DOCSLIB.ORG

The Subperitoneal Space and Peritoneal Cavity: Basic Concepts Harpreet K

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Subperitoneal Space and Peritoneal Cavity: Basic Concepts Harpreet K ª The Author(s) 2015. This article is published with Abdom Imaging (2015) 40:2710–2722 Abdominal open access at Springerlink.com DOI: 10.1007/s00261-015-0429-5 Published online: 26 May 2015 Imaging The subperitoneal space and peritoneal cavity: basic concepts Harpreet K. Pannu,1 Michael Oliphant2 1Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA 2Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA Abstract The peritoneum is analogous to the pleura which has a visceral layer covering lung and a parietal layer lining the The subperitoneal space and peritoneal cavity are two thoracic cavity. Similar to the pleural cavity, the peri- mutually exclusive spaces that are separated by the toneal cavity is visualized on imaging if it is abnormally peritoneum. Each is a single continuous space with in- distended by fluid, gas, or masses. terconnected regions. Disease can spread either within the subperitoneal space or within the peritoneal cavity to Location of the abdominal and pelvic organs distant sites in the abdomen and pelvis via these inter- connecting pathways. Disease can also cross the peri- There are two spaces in the abdomen and pelvis, the toneum to spread from the subperitoneal space to the peritoneal cavity (a potential space) and the subperi- peritoneal cavity or vice versa. toneal space, and these are separated by the peritoneum (Fig. 1). Regardless of the complexity of development in Key words: Subperitoneal space—Peritoneal the embryo, the subperitoneal space and the peritoneal cavity—Anatomy cavity remain separated from each other, and each re- mains a single continuous space (Figs. 2A, 3A). Distin- guishing the subperitoneal space from the potential space The article is based on the comprehensive and of the peritoneal cavity is important for understanding authoritative book by Drs Meyers, Charnsangavej, and the distinct patterns of disease spread in each. Oliphant titled Meyers’ Dynamic Radiology of the The term subperitoneal refers to tissue that is deep to Abdomen [1]. Key concepts from the book are high- the peritoneum and includes the extraperitoneal space, lighted in the following text and in Table 1. The text and the ligaments and the mesenteries and their suspended accompanying illustrative images are divided into 3 sec- organs (Fig. 2A). Organs whose surfaces are covered by tions on anatomy, an overview of the spread of disease, peritoneum are therefore subperitoneal. Subperitoneal and disease spread for selected organs. organs that are deep to the posterior peritoneum are called extraperitoneal. Since there are only 2 spaces in the Anatomy abdomen and there are no organs in the peritoneal cav- Lack of organs in the peritoneal cavity ity, all the abdominal pelvic organs, and their associated vessels, lymphatics, and nerves are in the subperitoneal The peritoneum is a serous membrane made up of vis- space. In other words, all the structures seen in the ceral and parietal layers. The visceral layer of the peri- abdomen and pelvis on cross-sectional imaging are in the toneum lines the surface of organs and the parietal subperitoneal space. The organs lie in the abdominal peritoneum lines the coelomic cavity. The peritoneal cavity, not the peritoneal cavity (Figs. 1, 2A). The peri- cavity is a potential space between the visceral and toneal cavity is a potential space devoid of organs. parietal layers of the peritoneum. There are no organs in the peritoneal cavity. The potential space of the peri- toneal cavity is normally not visible on imaging as it Importance of visualizing the subperitoneal space contains only a small amount of fluid (about 100 mL). as a single space The subperitoneal space is a large continuous space that is formed by regions interconnected by ligaments and Correspondence to: Harpreet K. Pannu; email: [email protected] mesenteries. Ligaments and mesenteries refer to the H. K. Pannu, M. Oliphant: The subperitoneal space and peritoneal cavity 2711 Table 1. Key concepts regarding the peritoneal cavity and subperitoneal space (SPS) Concept Discussion Spaces of the abdomen and pelvis There are 2 mutually exclusive spaces—the peritoneal cavity and the SPS The structure that defines the SPS & separates The peritoneum it from the peritoneal cavity The peritoneal cavity The peritoneal