Topic 217. Upper PART OF THE Abdominal Cavity PDF

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TOPIC 217. UPPER PART OF THE ABDOMINAL CAVITY ABDOMINAL CAVITY → space in the trunk below the diaphragm. It is divided into the abdominal cavity proper and pelvic cavity. 1. BORDERS - Anterolateral: o Rectus abdominis o External oblique o Internal oblique o Transversus abdominis - Posterior: o Lumbar segment of the spine o Psoas major o Quadratus lumborum - Superior – diaphragm - Inferior: o Iliac bones o Pelvic diaphragm 2. DIVISION The abdominal cavity is divided into 2 storeys: -

UPPER STOREY LOWER STOREY

UPPER PART OF THE ABDOMINAL CAVITY 1. BORDERS - Superior – inferior surface of the diaphragm - Inferior – transverse mesocolon 2. CONTENTS - Hepatic bursa - Pregastric bursa - Omental bursa - Organs: o Liver o Stomach o Gall bladder o Spleen o Superior poles of the kidneys o Adrenal glands o Superior part of the duodenum o Abdominal aorta o Inferior vena cava 3. BURSAE - Hepatic bursa o BORDERS  Superior – diaphragm  Inferior – transverse mesocolon  Anterior – anterior abdominal wall  Medial – falciform ligament - Pregastric bursa

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o BORDERS  Anterior – left lobe of the liver & abdominal wall  Posterior – lesser omentum Omental bursa (lesser sac of the peritoneum) o It has 2 recesses: superior and inferior o BORDERS  Superior – caudate lobe of the liver  Inferior – transverse mesocolon  Anterior – stomach and lesser omentum  Posterior – parietal peritoneum o EPIPLOIC FORAMEN  Superior – caudate lobe of the liver  Inferior – superior part of the duodenum  Anterior – hepatoduodenal ligament  Posterior – inferior vena cava

PERITONEUM -

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Serous membrane lining the abdominal and pelvic cavities o In males: closed o In females: communicates with the external environment by the uterine tubes Consists of 2 layers: o Parietal peritoneum o Visceral peritoneum *Between them, the peritoneal cavity is located → contains peritoneal fluid The extraperitoneal tissue (tela subserosa) contains a large amount of fatty tissue that is lodged between the peritoneum and the abdominal wall. o Richly developed on the posterior abdominal wall o Poorly developed on the anterior abdominal wall

1. PARIETAL PERITONEUM - Fibrous tissue - Lines the inner surface of the abdominal and pelvic cavities → forms the outer limit of the peritoneal cavity - Receives the same arterial and nerve supplies as the wall it lines - More sensitive to pain because it is innervated by SOMATIC INNERVATION o In the pelvis – devoid of somatic innervation 2. VISCERAL PERITONEUM - Composed of mesothelial cells - Covers the outer surface of the abdominal visceral organs - Receives the same arterial and nerve supplies as the organ it covers - Innervated by AUTONOMIC INNERVATION - Pain is only felt when the organ is distended or ischemic RELATIONS OF VISCERAL ORGANS TO PERITONEUM 1. INTRAPERITONEAL ORGANS - Completely (4 sides) covered by peritoneum - Generally mobile → can be moved away to access deeper organs in surgery and prone to herniation - They are:

o Stomach o Bulbus duodeni of the superior part of the duodenum o Jejunum o Ileum o Appendix o Transverse colon o Sigmoid colon o Supraampular part of the rectum o Spleen o Ovaries 2. MESOPERITONEAL ORGANS - Covered by the peritoneum by 3 sides - Degree of mobility is between the intraperitoneal and extraperitoneal organs - They are: o Liver o Gall bladder o Ascending part of duodenum o Caecum o Ascending colon o Descending colon o Ampular part of the rectum o Urinary bladder (when distended) o Uterus 3. EXTRAPERITONEAL (RETROPERITONEAL) ORGANS - Covered by peritoneum by only 1 side - Located in the retroperitoneal space - Not movable at all - They are: o Descending and horizontal parts of the duodenum o Anal canal o Pancreas o Kidneys o Adrenal glands o Ureters o Urinary bladder (when empty) o Major vessels like the abdominal aorta and the inferior vena cava...