Abdominal Anatomy Training for Medical Imaging Professionals

RADIOLOGY TRAINING RESOURCE FOR MEDICAL
IMAGING TECHNOLOGISTS/SONOGRAPHERS,
NURSES, MIDWIVES AND RELATED MEDICS
Module 5: Understanding Gross Abdominal
Anatomy
Course lecturer
Nchanji Nkeh Keneth
Radiologic Technologist/Sonographer
CSMRR: 001012016
+237 671459765
B.TECH/HPD in MDIRT
(St. LOUIS UNIHEBS, Univ Buea)
excellence660@gmail.com
MedicalImagingTrainingResourceForMedicalImagTech,Nurses,
MidwivesandMedics,NchanjiNkehKeneth
1
10/23/2020

Presentation outline
Overview of Gross
Abdominal Anatomy
10/23/2020 2
Medical Imaging Training Resource
For Medical Imag Tech, Nurses,
Midwives and Medics , Nchanji Nkeh

Outcome
 At the end of this presentation, students
would have:
Learned about Gross anatomy of the
abdomen
Be able to recognize structures and
name them
10/23/2020
Medical Imaging Training Resource For Medical Imag
Tech, Nurses, Midwives and Medics , Nchanji Nkeh
Keneth
3

Students shall be able to
identify and describe the
following Anatomic
Structures as listed on the
following slides
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★Recall Their Anatomy!!!!!!！
Stomach
 Lesser curvature
 Greater curvature
 angular incisure
 cardiac incisure
 Cardiac part
 Fundus of stomach
 Body of stomach
 Pyloric part
Duodenum
 Superior part
 Descending part
 Major duodenal papilla
 Horizontal part
 Ascending part
Large Intestine
 Colic bands
 Haustra of colon
 Epiploic appendices
 Cecum
 ileocecal valve
 Vermiform appendix
 Ascending colon
 Transverse colon
 Descending colon
 Sigmoid colon
5

★recall their anatomy！
Liver
 Falciform lig. of liver
 ligamentum teres hepatic
 porta hepatic
 Notch for ligamentum teres
hepatis
 Nothch for gallbladder
Gallbladder
 Fundus of gallbladder
 Body of gallbladder
 Neck of gallbladder
 Cystic duct
 Right and left hepatic ducts
 Common hepatic duct
 Common bile duct
Pancreas
 Head
 Uncinate process
 Neck
 Body
 Tail
Peritoneum
 Lessor omentum
 Omental foramen
 Greater omentum
 Mesentery
 Mesoappendix
 Gastrosplenic ligament
 rectovesical pouch
 Rectouterine pouch
 Vesicouterine pouch
6

★Remember their Anatomic Locations！
Kidney
 Renal hilum
 Renal sinus
 Renal cortex
 Renal pyramid
 Renal papilla
 Minor renal calices
 Major renal calicle
 Renal pelvis
Bladder
 Apex
 Fundus
 Body
 Neck
 Trigone of bladder
 Interureteric fold
Ureters
Peritoneum
 Lessor omentum
 Omental foramen
 Greater omentum
 Mesentery
 Mesoappendix
Spleen
 Splenic notch
7

★Recall and Rem their Locations！
Celiac trunk
 Left gastric artery
 Common hepatic artery
 Proper hepatic artery
 Right gastric artery
 Left and right branches
 Cystic artery
 Gastroduodenal artery
 Right gastroepiploic artery
 Splemic artery
 Short gastric arteries
 Left gastrioeploic artery
Superior mesenteric artery
 Jejunal and ileal arteries
 Ileocolic artery
 Right colic artery
 Middle colic artery
Inferior mesenteric artery
 Left colic artery
 Sigmoid arteries
 Superior rectal artery
 Renal artery
 Testicular (ovarian) artery
Inferior vena cava
 Right and left renal veins
 Right suprarenal vein
Hepatic portal vein
 Superior mesenteric vein
 Inferior mesenteric vein
 Splenic vein
8

Requirements for applicable comprehension of this
module:
All Students are Urged to review their anatomy and
physiology lectures on:
• Digestive System
• Urinary System
• Musculoskeletal System
And Pathological conditions
associated with these body systems
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Requirements for applicable comprehension of this
module:
All Students are Urged to review their anatomy and
physiology lectures on:
• Digestive System
• Urinary System
• Musculoskeletal System
And Pathological conditions
associated with these body systems
10/23/2020
10