cavity is a potential space and is inconspicuous on normal imaging studies. There are no organs in the peritoneal cavity. The SPS The SPS is a single extraperitoneal space encompassing the entire abdomen and pelvis. It is divided into regions but remains one interconnected space. The SPS contains all the organs, vessels, lymphatics, and nerves of the abdomen and pelvis. The importance of distinguishing the SPS from The routes of disease spread differ for the SPS and the peritoneal cavity the peritoneal cavity The distinct patterns of disease spread in the SPS Disease spread can occur via mesenteries, ligaments, and lymphatics, and by periarterial, perineural, transvenous, and intratubular routes The distinct patterns of disease spread within Disease spreads along the pathways of fluid flow in the single continuous the peritoneal cavity space of the peritoneal cavity Transperitoneal disease spread Transperitoneal spread occurs when disease crosses the peritoneum which separates the SPS from the peritoneal cavity. Transperitoneal spread is bidirectional Fig. 1. The peritoneal cavity vs the subperitoneal space. all the abdominal pelvic organs which are interconnected via This is a schematic diagram showing the peritoneal cavity ligaments and mesenteries. Dotted lines show some of these (PC) on the left and the subperitoneal space (SPS) on the interconnections which allow for disease spread. Abbre- right. The diagram illustrates that these are 2 completely se- viations for the peritoneal cavity: IC inframesocolic compart- parate spaces within the abdominal cavity. The peritoneal ment, LP left paracolic recess, LS lesser sac, M Morison’s cavity and the subperitoneal space are separated by the pouch, RP right paracolic recess, RS right subphrenic space, peritoneum. The peritoneal cavity is one continuous space and RV rectovesical space. Abbreviations for the subperi- with interconnecting recesses, some of which are shown. The toneal space: B bladder, C colon, K kidney, L liver, P pan- subperitoneal space is also one continuous space containing creas, S spleen, SB small bowel, and ST stomach. subperitoneal tissue between suspended organs and the The relationship between the bowel mesentery extraperitoneal space. Visualizing the subperitoneal and the peritoneum space as a single space explains the spread of disease between different regions of the abdomen pelvis and The mesenteries of the abdomen and pelvis are composed between the organs covered by peritoneum and the ex- of subperitoneal tissue between 2 layers of visceral peri- traperitoneum. toneum. Comparing an axial CT image with a cross- 2712 H. K. Pannu, M. Oliphant: The subperitoneal space and peritoneal cavity Fig. 2. Relationship between the mesentery and the peri- area). Spine is shown on the diagram only for orientation pur- toneum. A Diagram of a 4-week-old embryo shows the coe- poses. A aorta, K kidney, S spine, and VM ventral mesentery. B lomic cavity which will form the peritoneal cavity (PC) Axial CT image shows the dorsal mesentery of the small bowel surrounding the primitive gut (G). The medial visceral layer as subperitoneal tissue (arrowhead) between 2 layers of vis- (arrows) of the peritoneum is apposed on the gut and the me- ceral peritoneum (black arrows). The parietal peritoneal reflec- sentery, while the parietal layer is lateral. The dorsal mesentery tion (white arrows) is also seen anterior to the colon (C), kidney, (DM) conveys vessels from the aorta to the gut. Other than the and in the anterior and lateral abdomen. There is fluid (asterisk) peritoneal cavity, all the tissue in the abdominal cavity portion of in the peritoneal cavity between the visceral (black arrows)and the diagram is the subperitoneal space (light gray shaded parietal (white arrows) layers of the peritoneum. sectional diagram of an embryo, the dorsal mesentery tissues anterior to the kidney leaving a connecting carries vessels from the aorta to the gut (Fig. 2). The splenorenal ligament that contains the distal splenic ar- visceral peritoneum surrounds the mesentery, forms the tery and vein. The midgut and hindgut form within the serosal layer of the gut, and is in continuity with the dorsal mesentery creating the small intestine mesentery parietal peritoneum which covers the extraperitoneal and the mesocolon. space. As the ligaments, mesenteries, and suspended or- Anteriorly, the liver forms in the subperitoneal tissues gans develop, the peritoneal cavity forms recesses that anterior