Abdomen 2

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

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
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
100. Peritoneal Relations (Page 93)
103. Orifices
106. Blood Supply
110. Lymph Drainage
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
126. Lymph Drainage
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
132. Ascending & Descending Colons (Page 134)
135. Relations of Ascending & Descending Colons
140. Blood Supply
144. Lymph Drainage
146. Transverse Colon
151. Relations of Transverse Colon
152. A- Superficial Relations
158. B- Deep Relations
161. Peritoneal Covering
163. Transverse Mesocolon
166. Colic Flexures
170. Blood Supply of Colic Flexures
172. Sigmoid (pelvic) Colon
174. Relations of Sigmoid Colon
179. Peritoneal Coverings
181. Blood Supply & Lymph Drainage
184. Arterial Supply of Colon (Page 147)
186. Lymph Drainage of Colon
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.
194. Marginal Artery
196. Portal Vein (Page 165)
199. Relations
202. Tributaries of Portal vein
204. Porto-systemic Anastomosis
207. Splenic Vein
209. Superior Mesentric Vein