Introduction to The
Abdomen
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 This is the largest area of the Human body
 Multiple Organ Systems are found in the
abdominal Region
 The abdomen constitutes part of the Ventral
body cavity
 The abdomen has two Cavities: Abdominal
and Pelvic cavities, separated by an
Imaginary Line

From Outer to Inner Layers:
 The Skin or fascia, Adipose Tissues,
Muscularies layer, and Peritoneal Lining
 Peritoneal Lining Layers: Parietal and Visceral
Peritoneum; separating space between these
two is called the Peritoneal cavity
 Diverse pathologies affect the abdominal
Region and are related to the various body
systems
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Some Common Abdominal pathologies:
 Intestinal Obstruction
 Appendicitis
 Peritonitis; usually secondary to other
pathologies
 UTI
 Pathologies of the reproductive System
 Hernias
 portal Hypertension
 AAA
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Relations of abdominal viscera
 First layer－liver, gallbladder, stomach
 Second layer－duodenum, pancreas, spleen
 Third layer－suprarenal gland, kidney,
ureter, inferior vena cava, abdominal aorta,
nerves and lymphatics
14

Relations of the stomach
 Anteriorly:
– Live (right part)
– Diaphragm (left upper part)
– Anterior abdominal wall (left
lower part)
 Posteriorly－separated by
peritoneum of lesser sac from the
following (“stomach-bed”)
– Pancreas
– Left suprarenal gland
– Left kidney
– Spleen
– Transverse colon and
transverse mesocolon
15

Arteries of stomach
 Left and right gastric
arteries
– Arise from celiac
trunk and proper
hepatic artery,
respectively.
– These two vessels run
in lesser omentum
along lesser curvature ,
and anastomose end-
to-end.
16

17

Arteries of The Abdomen
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Arteries of The Abdomen
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Distribution of the Superior and Inferior
Mesenteric Arteries
Figure 19.13
20

Renal Arteries
Figure 19.11
21

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Major Veins of the Abdomen
Figure 19.21
L-5
23

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Major Veins of the Abdomen
Figure 19.21
25

Arteries of stomach
 Right and left gastroepiploic
arteries
– Arise from the
gastroduodenal and splenic
artery, respectively.
– These two vessels pass into
the greater omentum, run
parallel to the greater
curvature, and anastomose
end-to-end.
26

Arteries of stomach
– Branches of splenic artery
– Course through the gastrosplenic
ligament
– Supply the fundus of stomach.
 Posterior gastric artery (72%)
– Arise from the splenic artery
– Course through the gastrophrenic
ligament and supply the posterior
wall of fundus of stomach.
27

Arteries of stomach
 Right and left gastroepiploic
arteries
– Arise from the
gastroduodenal and
splenic artery,
respectively.
– These two vessels
pass into the greater
omentum, run parallel
to the greater
curvature, and
anastomose end-to-
end.
28

Venous drainage of stomach
 Right and left gastric veins
empty directly into hepatic
portal vein.
 Left gastroepiploic and
short gastric veins drain
into hepatic portal vein via
the splenic vein.
 Right gastroepiploic vein
drain into superior
mesenteric vein.
29

Lymph drainage of stomach
 Right and left gastric ln. lie
along the same vessels and
finally to the celiac ln.
 Right and left gastroomental ln.
lie along the same vessels, the
former drain into subpyloric ln.,
the latter drain into splenic ln.
 Suprapyloric and subpyloric ln.
receive lymphatics from pyloric
part and finally to the celiac ln.
 Splenic ln. receive lymphatics
from fundus and left third of
stomach, and finally to the celiac
ln.
30

Nerve supply of stomach
 Parasympathetic innervation
– The anterior vagal trunk divides
into anterior gastric and hepatic
branches
– The posterior vagal trunk divides
into posterior gastric and celiac
branches
– The anterior and posterior gastric
branches descend on the anterior
and posterior surfaces of the
stomach as a rule about 1 to 2 cm
from the lesser curvature and
parallel to it in the lesser omentum
as far as the pyloric antrum to fan
out into branches called “crow’s
foot” to supply the pyloric part
 Sympathetic innervation
– Mainly from celiac ganglia
– Afferent and efferent fibers derives
from thoracic segments (T5 －L1)
31

Relations of duodenum
Relations of superior part
 Anteriorly
– Quadrate lobe of live
– Gallbladder
 Posteriorly
– Common bile duct
– Gastroduodenal a.
– Hepatic portal v.
– Inferior vena cava
 Superioely
– Omental foramen
 Inferiorly
– Head of pancreas
32