to the stomach, or the ventral mesogastrium. remain interconnected as the peritoneal cavity and se- This divides the subperitoneal tissues into the gastro- parate from the subperitoneal space (Fig. 3A). hepatic ligament between the stomach and liver, and the falciform ligament between the liver and abdominal wall. Correlation between embryonic development and The free edge of the gastrohepatic ligament is the the abdominal ligaments hepatoduodenal ligament. The visceral peritoneum con- tinues over the stomach forming the serosal layer and The spleen, pancreas, liver, and gut form within the over the liver and spleen forming their capsules. mesentery that surrounds and suspends the primitive gut in the embryo. The development of these organs results Identifying the ligaments and bowel mesenteries in the creation of the abdominal ligaments that can be on imaging identified on CT. Posteriorly, the spleen and pancreas form in the The ligaments and mesenteries are named according to dorsal mesogastrium, or the part of the dorsal mesentery the viscera they connect and are identified by the vessels suspending the stomach (Fig. 3). The splenic artery runs that run in them. For example, the hepatoduodenal from the aorta through the dorsal mesogastrium to the ligament is identified by the portal vein, hepatic artery, spleen with branches continuing to the stomach.
Load more

Recommended publications
  • Bariatric Surgery in Adolescents: to Do Or Not to Do?
    children Review Bariatric Surgery in Adolescents: To Do or Not to Do? Valeria Calcaterra 1,2 , Hellas Cena 3,4 , Gloria Pelizzo 5,*, Debora Porri 3,4 , Corrado Regalbuto 6, Federica Vinci 6, Francesca Destro 5, Elettra Vestri 5, Elvira Verduci 2,7 , Alessandra Bosetti 2, Gianvincenzo Zuccotti 2,8 and Fatima Cody Stanford 9 1 Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy; [email protected] 2 Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; [email protected] (E.V.); [email protected] (A.B.); [email protected] (G.Z.) 3 Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; [email protected] (H.C.); [email protected] (D.P.) 4 Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy 5 Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; [email protected] (F.D.); [email protected] (E.V.) 6 Pediatric Unit, Fond. IRCCS Policlinico S. Matteo and University of Pavia, 27100 Pavia, Italy; [email protected] (C.R.); [email protected] (F.V.) 7 Department of Health Sciences, University of Milan, 20146 Milan, Italy 8 “L. Sacco” Department of Biomedical and Clinical Science, University of Milan, 20146 Milan, Italy 9 Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; [email protected] * Correspondence: [email protected] Abstract: Pediatric obesity is a multifaceted disease that can impact physical and mental health.
    [Show full text]
  • Sacrospinous Ligament Suspension and Uterosacral Ligament Suspension in the Treatment of Apical Prolapse
    6 Review Article Page 1 of 6 Sacrospinous ligament suspension and uterosacral ligament suspension in the treatment of apical prolapse Toy G. Lee, Bekir Serdar Unlu Division of Urogynecology, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas, USA Contributions: (I) Conception and design: All authors; (II) Administrative support: All authors; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Toy G. Lee, MD. Division of Urogynecology, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd, Galveston, Texas 77555, USA. Email: [email protected]. Abstract: In pelvic organ prolapse, anatomical defects may occur in either the anterior, posterior, or apical vaginal compartment. The apex must be evaluated correctly. Often, defects will occur in more the one compartment with apical defects contributing primarily to the descent of the anterior or posterior vaginal wall. If the vaginal apex, defined as either the cervix or vaginal cuff after total hysterectomy, is displaced downward, it is referred to as apical prolapse and must be addressed. Apical prolapse procedures may be performed via native tissue repair or with the use of mesh augmentation. Sacrospinous ligament suspension and uterosacral ligament suspension are common native tissue repairs, traditionally performed vaginally to re-support the apex. The uterosacral ligament suspension may also be performed laparoscopically. We review the pathophysiology, clinical presentation, evaluation, pre-operative considerations, surgical techniques, complications, and outcomes of these procedures.
