Anatomy

Review
Alessandro Motta, UVVG Med. English Class

***NOTICE: I cant explain you guys the entire anatomy, so I will focus on some arguments I suppose to be more difficult than other and more specifically, also from my point of view these arguments could be more dangerous during the oral phase of our exam, and our teacher loves to make some tricky questions

Peritoneum and Peritoneal Cavity From the beginning: The arrangement of the peritoneum and the formation of the bursae and of some ligaments can be explained by the embryological development of this complicated serous membrane As a matter o fact in utero the GI tract is a single tube suspended in the coelomic area by ventral and dorsal mesenteries It twists and pulls the mesenteries while in the meantime some organs (e.g. liver, spleen) are growing up fast, as a result we get the greater and lesser omentum and the omental bursae. In this picture it is easier to understand how the midgut will become the proximal colon, the duodenum and the jejunum

These pictures are here to explain the rotation of the foregut and how the peritoneum changes Below you can look at the developing phase of the liver (RED) and the spleen (violet). The arrow in the last picture shows the formation of the lesser omentum.

Lets move on to the complicated arrangement of the peritoneum and its connections In these pictures below you can appreciate how the lesser sac is formed (green zone) and the connections of the lesser omentum (liver- stomach) and the formation of the greater omentum (the gastro-colic ligament, shown in the arrow). Between the transverse colon and the pancreas (down and right positioned) we find also the formation of the transverse mesocolon, adherent to the greater omentum.

The peritoneum of the Upper Abdomen gives raises to:

*Take a look to a picture on the atlas or you wont be able to recognize them

One step backward and final review: 1. The peritoneum is a thin serous membrane quite similar to the pleural one 2. It provides a continues lining for the abdominal pelvic cavity 3. It is divided in parietal and visceral layer (they are continuous!) 4. Those organs who are virtually free within the abdominal cavity are connected to the wall of the cavity by a double sheet of peritoneum (e.g. small intestine) in which their blood vessels run = MESENTERIES for small intestine, MESOCOLON for colon of course! 5. What are these so called Omentae?! Briefly: these are double layers of peritoneum separated by a variable amount of connective tissue 6. The lesser omentum is derived from the ventral mesogastrium as abovementioned and runs from the inferior surface of the liver to the superior portions of the stomach (lesser curvature), esophagus, pylorus and first duodenal tract. The right lateral border of the lesser omentum is thickened and extends from the duodenum to the porta hepatis, giving the only real aperture to the lesser sac: the Epiploic foramen

Falciform ligament Coronary ligaments Lesser omentum (gastro-hepatic ligament and hepato- duodenal ligament) Greater omentum, including gastro-colic ligament) Gastro-splenic ligament Spleno-renal ligament Phreno-colic ligament

7. The greater omentum hangs inferiorly to the greater curvature of the stomach (anterior sheet); this sac descends a variable distance into the peritoneal cavity and the posterior sheet attaches to the posterior abdominal wall, continuously with the transvers mesocolon. (In fetal life these layers are separated, they fuse as a secondary arrangement) 8. The Liver is almost covered by the peritoneum, excepted a bare area made of areolar tissue (from the sub-phrenic space to the suprarenal gland) 9. Coronary ligament: from the diaphragm to the posterior surfaces of the right lobe of the liver 10.The Spleen is suspended in the left upper quadrant of the abdomen by a few connections 11.The gastro-spleen ligament runs from the greater curvature of the stomach, then split itself his layers to enclose the spleen and then rejoin to form the splenorenal and the phrenocolic ligament Guys Im sorry if I cant summarize more the argument but the connections of the internal organs are not so complicated, they just have to be studied one by one, and organ by organ... may the force be with you probably Ill make some more reviews tonite or even tomorrow Your beloved colleague, Alessandro Motta