Abdominal cavity & Posterior Abdominal wall…

الرحيم الرحمن الله بسم

In the last lecture we covered the anteirolaterl and the abdominal wall.……

Now we start to talk about the abdominal cavity and we finished up by talk about the posterior abdominal wall..………

Tab3an ba3ed 7aki kter 3an el practical exam. 1……2……3 .……O balashna …….:P

we introduce to you the idea of serous membrane in the introduction we told serous membrane are made of mesothelium they take a shape of closed sac and we don’t tear

them and put the organ inside …..No.…

Organ invaginate these membrane and these lead to arrangement of having two layer of membrane..…

1 .parietal: lining internal abdominal wall2 .visceral : lining abdominal organ (visara)

Serous: liquid Serous membrane: fluid filled sac to reduce friction

We studied the pleura and serous pericardium membrane which is also a serous membrane ……

Now we will study the serous membrane in the abdomen …we call it the peritoneum so serous membrane have special name in different location……

In the abdominal cavity, some of the organs are moving like stomach and small intestine and in the abdomen there is a muscle which contract and make movement so we need a fluid filled sac to reduce friction because the movement that come from a abdominal wall during wall during muscle contraction.

Note : the liver which is not movable ….But when you move the abdominal wall move and touch it and make friction….so we have fluid filled sac to reduce this friction so it cover the most of the abdominal wall organ whether they are movable

or non- movable..……

Q: does the peritoneal contain any organs?No ….so when I say or describe an organ as being intra peritoneal ….i don’t mean that inside the peritoneal cavity ….i mean it surrounded by the peritoneal membrane.

When we took a cross section through the abdomen you see the peritoneal and the organ invaginate this membrane (liver ,stomach, spleen ) but you notice some organ like the kidney they are not surrounded by peritoneal so you cant say it intra peritoneal we call it

retro peritoneal..…

Sooo..…The structure which is completely covered by peritoneum is called intra peritoneum… (Covered bay visceral layer from tow side ant, and post,)E.g.…stomach, spleen, jejunum, ileum .

The structure which is not completely covered by the peritoneum is called retro peritoneum (only ant. To organ)

E.g. : kidney, pancreases ,ascending and descending colons.…

So we start to talk about the peritoneal cavity as just I said we have two part.…

*main part : greater sac which is anterior to the stomach.…

*small part that continue the stomach :lesser sac (post to the stomach…)

both they communicate at an opening (epiploic foramen)…… epiploic foramen (foramen of Winslow connect the greater sac with the lesser sac.)

Boundaries of foramen of Winslow:

1 (Ant: the portal trial (portal vein that return blood from intestine to the liver hepatic artery that bring oxygenated blood to the liver..…Bile duct that take bile from the liver down to the intestine(..…

2 (Post : IVC3 (Sup : the liver (caudate lobe of the liver)

4 (Inf: the duodenum

We have to divide the peritoneum to specific part according to what structure they are covering..…

.The part of the peritoneum that cover the stomach omentum like an (apron :maryaleh :p)

.Peritoneum covering small intestine (mesentery) .Peritoneum covering large intestine (mesocolon)

.Peritoneum covering liver or spleen (ligament)

*The stomach has lesser curvature (located superiorly) and greater curvature.…

Peritoneum that go anterior to the lesser curvature we call it lesser omentum.…

Peritoneum that continue from greater curvature we call it greater omentum…

As the lesser omentum arrives to the liver it will be called ligament

Omentum is double layer sheet because there are two layers around the stomach.

As they join there will be two visceral layer of peritoneum.The omentum connect the stomach to another abdominal organ…

Intra abdominal fat (adipose tissue):Accumulation of fat around the greater omentum as it come down from the stomachاصفر( ) لونة

Then ,when they reach the transverse colon they open and called mesocolon…

Lesser omentum attach at its end to the duodenum that go to the liver…

As it attach to the duodenum it will not be called omentum because it is not attached to the stomach any more It will be called hepatoduodenal ligament

Hepatoduodenal ligament is the free margin of lesser omentum

Mesentery : double layer of peritoneum connect small intestine to posterior abdominal wall mesentery of small intestine.Mesocolon : double layer of peritoneum connect larg intestine to posterior abdominal wall Transverse mesocolone Sigmoid mesocolone Mesoapendix