 Anteriorly
– Live
– Transverse colon and
transverse mesocolon
– Loops of small intestine
 Posteriorly
– Right renal hilum and ureter
– Right renal vessels
 Medially
– Common bile duct and
pancreatic duct
 Laterally
– Right colic flexure
Relations of descending part
33

Relations of horizontal part
 Superiorly
 Inferiorly
– Loops of small intestine
 Anteriorly
– Radix of mesentery
– Superior mesenteric a. and v.
 Posteriorly
– Right ureter
– Abdominal aorta
34

Relations of ascending part
 Right — Head of pancreas and abdominal
aorta
 Left — left kidney and ureter
35

Blood supply of duodenum
Arteries
– Superior
pancreaticoduodenal a.
– Inferior
 Veins－follow arteries,
draining directly into
superior mesenteric and
hepatic portal veins
36

Relations of liver
 Diaphragmatic surface －
separated by diaphragm from the
following
– Right costodiaphramatic recess and
lung
– Cardiac base
 Visceral surface
– Left lobe is related to the
stomach and abdominal part of
esophagus
– Right lobe is related to the
right colic flexure anterioly,
gallbladder and superior
duodenal flexure medially,
right kidney, superarenal gland
posteriorly
37

Divisions and relations of common bile duct
Divisions
Supraduodenal
segment
Retroduodenal
segment
Pancreatic segment
Intraduodenal segmentMedical Imaging Training Resource
38

Relations of common bile duct
Supraduodenal segment
 Descends along the right margin of
hepatoduodenal lig.
 To the right of proper hepatic a.
 Anterior to hepatic portal v.
Retroduodenal segment
 Behind the superior part of duodenum
 Anterior to the vena cava
 To the right of the hepatic portal v.
39

Relations of common bile duct
Pancreatic segment
 Lies in a groove between
posterior surface of head of
pancreas and duodenum
Intraduodenal segment
 Enters the wall of
descending part of
duodenum obliquely where
jions the pancreatic duct to
form the hepatopancreatic
ampulla
 Opens at the major duodenal
papilla Medical Imaging Training Resource
40

Cystohepatic triangle
(Calot’s Triangle)
 Boundaries
– Common hepatic
duct on the left
– Cystic duct on the
right
– Live superiorly
 Content: cystic
artery
41

The Pancreas
Four parts
 Head
– Lies within the cancavity of the C-
shaped curvatune of duodenum
– Uncinate process－ a projection
to the left from the lower part of
the head behind the superior
mesenteric vessels.
 Neck－narrow part, overlies the
superior mesenteric vessels and
beginning of the portal vein
 Body－triangular in cross section,
passes upward and to the left across
the midline
 Tail－extends to the hilum of spleen
in the splenorenal ligament
42

PANCREASMedical Imaging Training Resource
43

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Arterial supply and venous drainage of the
pancreas and spleen
47

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Hepaticopancreatic ampulla
(Ampulla of Vater)
49

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51

makes
52

53

Relations of pancreas
Head of pancreas
 Located in C-shapes
curvature of
duodenum
 Anteriorly
– Transverse
meseocolon
 Posteriorly
– Right renal vessels
54

Neck of pancreas
 Anteriorly－
pylorus
 Posteriorly－
beginning of
hepatic portal v.
55

Body of pancreas
 Anteriorly
– Separated from stomach by
omental bursa
 Posteriorly
– Abdominal aorta
– Left suprarenal gland
– Left kidney
– Left renal vessels
– Spleen vein
 Superiorly
– Celiac trunk
– Celiac plexus
– Splenic a.
56

Tail of pancreas
 Runs in
splenorenal
ligament to reach
hilum of spleen
 Accompanies with
splenic vessels
57

Relations of spleen
 Diaphragmatic surface
－diaphragm
 Visceral surface
– Anteriorly－fundus of
stomach
– Posteriorly－left
suprarenal gland and
kidney
– Inferiorly－tail of
pancreas and left colic
flexure Medical Imaging Training Resource
58

Retroperitoneal space
 Position－it lies between the
parietal peritoneum and transvers
fascia of the posterior abdominal
wall, from diaphragm to
promontory of sacrum,
continuation with extraperitoneal
fascia.
 Contents
– Kidney
– Suprarenal gland
– Ureter
– Abdominal aorta
– Nerves and lymphatics
– Loose connective tissue
59

