Abdomen 2

Abdomen 2

This presentation covers the 2nd quarter of Anatomy of the Abdomen

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Dr.Sherif Fahmy

August 13, 2019
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Transcript

  1. Small Intestine 1- Duodenum. 2- Jejunum. 3- Ileum.

  2. Duodenum Jujenum Ileum

  3. Duodenum (Page 111)

  4. General Features Site: Epigastric and umbilical region. Length: 10 inches

    (25 cm or 12 finger breadth). Shape: C-shaped. Parts: 1st (2 inches), 2nd (3 inches(, 3rd part (4 inches) & 4th part (1 inch). Peritoneal coverings: 1st inch like stomach while the rest is retroperitoneal.
  5. Beginning, Parts & End

  6. Pyloro-duodenal junction (L1)

  7. Dudo-jujenal flexure Suspensory lig. Of Trietz Right crus of diaphragm

  8. Duodeno- jejunal flexure Body of pancreas

  9. Directions & Level of Parts of Duodenum

  10. 1st 2nd 3rd 4th Dr. Sherif Fahmy

  11. Peritoneal Coverings

  12. Lesser omentum Opening of lesser sac Greater omentum

  13. Retro- peritoneal parts bare areas

  14. Duodenal Folds & Recesses (Page 91)

  15. Superior fold Inferior fold Para- duodenal fold Retrro-duodenal recess Inferior

    mesenteric vein
  16. Relations of Duodenum

  17. Rt. kidney Rt. Psoas major m. Ureter Inf. Vena cava

    Abdominal aorta Lt. psoas major
  18. Head of pancreas Neck of pancreas Portal vein Quadrate lobe

    Gall bladder
  19. Relations of first part

  20. Upper & Anterior Relations of 1st part Quadrate lobe Neck

    of Gall bladder Lesser omentum Opening of lesser sac Greater omentum
  21. Quadrate lobe Neck of Gall bladder Anterior Relations of the

    1st part
  22. Portal vein Neck of pancreas Posterior & Lower Relations of

    1st inch Head of pancreas
  23. 1st 2nd 3rd 4th Common bile duct Gastroduodenal art Posterior

    Relations of 2nd inch of 1st part
  24. Relations of Second Part

  25. Anterior Relations of 1st part Rt lobe of liver Transverse

    colon
  26. Right lobe of liver Beginning of transverse colon Coils of

    jejunum Anterior relations of 2nd part
  27. Hilum of right kidney Posterior relations of 2nd part Right

    psoas major m.
  28. Posterior relations of 2nd part Right kidney Right psoas major

    muscle
  29. Right & Left relations of 2nd part Right colic flexure

    Ascending colon Head of pancreas
  30. Superior pancreatico- duodenal vessels Inferior pancreatico duodenal vessels

  31. Hepato-pancreatic ampulla of vater Postero-medial aspect of the middle of

    second part
  32. 1st 2nd 3rd 4th Major duodenal papilla Minor duodenal papilla

  33. Relations of 3rd part

  34. Superior mesenteric artery in root of mesentery of small intestine

    Anterior Relations of 3rd part 3rd part of duodenum
  35. Right psoas Right ureter Inf. Vena cava Right gonadal Aorta

    Inferior mesenteric art. Posterior (deep) & above (superior) relations of 3rd part Head of pancreas
  36. Relations of 4th part

  37. Dr. Sherif Fahmy

  38. Transverse colon

  39. Left psoas major m. Left sympathetic chain Uncinate process Abdominal

    aorta Posterior, Right and Left Relations Hilum of left kidney
  40. Blood Supply of Duodenum

  41. Hepatic artery Superior mesenteric artery Gastro-duodenal a. Superior pancreatico- duodenal

    Rt. Gastro-epiploic a Coeliac trunk Supra-duodenal (50%) Right gastric Inferior pancreatico- duodenal a.
  42. Portal vein Sup. Mesenteric vein Pancreatico- duodenal veins Rt. Gastro-epiploic

    vein Rt. Gastric vein
  43. Blood Supply of Duodenum

  44. Arterial Supply

  45. Hepatic artery Superior mesenteric artery Gastro-duodenal a. Superior pancreatico- duodenal

    Rt. Gastro-epiploic a Coeliac trunk Supra-duodenal (50%) Right gastric Inferior pancreatico- duodenal a.
  46. Venous Drainage

