Sectional Anatomy Abdomen - MIT324 Lecture PDF

finalf Al-Ghad International College for Applied Medical Sciences R A D I O L O G I C A L S C I E N C E S D E PA R T M E N T SECTIONAL ANATOMY -MIT324 SECTIONAL ANATOMY ABDOMEN...

finalf Al-Ghad International College for Applied Medical Sciences R A D I O L O G I C A L S C I E N C E S D E PA R T M E N T SECTIONAL ANATOMY -MIT324 SECTIONAL ANATOMY ABDOMEN Week No. 9 & 10  OBJECTIVES: By the end of this lecture the students will be able to: Locate and identify anatomical structures within the abdomen on cadaver sections and CT / MR images. Describe 2-D and 3-D relationship of anatomical structures. Distinguish between arterial and venous anatomy of the abdominal region. Classify the various sections of the abdominal anatomical regions and the associated parts.  CONTENTS: Abdomen Major organs and their accessories Vasculature Diaphragm THE ABDOMEN The abdominal cavity houses many critical structures that have a large array of functions. It is for this reason that cross section imaging of the abdomen is so essential in visualizing these various organs and body systems.  ABDOMINAL CAVITY: Is the region located between the diaphragm and sacral promontory. The contents of the abdominal cavity include: the liver, gallbladder and biliary system, pancreas, spleen, adrenal glands, kidneys, ureters, stomach, intestine ,and vascular structures. THE CONTENTS OF THE ABDOMINAL CAVITY PERITONEUM The walls of the abdominal cavity are lined by a thin serous membrane called the peritoneum. This membrane is divided into the parietal layer, which lines the abdominal wall, and the visceral layer, which covers the organs within the peritoneal cavity including the liver, gallbladder, spleen, stomach, and most of the intestines. AXIAL CT OF ABDOMEN AND PERITONEAL SPACES  AXIAL MR SCAN OF PERITONEAL AND RETROPERITONEAL STRUCTURES (SEPARATED BY DOTTED LINES). E 03 T.gl eritoneum AXIAL CT SCAN OF PERITONEAL AND RETROPERITONEAL STRUCTURES (SEPARATED BY DOTTED LINES). AXIAL MR SCAN OF RETROPERITONEUM Stomach (POSTERIOR TO DOTTED LINE). RETROPERITONEAL SPACES 400414610641 Pararenal spaces Perirenal space AXIAL VIEW OF RETROPERITONEUM SPACES AXIAL, T1-WEIGHTED MRI OF ABDOMEN WITH KIDNEYS AND PARA RENAL SPACES. CORONAL, T2-WEIGHTED MRI OF PERIRENAL SPACES ABDOMINAL REGIONS x 2 1 3 5 4 6 9 7 8 ABDOMINAL REGIONS Right (1) and left (3) hypochondriac regions – on either side of the epigastric region. Contains the diaphragm, some of the kidneys, right side of the liver, the spleen and part of the pancreas. Epigastric region (2) – superior (above) the umbilical region and contains most of the pancreas, part of the stomach, liver, inferior vena cava, abdominal aorta and duodenum. Right (4) and left (6) lumbar (lateral) regions – on either side of the umbilical region. They contain portions of the large and small intestines and kidneys. ABDOMINAL REGIONS Umbilical region (5) – area around the umbilicus (belly button). Includes sections of the large and small intestines, inferior vena cava and abdominal aorta. Right (7) and left (9) iliac (inguinal) regions – are on either side of the hypogastric region and include portions of the large and small intestines. Hypogastric (pubic) (8) region – inferior (below) the umbilical region. Contains parts of the sigmoid colon, the urinary bladder and ureters, the uterus and ovaries (women), and portions of the small intestines. LIVER: Is the largest organ of the abdomen, occupying a major portion of the right upper quadrant. The liver can be divided into lobes; left, right, caudate, quadrate. SPLEEN: Is the largest lymph organ in the body. It is located posterior to the stomach in the left upper quadrant of the abdomen. GALLBLADDER : The gallbladder is a pear- shaped located in a fossa on the antero-inferior portion of the right lobe of the liver. PANCREAS: Is long narrow organ that lies behind the stomach and extends transversely from the duodenum towards the spleen. ADRENAL GLAND: Is pyramidal-shaped sit on the upper border of each kidney. The right gland is generally lower and more medial than the left gland. URINARY SYSTEM: Includes the kidneys, ureters, and urinary bladder. The kidneys are located on each side of the spine between T12-L4 along the posterior abdominal wall. The left kidney frequently lies slightly higher than the right kidney.  