    [Show full text]
  • A Simplified Fascial Model of Pelvic Anatomical Surgery: Going Beyond
    Anatomical Science International https://doi.org/10.1007/s12565-020-00553-z ORIGINAL ARTICLE A simplifed fascial model of pelvic anatomical surgery: going beyond parametrium‑centered surgical anatomy Stefano Cosma1 · Domenico Ferraioli2 · Marco Mitidieri3 · Marcello Ceccaroni4 · Paolo Zola5 · Leonardo Micheletti1 · Chiara Benedetto1 Received: 13 March 2020 / Accepted: 5 June 2020 © The Author(s) 2020 Abstract The classical surgical anatomy of the female pelvis is limited by its gynecological oncological focus on the parametrium and burdened by its modeling based on personal techniques of diferent surgeons. However, surgical treatment of pelvic diseases, spreading beyond the anatomical area of origin, requires extra-regional procedures and a thorough pelvic anatomical knowl- edge. This study evaluated the feasibility of a comprehensive and simplifed model of pelvic retroperitoneal compartmen- talization, based on anatomical rather than surgical anatomical structures. Such a model aims at providing an easier, holistic approach useful for clinical, surgical and educational purposes. Six fresh-frozen female pelves were macroscopically and systematically dissected. Three superfcial structures, i.e., the obliterated umbilical artery, the ureter and the sacrouterine ligament, were identifed as the landmarks of 3 deeper fascial-ligamentous structures, i.e., the umbilicovesical fascia, the urogenital-hypogastric fascia and the sacropubic ligament. The retroperitoneal areolar tissue was then gently teased away, exposing the compartments delimited by these deep fascial structures. Four compartments were identifed as a result of the intrapelvic development of the umbilicovesical fascia along the obliterated umbilical artery, the urogenital-hypogastric fascia along the mesoureter and the sacropubic ligaments. The retroperitoneal compartments were named: parietal, laterally to the umbilicovesical fascia; vascular, between the two fasciae; neural, medially to the urogenital-hypogastric fascia and visceral between the sacropubic ligaments.
    [Show full text]
  • Abdominal Cavity.Pptx
    UNIVERSITY OF BABYLON HAMMURABI MEDICAL COLLEGE GASTROINTESTINAL TRACT S4-PHASE 1 2018-2019 Lect.2/session 3 Dr. Suhad KahduM Al-Sadoon F. I . B. M . S (S ur g. ) , M.B.Ch.B. [email protected] The Peritoneal Cavity & Disposition of the Viscera objectives u describe and recognise the general appearance and disposition of the major abdominal viscera • explain the peritoneal cavity and structure of the peritoneum • describe the surface anatomy of the abdominal wall and the markers of the abdominal viscera u describe the surface regions of the abdominal wall and the planes which define them § describe the structure and relations of : o supracolic and infracolic compartments o the greater and lesser omentum, transverse mesocolon o lesser and greater sac, the location of the subphrenic spaces (especially the right posterior subphrenic recess) The abdominal cavity The abdomen is the part of the trunk between the thorax and the pelvis. The abdominal wall encloses the abdominal cavity, containing the peritoneal cavity and housing Most of the organs (viscera) of the alimentary system and part of the urogenital system. The Abdomen --General Description u Abdominal viscera are either suspended in the peritoneal cavity by mesenteries or are positioned between the cavity and the musculoskeletal wall Peritoneal Cavity – Basic AnatoMical Concepts The abdominal viscera are contained either within a serous membrane– lined cavity called the Abdominopelvic cavity. The walls of the abdominopelvic cavity are lined by parietal peritoneum AbdoMinal viscera include : major components of the Gastrointestinal system(abdominal part of the oesophagus, stomach, small & large intestines, liver, pancreas and gall bladder), the spleen, components of the urinary system (kidneys & ureters),the suprarenal glands & major neurovascular structures.