  47. Dr. Sherif Fahmy Right gastric vein Portal vein Right gastro-

    epiploic vein Superior & inferior pancreatico- duodenal veins Superior mesenteric vein
  48. Lymph Drainage

  49. Subpyloric nodes Suprapyloric nodes Coeliac nodes Hepatic nodes

  50. None
  51. Nerve Supply From coeliac plexus: Parasympathetic: -Vagus. Sympathetic: -post-ganglionic branches

    of coeliac ganglia, preganglionic fibers from greater splanchnic nerve.
  52. Applied Anatomy ➢Duodenum is the commonest site of peptic ulcer.

    ➢Suspensory ligament of Treitz is a landmark to end of duodenum.
  53. Duodenal cap

  54. Jejunum & Ileum (Page 121)

  55. Duodenum Jejunum Ileum

  56. Duodeno-jejunal flexure Ileo-cecal junction

  57. Jejunum Ileum

  58. Vasculature Jejunum Ileum

  59. Mesentery of Small Intestine (Page 121)

  60. Course of the Root of the Mesentery

  61. Superior mesenteric artery in root of mesentery of small intestine

    Ileoceacal junction Dudeno- jejunal flexure Beginning & end of the root of the Mesentery
  62. Superior mesenteric a. Superior mesenteric vein 3rd part of duodenum

    Body of pancreas Course
  63. Contents of Mesentery 1- Jejunum and ileum. 2- Jejunal &

    ileal arteries. 3- Lymph nodes. 4- Extraperitoneal fat, lymphatics and autonomic nerves.
  64. Superior mesenteric artery in root of mesentery of small intestine

    Ileoceacal junction Dudeno- jujenal flexure Beginning & end of the root of the Mesentery
  65. Superior Mesenteric Artery (Page 156)

  66. Abdominal aorta Coeliac artery Superior mesenteric artery Inferior mesenteric artery

  67. Superior mesenteric artery in root of mesentery of small intestine

    Ileoceacal junction Splenic vein Course of Superior Mesenteric Artery Left renal vein Body of pancreas (cut)
  68. Course & Relations

  69. Abdominal aorta Inferior vena cava Right ureter and psoas major

    m. Ileo-caecal junction Head of pancreas Superior mesenteric artry
  70. Branches of Superior Mesentric Artery

  71. 1- Inferior pancreatico- duodenal. 2- Jejunal & ileal 3- Middle

    colic. 4- Right colic. 5- Ileocolic.
  72. Inferior pancreatico- duodenal a Right colic art. Ilio-colic art.

  73. Jejunal arteries Ileal arteries

  74. Superior mesenteric a. Inferior pancreatico- duodenal a.

  75. Jejunal arteries Ileal branches Middle colic a. Right colic a.

    Ilio-colic a.
  76. Large Intestine (Page 126)

  77. Orientation For Relations

  78. Dr. Sherif Fahmy

  79. Dr. Sherif Fahmy

  80. Dr. Sherif Fahmy

  81. General Orientation of Posterior Abdominal Wall

  82. Psoas major m Iliacus m Iliac crest Quadratus lumorum m

    Transversus abdominis Lateral arcuate ligament Medial arcuate ligament Diaphragm Dr. Sherif Fahmy
  83. Lumbo- sacral trunk Obturator n Genito-femoral nerve Femoral nerve Lat.

