Abdominal Cavity

Abdominal Cavity The Gastrointestinal Tract Lectured by Bien Eli Nillos, MD

Post-Test 

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Choose whether it is the Jejunum or the Ileum that is being described: coiled in the upper part of the peritoneal cavity below the left side of the transverse colon In the lower part, the plicae circulares are absent

3. mesenteric vessels form one or two arcades 4. Peyer’s patches are present in the mucous membrane 5. end of the mesentery, the fat is deposited near the root and scanty near the intestinal wall

Blood Supply: Write the blood supply of the following parts of the stomach: 6. Fundus 7. Pylorus 8. Lower part of the lesser curvature 9. Lower part of the greater curvature 10. Cardiac Orifice

True or False: 11. Duodenum is more proximal than the jejunum 12. Plicae circulares are folds in the mucosal membrane of the stomach 13. The Bile duct opens into the first part of the duodenum 14. The Jejunum hugs the uncinate process of the pancreas 15. Pyloric valve is a physiological valve.

The Gastrointestinal tract     

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Mouth Pharynx Esophagus Stomach Small intestine (Doudenum, Jejunum, Ileum) Large Intestine (Cecum, Ascending, Transverse, Descending, Sigmoid) Rectum

THE STOMACH

The Small Intestines 

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The longest part of the alimentary canal DOUDENUM JEJUNUM ILEUM

Jejunum versus Ileum 

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Jejunum is coiled in the upper part of the peritoneal cavity below the left side of the transverse colon; Ileum is in the lower part of the cavity and in the pelvis Jejunum is widerbored, thicker-walled and redder than the ileum

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Jejunum wall feels thicker because of the plicae circulares, largers and more numerous. In the lower part of the ileum, the plicae circulares are absent Jejunal mesentery is attached to the posterior abdominal wall above and to the left of the aorta; ileal mesentery is attached below and to the right of the aorta.

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Jejunal mesenteric vessels form one or two arcades with long and infrequent branches; Ilem has show terminal vessels that arise from a series of 3 or four or even more arcades. At the jejunal end of the mesentery, the fat is deposited near the root and scanty near the intestinal wall; at the ileal end of the mesentery, the fat is

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Peyer’s patches are present in the mucous membrane of the lower ileum along the antimesenteric border.

Large Intestines     

Cecum – appendix Ascending Colon Transverse Colon Descending Colon Sigmoid Colon

Blood Supply of the Gastrointestinal Tract 

Celiac Artery – short, at the level of T12  

From the Abdominal Aorta Branches: 

Left Gastric Artery 

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Splenic Artery   

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Esophageal branches Pancreatic branches Left gastroepiploic artery Short Gastric arteries

Hepatic Artery  

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Right gastric artery Gastroduodenal artery  Right gastroepiploic artery  Superior pancreaticoduodenal artery Right and left hepatic arteries

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Superior Mesenteric Artery 

Branches: Inferior Pancreaticoduodenal  Middle Colic  Right Colic  Ileocolic  Jejunal and Ileal branches 

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Inferior Mesenteric Artery 

Branches: Left Colic  Sigmoid Arteries  Superior Rectal Artery 

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Portal Vein  

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Formed behind the neck of the pancreas Union of: Superior mesenteric and Splenic Veins Posterior to the first part of the duodenum

LIVER   

Production and secretion of bile Involves in many metabolic activities Filtration of blood removing bacteria and other foreign particles

Gallbladder    

Pear-shaped sac Reservoir for bile – 50 ml capacity Concentrates bile Cholecystokinin (released by duodenum) – stimulates contraction of the gallbladder

Cystic Duct 

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Connects the neck of the gallbladder to the Common Hepatic Duct to form the Bile Duct S-shaped “spiral valve” – assists in keeping the lumen open

Pancreas  

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Both Exocrine and Endocrine Lobulated and lies on the posterior abdominal wall behind the peritoneum Head, body, neck and tail Uncinate Process (part of the head, extends to the left behind the superior mesenteric vessel)

Spleen 

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Reddish in color, lies in the left hypochondrium The largest single mass of lymphoid tissue in the body and is generally ovoid in shape Has a notched anterior border

“Tummy Tuck” 

Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in most cases restores weakened or separated muscles creating an abdominal profile that is smoother and firmer.

Tummy Tuck Procedure  

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Step 1 – Anesthesia Medications are administered Step 2 – The incision: A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and navel. The shape and length of the incision will be determined by the degree of correction necessary. Through this incision, weakened abdominal muscles are repaired and sutured and excess fat, tissue and skin is removed. A second incision around the navel may be necessary to remove excess skin in the upper abdomen.

END OF LECTURE

Post-Test    

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1-3. 3 parts of the Gallbladder 4-7. 4 parts of the Pancreas 8-9. 2 major blood supply of the Liver 10. hormone which stimulates contraction of the gallbladder 11. Source of the Hormone in No. 10 12. Part of the Large intestine located in the right iliac fossa 13. largest single mass of lymphoid tissue 14 – 15. 2 ducts which form the Common Bile Duct