    [Show full text]
  • Carcinomatous Cirrhosis of the Liver with Sarcomatosis of the Peritoneum 1
    CARCINOMATOUS CIRRHOSIS OF THE LIVER WITH SARCOMATOSIS OF THE PERITONEUM 1 S. SANES, M.D., AND K. TERPLAN, M.D. (From tile Pathological Laboratory of the Buffalo General Hospital and School of Medicine, University of Buffalo) The following case is reported because of the occurrence of two different types of malignant neoplasm with typical portal cirrhosis of the liver. That a pathogenetic relationship exists between Laennec's cirrhosis and primary carcinoma of the liver is generally recognized. Whether the association of a peritoneal sarcoma with the cirrhosis in this case was more than a coincidence seemed an interesting point for discussion. REPORT OF CASE E. G., 11 white Italian male fifty-seven years old, was admitted to the Buffalo General Hospital on the service of Drs. N. G. Russell and A. H. Aaron, Nov. 25, 1934. He died Nov. 29, 1934. All his adult life he had partaken of large amounts of wine and whiskey daily. At the age of seventeen years he had suffered an attack of jaundice of several weeks' duration. The patient first began to lose weight and strength in 1932 and noticed that his skin was becoming dark. In March 1934 he complained of cramp-like abdominal pain, diarrhea, and bloating. The stools were watery. There was no nausea or vomiting. Upon hos­ pitalization, April 9, 1934, physical examination revealed that the pupils reacted to light and accommodation. The chest was emphysematous; breath sounds were diminished in both bases. The heart was regular; a systolic murmur was heard. The blood pressure was 118/70. The liver and spleen were palpable three finger breadths below the costal margin.
    [Show full text]
  • Understanding the Anatomy of the Denonvilliers Fascia: Review Article Compreendendo a Anatomia Da Fáscia De Denonvilliers: Artigo De Revisão Mohammed Yousef Alessa1
    THIEME Review Article 193 Understanding the Anatomy of the Denonvilliers Fascia: Review Article Compreendendo a anatomia da fáscia de Denonvilliers: Artigo de revisão Mohammed Yousef Alessa1 1 King Faisal University Surgery, Hofuf, Eastern Province, Saudi Arabia Address for correspondence Mohammed Yousef Alessa, King Faisal University Surgery, Hofuf, Eastern Provience, Saudi Arabia J Coloproctol 2021;41(2):193–197. (e-mail: [email protected]). Abstract The postoperative outcome of rectal cancer has been improved after the introduction of the principles of total mesorectal excision (TME). Total mesorectal excision includes resection of the diseased rectum and mesorectum with non-violated mesorectal fascia (en bloc resection). Dissection along the mesorectal fascia through the principle of the “holy plane” minimizes injury of the autonomic nerves and increases the chance of preserving them. It is important to stick to the TME principle to avoid perforating the tumor; violating the mesorectal fascia, thus resulting in positive circumferential resectionmargin(CRM);orcausinginjuryto the autonomic nerves, especially if the tumor is located anteriorly. Therefore, identifying the anterior plane of dissection during TME is important because it is related with the autonomic nerves (Denonvilliers Keywords fascia). Although there are many articles about the Denonvilliers fascia (DVF) or the ► anatomy of anterior dissection plane, unfortunately, there is no consensus on its embryological denonvilliers fascia origin, histology, and gross anatomy. In the present review article, I aim to delineate ► understanding and describe the anatomy of the DVF in more details based on a review of the literature, anatomy in order to provide insight for colorectal surgeons to better understand this anatomical ► review article feature and to provide the best care to their patients.
