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Abdominal quadrants, regions and planes
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Innervation of the abdominal viscera
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy of the abdominal viscera: Small intestine
Anatomy of the anterolateral abdominal wall
Anatomy of the diaphragm
Anatomy of the inguinal region
Anatomy of the muscles and nerves of the posterior abdominal wall
Anatomy of the peritoneum and peritoneal cavity
Anatomy of the vessels of the posterior abdominal wall
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Inguinal region
Anatomy clinical correlates: Other abdominal organs
Anatomy clinical correlates: Peritoneum and diaphragm
Anatomy clinical correlates: Viscera of the gastrointestinal tract
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The abdominal cavity is home to plenty of organs. Some of them, like the stomach and intestines, are part of the gastrointestinal tract. Other organs, like the liver, gallbladder and pancreas, help with digestion, even though they’re not part of the GI tract itself. And then there are also organs like the spleen, kidneys and ureters, which are part of other important, non gastrointestinal systems. So let’s take a look at the injuries and diseases that can affect these abdominal organs.
First off, we have portal hypertension, which basically means increased pressure in the portal venous system. This is most commonly caused by liver cirrhosis, but can also be caused by vascular obstruction. Some causes of vascular obstruction include portal vein thrombosis, Budd-Chiari syndrome which is thrombosis or compression of the hepatic veins, as well as the parasitic flatworm infection known as schistosomiasis.
Okay, now, when fibrosis in the liver from cirrhosis obstructs the portal vein, the pressure rises in the portal vein and into its tributaries. This large volume of congested blood flows out from the portal system into the systemic system at the sites of portosystemic anastomoses, also called portocaval anastomoses.
The first site of portosystemic anastomosis is at the lower esophagus. At this point, the high pressure in the portal system can reach the anastomosis between the left gastric veins and the esophageal veins in the lower esophagus, causing engorged varicose veins which may then go on to rupture and lead to upper gastrointestinal bleeding.
In more severe cases of portal hypertension, the veins of the anterior abdominal wall, called the epigastric veins, which anastomose with the paraumbilical veins become varicose and look like small snakes radiating from the umbilicus under the skin. This clinical sign is called caput medusae.
There is another portosystemic anastomosis in the rectum, which in the case of portal hypertension, can lead to anorectal varices. Some other signs and symptoms of liver cirrhosis include palmar erythema, petechiae, ascites, and jaundice. These might be present in addition to the signs of portal hypertension as we discussed: anorectal varices, caput medusae and esophageal varices.
Now let’s talk about the gallbladder, which is often affected by gallstones. Gallstones are tiny stones that form in the gallbladder, and the technical term for these gallstones in the gallbladder is “cholelithiasis”.
To understand the clinical repercussions of gallstones, let’s review the anatomy of the hepatobiliary tree and the pancreatic ducts. So the liver cells, called hepatocytes, secrete bile, and the bile drains from the hepatocytes through bile canaliculi, to the interlobular biliary ducts, then the collecting bile ducts, and finally into the right and left hepatic ducts. The right and left hepatic ducts then join to form the common hepatic duct. Also, the gallbladder has its own duct, called the cystic duct. The common hepatic duct meets the cystic duct, and they join together to form the common bile duct.
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