The Infracolic Compartment

Ⅰ. Location It lies between the transverse colon with

its mesocolon and the superior aperture of

the lesser pelvis.

Ⅱ. Contents the jejunum, ileum, vermiform appendix,

colon and other viscera.

Ⅲ. The vermiform appendix The features

--- a narrow, worm-shaped, blind tube.

---about 5~7cm long.

---diameter is 0.5~1.0cm.

---intraperitoneal organ,

has a triangular

mesentery.

The position

---the root joins with the posteromedial wall

of the cecum.

---the 3 colic bands focus at the root.

---the projection of the root

of the vermiform

appendix

*The McBurngy’s point

at the junction of the lateral

and middle thirds of the line

between the right superior

iliac spine and the umbilicus.

---it is variable in position

A. the pelvic position: 41.3%;

B. the retrocecoal or retrocolic position:29.4%;

C. the subcecal position:17.4%;

D. the pre-ileal position: 7.4%;

E. the post-ileal position:4.4%.

(III) The appendix artery and vein I) the artery arises from the ileocolic a. and

usually is single.

II) the vein drains into the hepatic portal vein.

the appendicular v. the ileocolic v.

the superior mesenteric

v. hepatic portal v.

appendicitis the bacterial

emboli enter the liver by the

course and lead to hepatic

abscess.

The blood supply of colon ----the superior and inferior mesenteric arteries

Ⅳ. The hepatic portal vein ---a shorter and thicker venous trunk.

---about 6~8cm long and 1~1.2 cm in diameter

---drains the venous blood from the single

viscera(except the liver) in the abdominal

cavity.

---is the functional blood vessel of the liver.

( ) FormationⅠ It is formed by the union of the superior mesenteric and splenic veins behind the neck of the pancreas.

three types:

type 1 (51.2%) portal v. type 2(15.3%)

splenic v.

inf. mesenteric v.

sup. mesenteric v.

type 3 (32.7%)

( )RelationshipⅡ The hepatic portal vein ascends behind the head

of the pancreas and the sup. part of the duodenum, towards the right and upwards,enters the hepatoduodenal ligament.It ascends in the ligament and divides into right and left branches

at the porta hepatis. The common bile duct is right and anterior toit and the proper hepatic artery is left and anterior.

( ) TributariesⅢ splenic vein

superior mesenteric vein

inferior mesenteric vein

left gastric vein

right gastric vein

systic vein

paraumbilical vein

( ) CommunicationsⅣ

between hepatic portal and systemic veins

1. Esophageal venous plexus

2. Rectal venous plexus

3. Paraumbilical venous plexus

The retroperitoneal space

Ⅰ. Location

The space lies between the parietal peritoneum

and the fascia and musculature of the posterior

abdominal wall.

It extends superiorly from the diaphragm, and

inferiorly to the sacral promontory and the pelvis inlet.

Ⅱ. Communication

superiorly continuous with the posterior mediastinum

inferiorly continuous

with pelvic retroperitoneal

space.

Ⅲ. Contents kidneys, suprarenal glands, abdoinal part of the ureters, pancreas, duodenum, blood vessels, lymph nodes, and nerves.

Ⅳ. The kidneys 1. Position

The kidneys lie on each side of the lumbar part of the vertebral column. The left kidney is about

1.5cm higher than the right one.

L kidney R Kidney

Upper pole T11th T12th

Lower pole L2nd L3nd

The 12th rib crosses obliquely the upper third of the posterior surface of the right kidney; but the middle part of the left one.

the renal angle: the lateral border of the erector spinae crosses 12th rib. The hilum of the

kidneys is at the angle.

The projection of the kidneys

on the each side of the posterior surface of the

body, 2 vertical lines and 2 horizontal line form

a quadrilateral area, in which the kidney lies.

medial vertical line 2.5cm apart from the post. median line

lateral vertical line 7.5cm

Upper horizontal line

(passing the spine of T11th)

Lower horizontal line

(passing the spine of the L3rd)

2.Relation

The upper pole covered by the suprarenal

gland.

relation L kidney R kidney

upper

Ant. middle

lower

Post.

stomach,spleen right lobe of liver

tail of pancreas descending part of the duodenum

colis of jejunum

Left colic flexure

right colic flexure

diaphragm above,psoas major,qua-

dratus lumborum,transverse abdominis

3. The hilum, sinus and pedicle of the kidney

The hilum at the medial border, it’s the entrance of the sinus.

The sinus a hollow recess in the kidney.

The pedicle The structures, which enter or leave the hilum, form the pedicle. It contains mainly the renal artery,renal vein and pelvis.

arrangement of the pedicle

from anterior to posterior is: V, A and P.

from above downwards is: A,V and P.

4. Renal capsule

From outside inwards,the are renal fascia, adipose capsule and fibrous capsule.

1) The renal fascia

anterior layer

2 layers

posterior layer

2) The adipose capsule

supports and protects the kidney

3) The fibrous capsule