    [Show full text]
  • Magnetic Resonance Enterography Findings of a Gastrocolic Fistula in Crohn’S Disease
    Letter to the Editor Magnetic resonance enterography findings of a gastrocolic fistula in Crohn’s disease Sanne N. van Munster1, Mark F. J. Stolk2, Karel C. Kuypers3, Rene Wiezer1, Thomas L. Bollen4 1Department of Surgery, 2Department of Gastroenterology and Hepatology, 3Department of Pathology, 4Department of Radiology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands Correspondence to: Drs. Sanne N. van Munster. AMC, Academisch Medisch Centrum Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. Email: [email protected]. Submitted Jul 09, 2016. Accepted for publication Jul 30, 2016. doi: 10.21037/qims.2016.08.06 View this article at: http://dx.doi.org/10.21037/qims.2016.08.06 Crohn’s disease (CD) is characterized by patches of Definitive treatment was established by segment inflammation, which may affect the whole gastro-intestinal resection of the splenic flexure with stapling of the tract. Internal fistulization is a common complication of CD gastrocolic fistula Figure( 1). The postoperative course was due to the transmural nature of inflammation. However, unremarkable and patient recovered uneventfully. gastrocolic fistulas are rare in CD. We present the magnetic Gross pathological examination of the surgical specimen resonance enterography (MRE) findings of a gastrocolic confirmed the presence of fistulous disease. A deep fistula in a patient with longstanding CD with clinical and penetrating inflammatory process originated from the pathologic correlation. colonic mucosa, extended through the colonic wall and attached to the stomach. In this inflammatory tract, gastric mucosa was found represented by glands formed by parietal Case presentation and chief cells of fundic mucosa. A 29-year-old woman with perianal fistulizing CD visited our hospital for left-sided upper abdominal pain starting Discussion about 30 minutes after the meals, bloating, diarrhea, anorexia, and weight loss.
    [Show full text]
  • Porta Hepatis) - Bile Ducts, Portal Vein, Hepatic Arteries
    10 Al-Mohtaseb Faisal Nimri Shada gharaibeh The Liver continued The superior surface of the liver You can see * The right and left lobes. * Cut edge of the Falciform ligament. * The coronary ligament, continues on both sides as: * The left triangular ligament * The right triangular ligament * Between the edges of the coronary ligament is the Bare area of the liver (where there is no peritoneum covering the liver). * Groove for the inferior vena cava and the 3 hepatic veins that drain in it. * Cut edge of the Falciform ligament. * Caudate lobe of the liver more or less wrapping around the groove of the inferior vena cava * Fundus of gall bladder * Ligamentum teres → Relations of the superior surface • Diaphragm (the diaphragm is above the liver and is related to the anterior, superior and posterior surfaces of the liver but the visceral surface of the liver doesn’t have relations with the diaphragm). The diaphragm separates the Pleura & lung and the Pericardium & heart from the liver. 1 | P a g e → Relations of the liver anteriorly • Diaphragm • Rt & Lt pleura and lung (separated from the liver by the diaphragm) • Costal cartilage • Xiphoid process • Anterior abdominal wall → Relations of the liver posteriorly • Diaphragm • Rt. Kidney • Supra renal gland • Transverse colon (hepatic flexure) • Duodenum • Gall bladder • I.V.C • Esophagus • Fundus of stomach (pay attention to the impressions in the picture they are important) → lobes of the liver • Right Lobe • Left lobe • Quadrate lobe • Caudate lobe (the quadrate and caudate lobes are similar
    [Show full text]
  • A Novel Approach of Gross Structure of Human Liver