Suprarenal gland
Shape and position
 Right is pyramidal in shape, left one
semilunar in shape, consisting of out cortex
and inner medulla
 Located retroperitoneally, superomedial to
superior poles of each kidney, enclose with
the kidney by the renal fascia
Blood supply
 Arteries
– Superior suprarenal a.
– Middle suprarenal a.
– Inferior suprarenal a.
 Venous drain
– Right suprarenal v. drains into inferior
vena cava
– Left suprarenal v. joins left renal v.
60

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61

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62

Dissection
Omental foramen
63

Dissection
Radix of mesenRight mesenteric sinus
Ascending colon
Vermiform appendix
Transverse colon
64

Dissection
Descending colo
Transverses colo
Sigmoid colon
Left mesenteric s
Radix of mesentery
65

Left gastric a.
Common
hepatic a. Splenic a.
Gastroduode
nal a.
Proper
hepatic a.
Right gastric a.
Left
branch
Right branch
Cystic a.
Short gastric a.
Left gastroepiploic a.
Right gastroepiploic a.
Superior
Splemic branch
Celiac trunk
66

Superior
mesenteric a.
Inf. pancreaticodudenal a.
Jejunal and ilea
Ileocolic a.
Appendicular a.
Right colic a.
Middle colic a. Superior
Mesenteric v.
67

Inferior mesenteric a.
Left colic a.
Sigmoid a.
Superior rectal a.
Inferior mesenteric v.
68

★Recall Their Anatomy!!!!!!！
Stomach
 Lesser curvature
 Greater curvature
 angular incisure
 cardiac incisure
 Cardiac part
 Fundus of stomach
 Body of stomach
 Pyloric part
Duodenum
 Superior part
 Descending part
 Major duodenal papilla
 Horizontal part
 Ascending part
Large Intestine
 Colic bands
 Haustra of colon
 Epiploic appendices
 Cecum
 ileocecal valve
 Vermiform appendix
 Ascending colon
 Transverse colon
 Descending colon
 Sigmoid colon
69

★recall their anatomy！
Liver
 Falciform lig. of liver
 ligamentum teres hepatic
 porta hepatic
 Notch for ligamentum teres
hepatis
 Nothch for gallbladder
Gallbladder
 Fundus of gallbladder
 Body of gallbladder
 Neck of gallbladder
 Cystic duct
 Right and left hepatic ducts
 Common hepatic duct
 Common bile duct
Pancreas
 Head
 Uncinate process
 Neck
 Body
 Tail
Peritoneum
 Lessor omentum
 Omental foramen
 Greater omentum
 Mesentery
 Mesoappendix
70

★Remember their Anatomic Locations！
Kidney
 Renal hilum
 Renal sinus
 Renal cortex
 Renal pyramid
 Renal papilla
 Minor renal calices
 Major renal calicle
 Renal pelvis
Bladder
 Apex
 Fundus
 Body
 Neck
 Trigone of bladder
 Interureteric fold
Ureters
Peritoneum
 Lessor omentum
 Omental foramen
 Greater omentum
 Mesentery
 Mesoappendix
Spleen
 Splenic notch
71

★Recall and Rem their Locations！
Celiac trunk
 Left gastric artery
 Common hepatic artery
 Proper hepatic artery
 Right gastric artery
 Left and right branches
 Cystic artery
 Gastroduodenal artery
 Right gastroepiploic artery
 Splemic artery
 Left gastrioeploic artery
Superior mesenteric artery
 Jejunal and ileal arteries
 Ileocolic artery
 Right colic artery
 Middle colic artery
Inferior mesenteric artery
 Left colic artery
 Sigmoid arteries
 Superior rectal artery
 Renal artery
 Testicular (ovarian) artery
Inferior vena cava
 Right and left renal veins
 Right suprarenal vein
Hepatic portal vein
 Superior mesenteric vein
 Inferior mesenteric vein
 Splenic vein
72

Identify abnormalities with the AXRs
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Anatomy Review: Where is it, or, at least, where should it be?
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LBO (Left) and Pneumoperitoneum (Right)

ANY QUESTIONS ?
Medical Imaging Training Resource For Medical Imag Tech, Nurses, Midwives and Medics ,
Nchanji Nkeh Keneth
76
10/23/2020

References
ABDOMINAL VESSELS (n.d)
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https://rpop.iaea.org/SAFRON/
https://rpop.iaea.org/safrad/
https://nucleus.iaea.org/isemir/
http://nucleus.iaea.org/HHW/MedicalPhysics/index.html
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7910/23/2020

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I am a proud Polyvalent Medical Imaging
Technologist
I love my Professional Field
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81
Nchanji Nkeh Keneth

8210/23/2020

Abdominal Anatomy Training for Medical Imaging Professionals

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