abdominal cavity 1 e-learning(1)

7/31/2019 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)

abdominal cavity 1 e-learning(1)

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