    wjpmr, 2019,5(2), 181-186 SJIF Impact Factor: 4.639 WORLD JOURNAL OF PHARMACEUTICAL Research Article Manoj et al. AND MEDICAL RESEARCH World Journal of Pharmaceutical and Medical ResearchISSN 2455 -3301 www.wjpmr.com WJPMR A NOVEL APPROACH OF GROSS STRUCTURE OF HUMAN LIVER A. Manoj and Annamma Paul Department of Anatomy, School of Medical Education, M.G University (Accredited by NAAC with A-Grade), Kottayam, Kerala, India. *Corresponding Author: A. Manoj Department of Anatomy, Government Medical College, Thrissur- 680596, under Directorate of Medical Education Health and Family Welfare– Government of Kerala, India. Article Received on 05/12/2018 Article Revised on 26/12/2018 Article Accepted on 16/01/2019 ABSTRACT This current exploratory research conducted to design for comprehensive study of human liver inorder to get best knowledge of learning objectives of its Gross structure. Topography of the liver was taken to know the exact position of liver. The weight, length of surfaces and borders were measured. It had two principal anatomical lobes based on attachment of ligaments and two functional lobes due to the distribution of blood and bile. It had five surfaces with one distinct border. Owing to the dichotomous divisions of the hepatic artery, portal vein and bile ducts it has to have eight vascular segments which can be resected without damaging those remaining. Apart from peritoneal covering it had been connected with falciform ligaments, Coronary ligaments, Triangular ligaments, Ligamentum teres, Ligamentum venosum. The nonperitoneal areas were fissures of ligamentum venosum, teres hepatis, Groove of inferior venacava, Fossa for gall bladder and bare area.
    [Show full text]
  • Parts of the Body 1) Head – Caput, Capitus 2) Skull- Cranium Cephalic- Toward the Skull Caudal- Toward the Tail Rostral- Toward the Nose 3) Collum (Pl
    BIO 3330 Advanced Human Cadaver Anatomy Instructor: Dr. Jeff Simpson Department of Biology Metropolitan State College of Denver 1 PARTS OF THE BODY 1) HEAD – CAPUT, CAPITUS 2) SKULL- CRANIUM CEPHALIC- TOWARD THE SKULL CAUDAL- TOWARD THE TAIL ROSTRAL- TOWARD THE NOSE 3) COLLUM (PL. COLLI), CERVIX 4) TRUNK- THORAX, CHEST 5) ABDOMEN- AREA BETWEEN THE DIAPHRAGM AND THE HIP BONES 6) PELVIS- AREA BETWEEN OS COXAS EXTREMITIES -UPPER 1) SHOULDER GIRDLE - SCAPULA, CLAVICLE 2) BRACHIUM - ARM 3) ANTEBRACHIUM -FOREARM 4) CUBITAL FOSSA 6) METACARPALS 7) PHALANGES 2 Lower Extremities Pelvis Os Coxae (2) Inominant Bones Sacrum Coccyx Terms of Position and Direction Anatomical Position Body Erect, head, eyes and toes facing forward. Limbs at side, palms facing forward Anterior-ventral Posterior-dorsal Superficial Deep Internal/external Vertical & horizontal- refer to the body in the standing position Lateral/ medial Superior/inferior Ipsilateral Contralateral Planes of the Body Median-cuts the body into left and right halves Sagittal- parallel to median Frontal (Coronal)- divides the body into front and back halves 3 Horizontal(transverse)- cuts the body into upper and lower portions Positions of the Body Proximal Distal Limbs Radial Ulnar Tibial Fibular Foot Dorsum Plantar Hallicus HAND Dorsum- back of hand Palmar (volar)- palm side Pollicus Index finger Middle finger Ring finger Pinky finger TERMS OF MOVEMENT 1) FLEXION: DECREASE ANGLE BETWEEN TWO BONES OF A JOINT 2) EXTENSION: INCREASE ANGLE BETWEEN TWO BONES OF A JOINT 3) ADDUCTION: TOWARDS MIDLINE
    [Show full text]
  • Clinical Considerations of Intestinal Entrapment Through the Gastrosplenic Ligament in the Horse K