    Cut. Nerve of Thigh Ileo-hypogastric nerve Ileoinguinal n Subcostal vs & n Dr. Sherif Fahmy
  84. Aorta IVC Common iliac artery External iliac artery Dr. Sherif

    Fahmy
  85. Site & parts

  86. Appendix Ceacum Ascending colon Rt. Colic flexure Transverse colon Lt

    colic flexure Descending colon Pelvic colon
  87. Sigmoid colon Rectum Anal canal

  88. Characters

  89. Sacculation Taenia coli Appendices epiploicae

  90. Tinea coli Sacculations Appendicis epiploice

  91. Ceacum (Page 128)

  92. Site & Surface Anatomy

  93. Rt. Mid- clavicular plane Transtubercular plane Inguinal ligament

  94. Relations

  95. Anterior Relations Greater omentum Coils of small intestine

  96. Psoas major m. Femoral nerve Lateral cut. N. of thigh

    over iliacus m. Gonadal vessels
  97. Psoas major m Iliacus m Iliac crest Quadratus lumorum m

    Transversus abdominis Lateral arcuate ligament Medial arcuate ligament Diaphragm
  98. Lumbo- sacral trunk Obturator n Genito-femoral nerve Femoral nerve Psoas

    major m. Lat. Cut. Nerve of Thigh Iliacus m. Iliac crest Ileo- hypogastric nerve Ileoinguinal n Subcostal vs & n
  99. None
  100. Peritoneal Relations (Page 93)

  101. None
  102. None
  103. Orifices

  104. None
  105. None
  106. Blood Supply

  107. None
  108. None
  109. None
  110. Lymph Drainage

  111. None
  112. Vermiform Appendix (Page 119)

  113. Appendix (2 – 20 cm) Caecum

  114. Caecu m Appendix Mesoappendi x tenia coli

  115. Site

  116. Shape, length and orifice

  117. Opening of appendix Ileocecal orifice (valve)

  118. Positions of Appendix

  119. Retrocecal 75% Pelvic 20% Subcecal Preileal Postileal

  120. Transverse section of vermiform appendix

  121. Mesoappendix & Blood Supply

  122. Appendicular artery Mesoappendix

  123. Superior mesenteric artery Ileocolic artery Blood supply of appendix

  124. None
  125. None
  126. Lymph Drainage

  127. None
  128. Nerve supply: A-Parasympathetic: Vagus nerve. B-Sympathetic: From Caeliac plexus through

    superior mesenteric plexus.
  129. Surface Anatomy

  130. McBurney’s point Surface anatomy of base of appendix

  131. None
  132. Ascending & Descending Colons (Page 134)

  133. None
  134. None
  135. Relations of Ascending & Descending Colons

  136. None
  137. None
  138. None
  139. None
  140. Blood Supply

  141. None
  142. None
  143. None
  144. Lymph Drainage

  145. None
  146. Transverse Colon

  147. None
  148. None
  149. None
  150. None
  151. Relations of Transverse Colon

  152. A- Superficial Relations

  153. None
  154. None
  155. None
  156. None
  157. None
  158. B- Deep Relations

  159. None
  160. None
  161. Peritoneal Covering

  162. None
  163. Transverse Mesocolon

  164. None
  165. None
  166. Colic Flexures

  167. None
  168. None
  169. None
  170. Blood Supply of Colic Flexures

  171. None
  172. Sigmoid (pelvic) Colon

  173. None
  174. Relations of Sigmoid Colon

  175. None
  176. None
  177. None
  178. None
  179. Peritoneal Coverings

  180. None
  181. Blood Supply & Lymph Drainage

  182. None
  183. None
  184. Arterial Supply of Colon (Page 147)

  185. None
  186. Lymph Drainage of Colon

  187. None
  188. Nerve Supply of Colon -Parasympathetic supply. -Sympathetic.

  189. Inferior Mesenteric Artery (Page 161)

  190. Abdominal aorta Common iliac artery Coeliac artery Superior mesenteric artery

    Inferior mesenteric artery
  191. Inferior mesenteric a. Superior rectal a.

  192. Branches of inferior mesenteric artery: 1- Superior left colic. 2-

    Inferior left colic (sigmoidal). 3- Superior rectal artery.
  193. None
  194. Marginal Artery

  195. None
  196. Portal Vein (Page 165)

  197. None
  198. None
  199. Relations

  200. None
  201. None
  202. Tributaries of Portal vein

  203. None
  204. Porto-systemic Anastomosis

  205. None
  206. None
  207. Splenic Vein

  208. None
  209. Superior Mesentric Vein

  210. None