I STOMACH: It is located under the left dome of diaphragm, with the superior portion joining the esophagus at the cardiac orifice (T10), creating the esophago-gastric junction. INTESTINE: The small intestine consists of loops of bowel averaging 6 to 7 m in length and can be divided the duodenum, jejunum, and the ileum. LARGE INTESTINE The large intestine lies inferior to the stomach and liver and almost completely frames the small intestine. The parts of the large intestine are the cecum, colon “ascending, transverse, descending, and sigmoid”, and rectum. ABDOMINAL AORTA AND BRANCHES: Unpaired branches: The unpaired branches of the aorta include the celiac trunk (axis), superior and inferior mesenteric arteries. Paired branches: The paired branches of the abdominal aorta include the suprarenal, renal, and gonadal arteries. INFERIOR VENA CAVA AND TRIBUTARIES: is formed by the union of the common iliac veins at approximately the level of L5. It receives many tributaries through its course in the abdomen, which include the lumber, right gonadal, renal, and hepatic veins. THE DIAPHRAGM The diaphragm is a dome-shaped muscle separating the thoracic cavity from the abdominal Caval cavity. opening Esophageal opening OPENINGS IN THE DIAPHRAGM Aortic opening (hiatus) ( at level of T12) Caval opening (hiatus) ( at level of T8) Oesophageal opening (hiatus) ( at level of T10) Aortic opening OPENINGS IN THE DIAPHRAGM Caval opening Esophageal Aortic opening (hiatus) ( at level of T12) opening Caval opening (hiatus) ( at level of T8) Oesophageal opening (hiatus) ( at level of T10) Aortic opening CT ABDOMINAL REGION  CT taken at level of L1: 1. Gallbladder 2. Liver ABDOMINAL REGION 3. Ribs 17 16 14 13 12 4. Right kidney 1 18 15 5. Psoas major Is 6. Vertebral canal 2 7. L1 8. Quadratus lumborum live 9. Abdominal aorta 10.Left kidney 11.Descending colon s 11 12.Jejunum Ribs 13.Left renal vein 3 14.Rectus abdomenus kiding BD 10 15.Transverse colon Aorta 16.Inferior vena cava 9 17.Duodenum 4 as a 5 i 6 8 7 18.Right colic “hepatic” flexure  CT taken at level of L2: 1. Transverse colon 2. Liver ABDOMINAL REGION 3. Ribs 1 18 17 16 15 14 4. Right kidney 5. Psoas major Eyes I pman 6. Vertebral canal 7. L2 2 Liver 8. Quadratus lumborum 9. Abdominal aorta 13 10.Left kidney 12 11.Descending colon S 11 12.External oblique muscle Ribs 13.Internal oblique muscle 3 14.Jejunum King 15.Transversus abdominis muscle 10 King 16.Inferior vena cava 9 17.Duodenum 4 5 i 6 7 8 18.Ileum  CT taken at level of L3: 1. Rectus abdominus 2. Ascending colon ABDOMINAL REGION 3. Right kidney 13 12 11 4. Psoas major 1 5. Quadratus lumborum 2 Fits a 6. Vertebral canal 7. L3 8. Abdominal aorta c 9. Abdominal muscles “External and internal oblique and transverse abdominus muscles” Tennis10 10.Descending colon Yong 3 11.Jejunum 12.Inferior vena cava 9 13.Transverse colon 4 m 5 6 7 8  so_ a ABDOMINAL REGION CT taken at level of L4: 1. Rectus abdominus 1 12 11 10 9 2. Ascending colon 3. Ilium 2 to 4. Psoas major 5. Vertebral canal Egoing 6. L4 7. Quadratus lumborum 8 8. Descending colon 9. Jejunum 10.Transverse colon 3 11.Right and left common iliac 7 arteries 12.Inferior vena cava 4 in5 6  ABDOMINAL REGION CT taken at lower level of L5: 1. Ileum 1 10 9 2. Ascending colon 3. Ilium 2 4. Psoas major 5. Vertebral canal 6. L5 7. Right and left common iliac veins 8 8. Descending colon 9. Transverse colon 10.Right and left common iliac 3 arteries 4 5 6 7  ABDOMINAL REGION CT taken at lower level of L5: 1. Ileum 1 10 9 2. Cecum 3. Ilium 2 4. Psoas major 5. Vertebral canal 6. Right and left common iliac veins 7. L4 8 8. Right and left common iliac arteries 9. Descending colon 3 10.Transverse colon 4 5 6 7 MRI Abdominal Aorta Gall bladder and biliary system