    EQUINE VETERINARY EDUCATION / AE / JANUARY 2013 21 Clinical Commentary Clinical considerations of intestinal entrapment through the gastrosplenic ligament in the horse K. F. Ortved Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, New York, USA. Corresponding author email: [email protected] The gastrosplenic ligament (GSL) is rarely involved in intestinal common and although small intestinal incarceration is the accidents and consequently is infrequently mentioned in the most common form of GSL entrapment, net reflux on equine veterinary literature. The vast majority of reports of the presentation is not common. Jenei et al. (2007) suggested GSL involve small intestinal incarceration through a rent that this may be due to the distal small intestine becoming (Yovich et al. 1985; Mariën and Steenhaut 1998; Jenei entrapped most frequently, recent gastric decompression, et al. 2007; Hunt et al. 2013) with few reports describing dehydration and/or a short duration of entrapment prior to incarceration of other gastrointestinal structures including the presentation. Small intestinal distension may be palpated on small colon (Rhoads and Parks 1999) and large colon (Trostle rectal examination but this does not appear to be a consistent and Markel 1993; Torre 2000). Although there is documentation finding. Transabdominal ultrasonography is a useful diagnostic of strangulation of the jejunum alone, jejunum and ileum, or tool for confirming small intestinal dilation (Beccati et al. 2011) ileum alone through rents in the GSL, Jenei et al. (2007) in equine colic. Small intestinal dilation noted in the left reported that GSL entrapment accounted for only 1.5% of all cranioventral abdomen lateral to the spleen may be positively horses undergoing exploratory celiotomy and only 4.6% of correlated with GSL entrapment as suggested by Hunt et al.
    [Show full text]
  • Greater Omentum Connects the Greater Curvature of the Stomach to the Transverse Colon
    Dr. ALSHIKH YOUSSEF Haiyan General features The peritoneum is a thin serous membrane Consisting of: 1- Parietal peritoneum －lines the ant. Abdominal wall and the pelvis 2- Visceral peritoneum - covers the viscera 3- Peritoneal cavity - the potential space between the parietal and visceral layer of peritoneum - in male, is a closed sac - but in the female, there is a communication with the exterior through the uterine tubes, the uterus, and the vagina ▪ Peritoneum cavity divided into Greater sac Lesser sac Communication between them by the epiploic foramen The peritoneum The peritoneal cavity is the largest one in the body. Divided into tow sac : .Greater sac; extends from diaphragm down to the pelvis. Lesser Sac .Lesser sac or omental bursa; lies behind the stomach. .Both cavities are interconnected through the epiploic foramen(winslow ). .In male : the peritoneum is a closed sac . .In female : the sac is not completely closed because it Greater Sac communicates with the exterior through the uterine tubes, uterus and vagina. Peritoneum in transverse section The relationship between viscera and peritoneum Intraperitoneal viscera viscera is almost totally covered with visceral peritoneum example, stomach, 1st & last inch of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen and ovary Intraperitoneal viscera Interperitoneal viscera Retroperitoneal viscera Interperitoneal viscera Such organs are not completely wrapped by peritoneum one surface attached to the abdominal walls or other organs. Example liver, gallbladder, urinary bladder and uterus Upper part of the rectum, Ascending and Descending colon Retroperitoneal viscera some organs lie on the posterior abdominal wall Behind the peritoneum they are partially covered by peritoneum on their anterior surfaces only Example kidney, suprarenal gland, pancreas, upper 3rd of rectum duodenum, and ureter, aorta and I.V.C The Peritoneal Reflection The peritoneal reflection include: omentum, mesenteries, ligaments, folds, recesses, pouches and fossae.
    [Show full text]