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Lecture 08 Abdomen

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Dirk De Clercq

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Outline of Lecture 08 Abdomen 0. Overview of the gut tube - Divided into 3 sections - Foregut: stomach to bile duct in duodenum plus associated organs; celiac artery - Midgut: duodenum to transverse colon; superior mesenteric artery - Hindgut: transverse colon to rectum; inferior mesenteric artery - Gut tube derives from folding of endoderm, continuous with yolk sac I. Mesentery - Overview of mesentery - Def mesentery: opposing layers of visceral mesothelium (sim. squa. serosal epithelium) - Def ligaments: mesenteries that connect organs - Gut tube suspended in peritoneal cavity by dorsal and ventral mesenteries, but later ventral mesentery breaks down - Examples of mesenteries: pleura (lungs), pericardium (heart), peritoneum (gut) - Derivatives of dorsal mesentery - Greater omentum (func. includes sealing off infection and inflammation) - Lesser sac (potential space is omental bursa) - Epiploic foramen (aka omental foramen, foramen of Winslow) - Gastrosplenic ligament (greater curvature  spleen) - Splenophrenic ligament (spleen  diaphragm) - Splenorenal ligament (spleen  posterior abdominal wall near left kidney) - Derivatives of ventral mesentery - Lesser omentum - Hepatoduodenal ligament (liver  duodenum) - Hepatogastric ligament (liver  lesser curvature) - Falciform ligament (ventral liver  anterior abdominal wall) - Development explains dorsal versus ventral mesentery structures - The spleen is a dorsal structure, hence spleno-/-splenic ligaments are dorsal mesentery - The liver is a dorsal structure, hence hepato- ligaments are ventral mesentery - However, all -colic ligaments are adhesions (see below) - The broad ligament of the uterus is a true mesentery of the pelvis - Suspensory ligament of the ovary (lateral) - Mesovarium (posterior) - Mesosalpinx (superior) - Ligaments that are NOT mesenteries - Fibrous cords - Ligamentum teres ( umbilical vein) - Ovarian ligament, round ligament of uterus ( gubernaculum) - Adhesions (all of the -colic ligaments) - Gastrocolic ligament - Phrenicocolic ligament - Hepatocolic ligament - Understand difference between intraperitoneal, primarily retroperitoneal, secondarily retroperitoneal II. Foregut - Stomach - Development such that dorsal side rotates left an
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