Abdomen pt. 2 Flashcards
Fascia contributing to the abdomen from the Transversus Abdominis Muscle.
-Deep to this is pre-peritoneal Fat
Transversalis Fascia
Which abdomen is weaker, upper or lower?
Lower is weaker than upper. In the lower abdomen, aponeuroses don’t go completely around the abdominal aorta. They combine and go anterior to the Rectus Abdominis, but not posterior.
-Hernias are more likely to occur here due to incomplete Rectus Sheath not bracing these muscles.
-Has rectus sheath anteriorly and posteriorly
-External Abdominal Oblique aponeurosis runs in front
-Internal Abdominal Oblique aponeurosis splits, and some go in font and some go behind
-Transversus Abdominis aponeurosis fibers run behind
Upper Abdomen
The deepest layer; the body wall itself. Lines the internal abdominal cavity
Parietal Peritoneum
Connects the peritoneum posteriorly with a visceral structure. Fold of peritoneum that sticks out. Ligament that attaches something in back to something in front.
Mesentery
Attaches the stomach to the liver
Lesser Omentum
Joins the stomach, and then flops down, folds on itself to wrap around transverse colon.
-Has to be kept warm during surgery, can lower a patient’s body temp
-Fatty Apron
-Has a free end
Greater Omentum
Runs from posterior body wall, has parietal peritoneum on it.
-Attaches into Transverse Colon
Transverse Mesocolon
A sac between the stomach and pancreas, has liver above it and transverse colon below.
-Cushion for organs to rest on
-Has an opening formed by the free edge of Lesser Omentum, called the Epiploic Foramen of Winslow.
Omental Bursa
The entrance into the Omental Bursa.
-Good place for infections to hide (blind pouch)
-Acts as a water-bed for organs to rest on
-Found on the Right side of the body at the attachment between the Duodenum and Liver
-Lesser Omentum lies in front and IVC is behind
Epiploic Foramen of Winslow
Liver is suspended from Diaphragm. LO joins Liver to stomach, so stomach is suspended from Liver via LO. Then, Transverse Colon. GO forms the fold (Apron of fat) that overlies abdominal viscera.
Omentum
A vertical layer of peritoneum between the right and left lobes of the liver.
-Attaches to the posterior side of the abdominal wall
-In fetal life, was the Umbilical Vein
Ligamentum Teres Hepatis (Round Ligament of the Liver) & Falciform Ligament
-Cardia: portion that joins esophagus
-Fundus: Part that bulges, touches spleen
-Body: biggest portion
-Pylorus: termination into the duodenum
-Attached to the liver via Lesser Omentum
Stomach
Hidden from view unless enlarged. Tucked in under 12th rib. Have to retract viscera to view.
Spleen
Fits snugly between right lobe and quadrate lobe in fossa for the gallbladder.
Gallbladder
-Attached between right and left lobe. Vertically running slip of peritoneum. Attaches to the anterior body wall from the posterior side.
-Supports the vein running in the free edge of the Falciform Ligament called the Ligamentum Teres Hepatis (old Umbilical vein in-utero)
Falciform Ligament
Found to the left of the IVC where it passes through the liver.
-IVC passes between this and the Right Lobe
Caudate Lobe
-C Shaped with concavity facing towards the left.
-Comes off the pyloric portion of stomach, then get to portion lying horizontally called the Superior Portion of the Duodenum or the Duodenal Bulb. Significant for dz - peptic ulcers occur here (70% of cases occur here).
-Descending Portion of the Duodenum
-Transverse Portion of the Duodenum
-Ascending Portion of the Duodenum
These are about the level of the xiphoid process
Duodenum