Abdomen I compiled by Andrs Csillag Abdomen I

Abdomen I compiled by András Csillag

Abdomen I. • location • borders • division transversal and sagittal planes 2

Abdomen I. topography • Abdominal cavity • Parietal and visceral peritoneum • Peritoneal cavity Ø Intraperitoneal organs have a peritoneal covering and bulge into the cavity Ø Retroperitoneal region Ø Infraperitoneal region 3

Abdomen I. Retroperitoneal organs 4

Abdomen I. • Abdominal wall • Superficial layer • cutis • subcutis • fascia abdominis • Middle layer • Muscular aponeurotic abd. wall • • • m. erector spinae m. psoas major m. obliquus ext. m. obliquus int. m. transversus • Internal layer • fascia transversalis • Subperitoneal connective tissue • Parietal peritoneum • Blood supply, neuronal network, lymphatic vessels 5

Abdomen I. upper abdominal region • borders • organs • • • liver stomach spleen duodenum pancreas transverse colon flexura coli dextra et sinistra 6

Abdomen I Liver • location • Motion together with the diaphragm • Intraperitoneal organ, double peritoneal layer fixes to the anterior abd. wall and to the diaphragm. • lig. falciforme hepatis • lig. coronarium dextrum et sinistrum • To anterior abdominal wall and diaphragm 7

Abdomen I. topography of the liver • Through diaphragm • Right lung, left lung, heart • dorsal • Right kidney and adrenal gland • hepatic hilum • Incoming structures in loose connective tissue: vein • Anterior right ductus choledochus (common bile duct) • Left proper hepatic artery • Other (vegetative neural plexus, veins, lymphatic vessels, lymph nodes • Dorsal portal 8

Abdomen I. liver segments Left lobe lobus caudatus (I) lobus quadratus (IV) right lobe 9

Abdomen I. liver segments • Left lobe • • I. caudate II. lat. superior III. lat. inferior IV. quadrate • a. med. superior • b. med. inferior • Right lobe • • V. anterior inferior VI. posterior inferior VII. posterior superior VIII. anterior superior 10

Abdomen I. portal vein tributaries • Portal vein collects the blood from unpaired abdominal organs and enters to the substance of the liver, where it branches 11

Abdomen I. portal vein 12

Abdomen I porto-caval anastomoses • Through cardial veins superior vena cava • Through rectal veins to the inferior vena cava • Paraumbilical veins IVC, SVC anastomoses (epigastric superficial veins, thoraco-epigastric veins) • Anastomoses between superficial and deep abdominal wall veins Connects the portal system from IVC and SVC 13

Abdomen I. biliary ducts, gallbladder 14

Abdomen I. biliary ducts, gallbladder 15

Abdomen I spleen • Localisation • left hypochondrium, between ribs #9 -11 • Under the diaphragm (this side is convex) • The lung overlaps the facies diaphragmatica, during expiration • Relates to the costodiaphragmatic sinus (US: pleural fluid can be seen) • Visceral surface imprint of organs • stomach fundus greater curvature • dorsal left kidney and adrenal gl. • pancreatic tail in hilum • Splenic recess of omental bursa • Intraperitoneal organ • lig. phrenico-lienale • lig. gastro-lienale • lig. phrenico-colicum 16 Tillmann, Atlas der Anatomie, Springer 2005

Abdomen I surfaces of the spleen § Splenic hilum § Splenic artery and vein § Lymphatic vessels § nerves 17 Tillmann, Atlas der Anatomie, Springer 2005

Abdomen I. : spleen • Blood supply • Coeliac trunk → splenic artery → splenic hilum • branches: • To stomach (gastrosplenic ligament) • To pancreas (phrenicosplenic ligament) • Splenic vein (runs on the superior part of pancreas from left to right) • → joins the sup. mes. vein → sinus confluens → portal v. • Lymphatic vessels • unite with the gastric lymphatic vessels • pancreatic and splenic lymph nodes → coeliac lymph nodes 18 Tillmann, Atlas der Anatomie, Springer 2005

Spleen, axial CT 1. 2. 3. 4. 5. 6. 7. 8. 9. Lobus sin. hepatis Gaster Costa V. portae Lobus caudatus hepatis Art. lienalis Flexura coli sin. V. cava inf. Aorta 10. 11. 12. 13. 14. 15. Hilus lienis (facies visceralis) Lobus dext. hepatis Gl. suprarenalis dext. Diaphragma, crus dext. Vertebra Lien, facies diaphragmatica 19 Csillag, Anatomy of the Living Human, Könemann 1999