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Overview
Oesophagus
10
inches from pharynx to stomach narrow at cricoid cartilage where left bronchus crosses oesophageal hiatus in diaphragm mucous membrane folded (normally collapsed) stratified squamous epithelium striated above smooth below trachea on right, lower aorta on left medial to L. lung, behind left atrium
Stomach
Variable size and shape, distensible J shaped related to body form Lesser and greater curvature gastroesophageal junction fundus,cardiac part, body, pyloric part pyloric antrum and sphincter rugae and gastric pits
Splenic tissue
Epiploic Foramen
Omentum
Omentum
of stomach forms the greater omentum (allows stomach distension and infection control) Omental bursa or Lesser sac is inside omentum (a potential space)
Lesser
omentum runs from stomach to liver (note free lower border above epiploic foramen contains portal vein, hepatic artery and bile duct
Falciform
Venous system
Portal
Vein
vein
Splenic
inferior
mesenteric vein
Superior
Veins
Anastomoses
Duodenum
first 12 inches of gut four parts form C shape duodenal cap radiologically identified, ulcers form here mobile descending part pancreatic and bile ducts horizontal part crosses psoas, IVC and aorta crossed by mesentery, sup mesen. art. ascending part
Jejunum
2/5ths of small intestine gradual transition to ileum many small villi increasing numbers of lymph nodules no submucosal glands lacteals in each villus columnar epithelium
Ileum
distal
3/5ths of intestine narrower, thinner, less vascular, slower, more fat and arterial arcades in mesentery than jejunum. Peyers patches of lymphoid tissue
Colon
ascending colon retroperitoneal right colic or hepatic flexure transverse colon (mesocolon) droops towards pelvis? left colic or splenic flexure descending colon retroperitoneal pelvic or sigmoid colon S shaped
Appendix
The Liver
Largest Gland (one of largest organs) Right upper abdomen under diaphragm Grows as outgrowth of gut plus mesoderm Diaphragmatic surface Visceral surface down and left related to stomach, duodenum, r. kidney, r. colonic flexure bears gall bladder
Liver
pg 610
Largest
bile pick up glucose detoxify poison, drugs make blood proteins many others pg 635
surface
surface
Quadrate
Gallbladder
Muscular
sac Between right + quadrate liver lobes Bile is stored + concentrated Bile: breaks down fats = emulsification Bile
Produced
pg 610
Bile Ducts
Cystic
duct
bile from gallbladder
carries
Hepatic
carries
joins
duct
bile from liver
Common
Bile duct
pg 628
Movement of Bile
pg 628
Bile secreted by liver continuously Hepatopancreatic (Vater) ampulla common bile + main pancreatic duct meet and enter duodenum Sphincter of Oddi around it closed when bile not needed for digestion Bile then backs up into gallbladder via cystic duct When needed gallbladder contracts, sphincters open
Pancreas
Retroperitoneal Gland
Exocrine
digestive enzymes
Endocrine
Location
curve
pg 639
Main
Ducts of Pancreas
pg 628
duct joins common bile duct enters duodenum Hepatopancreat ic (Vater) ampulla Accessory Pancreatic duct enters duodenum in other location
Pancreatic
Biliary System
R and L Hepatic ducts Common hepatic duct Joined by cystic duct (to gall bladder) Forms bile duct (common bile duct) Gall Bladder body and fundus, salts and water absorbed store for bile, released in response to cholecystokinin
Pancreas
Pancreas
Head
in concavity of duodenum body across vertebrae tail reaches the spleen pancreatic duct (+ accessory?) ampulla duodenal papilla
Spleen
Spleen
Largest
lymph
blood-borne antigens (immune) remove and destroy old/damaged blood cells stores blood platelets In fetus: site of hematopoiesis
pg 639
The Spleen
Lies
in left hypochondriac region between gastric fundus and diaphragm at level of 9th-10th rib (not normally palpable) Soft, friable, highly vascular, dark purple Diaphragmatic surface convex and smooth facing diaphragm Visceral surface gastric, renal, pancreatic and colic impressions
of spleen long fissure through which vessels and nerves pass Suspended from stomach by gastrolienal ligament (contains short gastric and left gastro-epiploic branches of spenic artery) Suspended from posterior abdominal wall by lienorenal ligament Covered by adherent peritoneum
Urinary System
Kidneys
Purify
Ureters Drain
blood
urine from kidney to bladder Urinary Bladder Store urine Urethra Drain urine from bladder to outside body
pg 5
ions
Urea,
Regulates
Maintains
Kidneys
In fat capsule Suprarenal glands superiorly
Located superior lumbar region Posterior abdominal wall (T12-L3) Retroperitoneal Hilus Adrenal Gland: superomedial to kidney Renal Artery + Vein Innervation: branches of renal plexus
pg 648
- Vein - Ureter
CLINICAL ANATOMY
Peritonitis:
Inflammation of the covering of the abdominal structures, causing rigidity and severe pain. Acute abdomen:
Appendicitis:
Cholecystitis:
Dyspepsia:
The feeling of an upset stomach or indigestion. Constipation: Having fewer than three bowel movements per week. Gastritis: Inflammation of the stomach, often causing nausea and/or pain. Peptic ulcer disease: Ulcers are erosions and peptic refers to acid. Intestinal obstruction: A single area of the small or large intestine can become blocked Vomiting and abdominal distension are symptoms.
Gastroparesis:
The stomach empties slowly due to nerve damage from diabetes or other conditions. Nausea and vomiting are symptoms. Pancreatitis: Inflammation of the pancreas. Alcohol and gallstones are the most common causes of pancreatitis. Other causes include drugs and trauma; about 10% to 15% of cases are from unknown causes. Hepatitis: Inflammation of the liver, usually due to viral infection. Drugs or immune system problems can also cause hepatitis.
Cirrhosis:
Scarring of the liver caused by chronic inflammation. Heavy drinking or chronic hepatitis are the most common causes. Ascites: Abdominal fluid buildup often caused by cirrhosis. Abdominal hernia: A weakening or gap in the abdominal fascia allows a section of the intestine to protrude. Abdominal aortic aneurysm: A weakening of the aorta's wall creates a balloon-like expansion of the vessel that grows over years.