Lecture 3, Peritoneum And Abdominal Cavity, Part 2, 27 Apri

Courtney Takahashi Anatomy Lecture #3 27 April 2006 Identify: Lobes of the liver - Diaphragmatic surface of the liver Where is the bare area? - Visceral surface of the liver - Coronary ligament - Round ligament What are the physiologic lobes? Which lobe has the majority of the caudate and quadrate regions? What are they anatomic lobes of the liver? Ligamentum venosum Importance? Ligamentum teres Importance? Gallbladder What is its location? - Fundus - Body - Neck Where do gallstones commonly collect? Triangle of Calot What is in it? Pancreas - Head - Uncinate process - Neck - Body - Tail Describe its location What is special about the pancreas’ embryologic formation? What is annular pancreas? What is the course of the main pancreatic duct? (of Wirsung) What is it called if the ventral

Bare area – Place where liver contacts the diaphragm Physiologic lobes – Right and Left lobes of the liver, functionally independent, i.e. own blood supply and biliary system Left lobe has most of the caudate and quadrate regions Anatomic lobes are the right, left, caudate and quadrate lobes of the liver

Fibrous remnant of the ductus venosus, which shunted blood from the umbilical vein to the IVC in the fetus Fibrous remnant of the umbilical vein. Paraumbilical veins here can get engorged with blood during portal HTN and cause caput medusae Under the costal margin, next to the linea semilunaris, at the junction of the right and left lobes of the liver Gallstones are usually found at the junction of the neck and cystic duct, i.e. infundibulum or Hartmann’s pouch Right lobe of liver, common hepatic duct, common cystic duct Contains the cystic artery Retroperitoneal, posterior to the stomach, between the duodenum and the spleen Starts of intraperitoneal and becomes retroperitoneal, made from both ventral mesentery and dorsal mesentery, ventral bud moves dorsally during the rotation of the stomach A bifid ventral bud fuses with the dorsal bud. The two parts of the ventral bud go around the duodenum and constrict it. Goes from distal part of dorsal duct through the entire ventral duct Accessory pancreatic duct (of Santorini)

opening of the dorsal duct remains? What part of the pancreas does the ventral duct form? What organ does the cranial limb give rise to? What organ does the caudal limb give rise to? How many degrees does the intestine turn when it herniates? What are the differences between congenital omphalocele, umbilical hernia, and gastroschisis? What is Meckel’s diverticulum? What conditions can it mimic? What are some signs and symptoms? Superior pancreaticoduodenal artery Inferior pancreaticoduodenal artery Why are these significant? Superior mesenteric artery - Ileocolic artery - Middle colic artery - Right colic artery Duodenum – What are the important features in each part? - 1st part: Ampulla / Duodenal cap - 2nd part: Descending - 3rd part: Horizontal - 4th part: Ascending Jejunal / Ileal arcades Jejunal / Ileal loops Teniae coli Haustra Epiploic (omental appendices) Cecum Ileocecal valve Appendix Ascending, transverse, descending, sigmoid colon Left colic artery Sigmoid arteries Superior rectal arteries

Uncinate process and inferior part of the head Small intestines Large intestine 270 Omphalocele – Failure of intestines to return to abdominal cavity during the 10th week Umbilical hernia – Imperfectly closed umbilicus allows intestines to herniate out after it has returned to abdomen Gastroschisis – Abdominal wall defect Failure of involution of vitelline duct Can mimic appendicitis Can cause ulceration, bleeding, if patent, fecal discharge can exit the umbilicus Superior pancreaticoduodenal and inferior pancreaticoduodenal provide and important anastomoses between celiac trunk and SMA

1st part – No circular folds, has mesentery and is mobile 2nd part – Site where bile and pancreatic ducts enter 3rd part – Crossed by SMA and SMV 4th part – Ligament of Treitz