Podcast
Questions and Answers
What anatomical structures must be cut to reflect the anterior thoracoabdominal wall?
What anatomical structures must be cut to reflect the anterior thoracoabdominal wall?
Where should incisions be made when reflecting the abdominal wall?
Where should incisions be made when reflecting the abdominal wall?
What is the inferior epigastric artery's source of origin?
What is the inferior epigastric artery's source of origin?
Which structure separates the abdominal part of the esophagus from the duodenum?
Which structure separates the abdominal part of the esophagus from the duodenum?
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What two layers make up the peritoneal cavity?
What two layers make up the peritoneal cavity?
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Which ligament spans between the lesser curvature of the stomach and the liver?
Which ligament spans between the lesser curvature of the stomach and the liver?
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During the abdominal dissection, what part of the stomach is identified at the entry point from the esophagus?
During the abdominal dissection, what part of the stomach is identified at the entry point from the esophagus?
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What should be carefully avoided while loosening the abdominal wall from the peritoneum?
What should be carefully avoided while loosening the abdominal wall from the peritoneum?
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What is the initial step in cleaning the bile duct during the dissection?
What is the initial step in cleaning the bile duct during the dissection?
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Which artery should you follow as it passes posterior to the stomach to reach the spleen?
Which artery should you follow as it passes posterior to the stomach to reach the spleen?
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What anatomical feature should be identified along the colon during dissection?
What anatomical feature should be identified along the colon during dissection?
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What should you do with the greater omentum during the dissection?
What should you do with the greater omentum during the dissection?
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Which arteries branch from the celiac trunk and need to be revealed during dissection?
Which arteries branch from the celiac trunk and need to be revealed during dissection?
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What technique is recommended when opening the mesentery to reveal the superior mesenteric artery?
What technique is recommended when opening the mesentery to reveal the superior mesenteric artery?
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What should be done after identifying the jejunum and ileum during dissection?
What should be done after identifying the jejunum and ileum during dissection?
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During the dissection, what is the proper way to trace the digestive tract?
During the dissection, what is the proper way to trace the digestive tract?
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Study Notes
Abdominal Wall Reflection
- Reflect thoracic wall by making lateral cuts along the ribs and extending towards the anterior superior iliac spines (ASIS), stopping just superior to ASIS.
- Loosen abdominal wall from the peritoneum; avoid cutting the intestine or other organs.
- Reflect entire anterior thoracoabdominal wall inferiorly to access the abdominal cavity; cut the falciform ligament and round ligament of the liver as needed to assist in reflection.
- Identify the arcuate line and transversalis fascia on the deep surface of the anterior abdominal wall.
- Identify the inferior epigastric artery, noting its origin and anastomosis with another artery.
Abdominal Viscera Examination
- Locate features of the peritoneal cavity including parietal and visceral peritoneum, greater omentum, and lesser omentum.
- Identify the liver, stomach, and gall bladder; retract the liver’s inferior border if necessary to visualize stomach and gall bladder.
- On the stomach, identify structural components: greater and lesser curvatures, body, fundus, cardia, pylorus, and the abdominal part of the esophagus.
- Recognize the pyloric sphincter separating the stomach from the proximal duodenum, often palpable.
- Lift the left side of the stomach to locate the spleen.
Liver and Omental Structures
- On the liver, identify right and left lobes, falciform ligament, and ligamentum teres (round ligament of the liver).
- Note the lesser omentum connecting the stomach and liver; employ closed-open technique with scissors to expose the portal triad: bile duct, proper hepatic artery, and portal vein.
- Clean bile duct to reveal cystic duct and hepatic duct; trace these to the duodenum.
- Clean proper hepatic artery to demonstrate its branches: common hepatic artery, right gastric artery, and gastroduodenal artery.
- Uncover common hepatic artery origin on the celiac trunk and identify remaining celiac trunk branches: left gastric and splenic arteries.
- Follow splenic artery to spleen, noting its relationship to the pancreas, particularly the head of the pancreas to the descending duodenum.
Intestinal Tract Inspection
- Turn the greater omentum superiorly; identify large and small intestines.
- Trace the digestive tract from the stomach through duodenum, jejunum, ileum, ileocecal junction, cecum, ascending colon, right colic flexure, transverse colon, left colic flexure, descending colon, to sigmoid colon.
- Haustra and teniae coli should be identified along the colon but exact transitions in the small intestine are not necessary.
- Free the transverse colon from the greater omentum; detach transverse mesocolon from the duodenum and pancreas.
- Push jejunum and ileum to the right to inspect the mesentery; feel for the superior mesenteric artery and vein within the mesentery.
- Use closed-open technique with scissors to open mesentery and reveal superior mesenteric artery and vein; clean enough mesentery to follow the artery to the aorta.
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Description
This quiz covers essential techniques for dissection, specifically focusing on the reflection of the abdominal wall. It includes step-by-step instructions for safely extending cuts and loosening the abdominal wall without damaging underlying organs. Ideal for students in anatomy or surgical courses.