Q: what about ascending and desending meso colon?We call it ascending and descending mesocolon ….!!! No…because these part are reteroperitonel

Soo.…Mesentery :covering small intestine Mesocolon : covering large intestine

*ligament attached to the liverfalciform ligament : attach the liver with anterior abdominal wall

)falci>>>>sickle shape(the end of the falciform ligament enclose another ligament which is not part of the peritoneum (ligament terse) or (round ligament of the liver )

)GIT(

esophagus , stomach, small intestine, large intestine.… Of course we have another part but these what we covered in the abdomen…Now start in esophagus…

Esophagus enter the abdomen through esophageal opining which is a sling of the right curs of the diaphragm at (T 10)

The length of the esophagus is about 25 cm only les than 2 cm enter the abdomen and terminate at the cardiac orifice (T 11)

stomach: (intra peritoneal)

4 regions:1 .the smallest region (cardia) it is sup . area where esophagus meet the stomach

2 .dome shape fundus is the must superior part. 3 .body : main part of the stomach extend from cardiac orifice down to a small notch

called incisure's angular (small notch in the lower part of lesser curvature ).

4. pylorus : (gate guard )made of two subdivision:

pyloric antrum : extend from incisure's angularis to pylorus pyloric canal : cavity of the pylorus.

)2 opening: (

cardiac orifice:between esophagus and stomach( physiologic sphincter )mean it is has a function

pyloric orifice:between stomach and duodenum (physiological and anatomical sphincter)Anatomical sphincter : which mean thickened circular muscular layer.

The stomach have two curvature -Lesser curvature: smaller one, cancave on right side

-greater curvature: largest one, on the left side and convex

stomach consist of three layers:

1.outer layer : longitudinal fiber 2.middle layer: circular fiber

3.inner layer :oblique fiber

by contraction of this fibers that mechanical digestion occurs in the stomach just few drugs absorption in the stomach most of absorption in the intestine…

small intestine: longest part of the GIT. three part:

1 .duodenum 2 .jejunum

3 .Ileum

The length is about 10 meter but of course is shorter in living individual why???Because of muscle tone (minimal contraction in muscle fiber) this tone is decrease in

length of the small intestine in living individual.…

Duodenum:Retroperitoneal except wher it attach by the (hepatodudenal ligament)

It composed of four main part:

1 (Superior part 2 (Descending part

3 (Ascending part4 (Inferior part

1 .sup . part (horizontal ) : -it is the first part

-it is directly attached to pylorus -it is at vertebral level of ( L 1 )

:2 .Descending part -at the vertebral level of ( L2 – L3 )

it goes down in the right side of vertebral column and around the head of pancreas and receive bile secretion from the liver and gallbladder and also receive secretion from pancreasthe pancreatic duct and the bile duct from the liver they merge together as one duct to empty in the descending duodenum or the second part of duodenum and that opening we

call it the major papilla or ampulla's of vater… when we remove the pancreas we see the green structure is the pancreatic duct it merge with the bile duct which come from the liver and gallbladder and they empty in the duodenum and this main duct we call it ampulla's of vater this major duodenal papilla we will see in the lumen of the duodenum not in the outer

surface…

The end

I recommend you to go to the slides for anything u didn't understand Good luck every body and forgive me for any mistake

Bhdi hadi el lecture la a7la sa7beh bl denia 3athari luv u ya 2mar o el 5er be yali b2dro rabna so el 7amdollah 3a kol shi

O amon 5asawneh (bjanen el a5dar 3aleki ya wasema :P)

Byname bashair el hersh fa 7sabek ba3den tete tete Mastashfa !! ramadi !! mo fahmeh!!

)ra7 nos 3omrek ah(… :D :D:D:D

o shoroo8 ( shedi 7elek nshallah ma bde3lek ta3ab )

)b7b7(.… ma nsetak ola bansak ya a7la shi be 7aiati (laith) thnx 3a kol shi o 3'alabtak ma3i be teba3et hal mo7adara o dayman m3'alebtak bs t7amalni l2ni 8adarak..………

jad thnx

done by:yara magableh