Transcript Abdomen-Part 3 - kylethornton.org

Marilyn Rose
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Kidneys, ureters, bladder, urethra
Kidneys- retroperitoneal, bean-shaped
Oblique orientation, paravertebral gutters along
posterior abdominal wall
One on each side of spine at the
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level of T12 – L4
Surrounded by perirenal fat, and Gerota’s fascia
Composed of
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outer cortex- functional subunit- nephrons- filter urine
inner renal medulla- pyramids, Loops of Henle
Mass on CT recon of
Horseshoe Kidney
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Retroperitoneal, paired, suprarenal, y shaped
Rt adrenal- posterior to IVC, medial to Rt hepatic
lobe, lateral to Rt crus of diaphragm.
Lt adrenal- in “triangle” of the aorta, pancreatic
tail, and Lt kidney- borders Lt crus of diaphragm
Outer cortex- produce steroids
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Corticosteroids
 glucocorticoids, mineralocorticoids and androgens
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Inner medulla
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Hormones
 Epinephrine and norepinephrine- fight or flight
Neuroblastoma
Of Lt adrenal gland
Adrenal Hemorrhage
Neuroblastoma
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Stomach- food reservoir and early digestion
Located under Lt dome of diaphragm
Superior portion- joins esophagus at cardiac orifice
(cardiac sphincter)
Boder- lesser and greater curvature
Inferior portion- pyloric antrum -> duodenum
Anterior surface- contact with diaphragm, anterio
abdominal wall and Lt lobe of liver
Lining of stomach = rugae
Gastric juices= mucus, hydrochloric acid, intrinsic
factor and pepsinogen and lipase
Very vascular organ
CT scan of chest & upper abdomen
(coronal section); herniation of stomach &
splenic flexure of colon, along with
collapse of lung and mediastinal shifting
Intestines
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Small bowel
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between pylorus and ileocecal valve
6-7 meters in length
Duodenum
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Pylorus- head of panc- retroperitoneal
4 portions
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jejunum– duodenojejunal flexure
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First- superior-duodenal bulb
Second- descend- ampulla of Vater
Third- horizontal- L3- ant to SVC, AO
Fourth- ascending- Lt of AO at L2 meets with Jejunum
ligament of Treitz- suspensory lig-around celiac axis
Entry of small bowel into peritoneal cavity
Lt upper abdomen/ umbilical region- absorption occurs- folds??
Ileum
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Longest portion, RL abdomen- terminate at ileocecal valve- CECUM
Often this is the site of intussusception / inflammation and WHAT?
Intussesseption
hernia
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Inferior to stomach and liver
Larger diameter, haustra and bands called taenia coli
The appendix attaches to posteromedial surface of
cecum
Ascending
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Transverse
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Peritoneal, horizontal, toward spleen, splenic flexure
Descending
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retroperitoneal, cecum to liver- hepatic flexure
Retroperitoneal, Lt lat abd to sigmoid
Sigmoid
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Chains along branches of arteries of intestine and AO
Small, oblong, soft and difficult to visualize –unless
ABNORMAL
Enlarged= greater than 1 cm in short axis and 2 cm in
long axis.
Abdominoaortic nodal groups- surround AO/IVC
Visceral –drain adjacent organs
Lymph drains from abdominal cavity into lumbar
trunk, and intestinal in to intestinal trunk and both
trunks join the thoracic duct and then the venous
system
PTLD????
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Diaphragm
Quadratus lumborum
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Psoas
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Lateral surpaces of lumbar vertebrae
Insert into greater trochanter of femur
Rectus abdominis
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Lg portion of posterior abdominal wall
Iliac crest- inferior 12th rib
Anterior surface of abd/pelvis
Linea alba
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Xiphoid- symphysis pubis- midline and interlacing