Cardiac orifice

esophagus stomach

(Physiologic sphincter)

Pyloric sphincter

stomach duodenum

(Anatomic & Physiologic)

Anat = thickened circular m. layer

2 curves:

greater(lf.) & lesser(Rt.)


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StomachStomach


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Muscular Wall of StomachMuscular Wall of Stomach

Outer L??Outer L??

Middle ??Middle ??

inner ??inner ??

??????


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Small IntestineSmall Intestine

((Read your text for detailed anatomy))

Duodenum (C-shaped)

Jejunum

Ileum


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DuodenumDuodenum

* Retroperitoneal except over omental attachment (first 2 cm)

4 parts

1. Superior (1st):

From pylorus

Horizontal (vertebral level ??)

2. Descending (2nd

):Rt. To L2 & L3

Curves around head of pancreas

Receives bile & main pancreatic ducts

(Major papilla)


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DuodenumDuodenum


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Ampulla of Vater & Major duodenalAmpulla of Vater & Major duodenal

papillapapilla


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3. Horizontal (3rd):

Ant. to IVC

At level of L3

4. Ascending (4th):

At left side of L3

Ends at duodenojejunal jxn.

Forms flexure

The flexure is surrounded by aperitoneal fold

(lig. of treitz)

Small intestine enters peritoneum at the lig. of treitz


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Jejunum & IleumJejunum & Ileum

* Intraperitoneal

Jejunum: (L, empty)

upper left half

wider & thicker

Ileum: (G, twisted)

lower right half

ends at ileocecal junction

(valve)


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Peptic UlcerPeptic Ulcer

A discontinuation (erosion) in themucosal covering in an area of the

GIT (esophaguslarge intestine).

Most commonly in the ?

Causes:

1. Bacteria: Helicobacter pylori

~80% PUD

2. Drugs & Irritants:

NSAIDs (aspirin), smoking, alcohol

3. Hypersecretion ofHCl


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Rx.:

antibiotics: only when ??

Amoxi. + Mitro.

gastric acid inhibitors:

histamine receptor (H2) blockers

Antacids: buffer

Diet:irritants

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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Large Intestine

Cecum & Appendix

Ascending (retro)

Transverse (intra)

Descending (retro)

Sigmoid (intra)

Rectum (in pelvic cavity)


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McBurneys PointMcBurneys 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)

Abdominal Cavity 1 (Slides)

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