Abdomen 4

Abdomen 4

This presentation shows the 4th quarter of Anatomy of the Abdomen


Dr.Sherif Fahmy

August 15, 2019


  1. 1.
  2. 8.
  3. 9.

    Spleen is completely covered with peritoneum except hilum that gives

    attachment to: -Gastrosplenic lig. -Lienorenal lig. Gastrosplenic lig. Lienorenal lig.
  4. 10.

    Features of Spleen It has: 1- Two Ends: Anterior &

    Posterior. 2- Two Borders: Upper & Lower. 3- Two Surfaces: Diaphragmatic & Visceral.
  5. 16.

    Gastric impression Renal impression for left kidney Colic impression for

    left colic flexure Impression of tail of pancreas
  6. 20.

    Lymph Drainage ➢Red bulbs of spleen has no lymphatics. ➢Few

    lymphatics from the capsule and trabeculae are drained to pancreatico- splenic nodes.
  7. 23.

    Functions of Spleen 1- Store of blood and iron. 2-

    Destruction of old red blood cells. 3- Formation of red blood cells during intra-uterine life till the 5th month of intrauterine life.
  8. 24.

    Applied Anatomy 1- Common causes of splenic enlargement? 2- Spleen

    can be felt below costal margin after being enlarged 3 times its normal size. 3- Spleen enlarge downwards and to the right due to presence of phrenico-colic ligament.
  9. 25.
  10. 38.

    3- Relations of the Body The body of pancreas is

    triangular in cross section. It has 3 surfaces & 3 borders: Surfaces: - Anterior. - Posterior. - Inferior. Borders: - Anterior. - Upper. - Lower
  11. 40.

    Omental tuberosity Transverse mesocolon Celiac trunk Celiac lymph nodes Splenic

    artery Pancreatico-splenic lymph nodes Duodeno-jujenal flexure Coils of jujenum Left colic flexure
  12. 41.

    Abdominal aorta Superior mesenteric artery Splenic vein Left renal vein

    Left crus of diaphragm Left sympathetic chain Left psoas major muscle Left kidney Left suprarenal gland
  13. 45.

    Main pancreatic duct Common bile duct Ampulla of Vater Sphincter

    of Oddi in the major duodenal papilla Accessory pancreatic duct Minor duodenal papilla
  14. 47.

    Celiac trunk Splenic artery Gastro-duodenal a. Superior mesenteric artery Inferior

    pancreatico- duodenal artery Superior pancreatico- duodenal artery
  15. 51.

    Applied Anatomy Cancer head: may lead to obstruction of: 1-

    Common bile duct: leads to jaundice. 2- Inferior vena cava: Edema in lower limb. 3- Portal vein: Portal hypertension. 4- Pyloric end: leads to pyloric stenosis. 5- Duodenum: Duodenal obstruction. Pancreatic pain: Felt in epigastric region, referred to back. Relieved by leaning forward. Duodenal ulcer: May be complicated by erosion of pancreas.
  16. 53.

    Abdominal aorta Coeliac artery (upper border of L1) Superior mesenteric

    artery (lower border of L1) Inferior mesenteric artery (L3)
  17. 56.

    Lesser omentum & lesser sac Coeliac trunk (at lower border

    of T12 or upper border of L1) Median arcuate ligament Anterior Relations Superior Relations
  18. 64.

    Coeliac trunk Splenic artery 5 terminal splenic branches (end arteries)

    Short gastric arteries Left gastro-epiploic artery Posterior gastric 50 %
  19. 66.

    Coeliac trunk Common hepatic artery Right gastric artery Gastroduodenal artery

    Supraduodenal artery (50 %) Right gastro-epiploic a. Superior pancreatico- duodenal artery Hepatic artery proper
  20. 67.
  21. 71.

    Splenic vein Left renal vein Head of pancreas (cut) Superior

    mesenteric a. 3rd part of duodenum Inferior vena cava
  22. 72.

    Branches of Superior Mesentric Artery 1- Inferior pancreatico-duodenal. 2- Jujenal

    & ileal 3- Middle colic. 4- Right colic. 5- Ileocolic.
  23. 75.
  24. 79.

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

    Inferior left colic (sigmoidal). 3- Superior rectal artery.
  25. 80.
  26. 82.
  27. 91.
  28. 92.
  29. 106.

    Xiphoid process Lower 6 ribs & costal cartilages Right crus

    of diaphragm Left crus of diaphragm Median arcuate ligament Medial arcuate ligament Lateral arcuate ligament Psoas major muscle Quadratus lumborum Central (trifoliate) tendon
  30. 108.

    Sternal origin Costal origin Vertebral origin Anterior defect (foramen of

    Morgagni) Posterior defect (foramen of Bockdalek – vertebrocostal triangle) Central tendon Median part (folium) of central tendon Lateral parts (folia) of central tendon
  31. 111.

    Vena caval opening (1 inch to the right of midline

    at T8) IVC Right phrenic nerve Esophageal opening (1 inch to the left of midline at T10) Esophagus Anterior & posterior vagal trunks Aortic opening of diaphragm (midline at T12) Aorta Thoracic duct
  32. 112.

    Minor openings of diaphragm ➢Superior epigastric and musculophrenic arteries. ➢Lower

    5 intercostal nerves and subcostal nerve. ➢Subcostal vessels. ➢Inferior hemiazygos vein. ➢Splanchnic nerves and sympathetic chain.
  33. 113.

    Arterial supply of diaphragm ➢Superior phrenic artery from descending aorta.

    ➢Inferior phrenic artery from abdominal aorta. ➢Musculophrenic artery. ➢Lower posterior intercostal arteries. ➢Pericardiacophrenic artery.
  34. 114.

    Applied anatomy Diaphragmatic hernia: A- Hiatus hernia: through esophageal opening.

    B- Hernia of Bockdalk: between vertebral and costal origin of diaphragm. C- Hernia of Morgagni: between sternal and costal origin of diaphragm.
  35. 119.

    Psoas major m. T12 Lumbar vertebrae Ilio-psoas tendon to lesser

    trochanter & 1 inch below Inguinal lig.
  36. 123.

    Right kidney 2nd part of duodenum 3rd part of duodenum

    Ureter Gonadal artery Genito-femoral nerve 4th part of duodenum
  37. 126.

    Quadratus lumborum Ilio-hypogastric nerve Ilio-inguinal nerve Iliacus muscle Lateral cutaneous

    nerve of thigh Femoral nerve Quadratus lumborum muscle Iliac crest Iliacus muscle Lumbar plexus and transverse processes of lumbar vertebrae Posterior Relations Lateral Relations
  38. 131.
  39. 133.
  40. 134.
  41. 139.