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Abdominal quadrants, regions and planes
Anatomy of the anterolateral abdominal wall
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: Small intestine
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Anatomy of the abdominal viscera: Innervation of the abdominal viscera
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
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: Viscera of the gastrointestinal tract
Anatomy clinical correlates: Peritoneum and diaphragm
Anatomy clinical correlates: Other abdominal organs
Anatomy clinical correlates: Inguinal region
Anca-Elena Stefan, MD
Sam Gillespie, BSc
David G. Walker
Patricia Nguyen, MScBMC
The peritoneum is a transparent serous membrane that lines the abdominal cavity and covers the abdominal organs, whereas the diaphragm is a skeletal muscle that separates the thoracic cavity from the abdominal cavity and plays an important role in respiration.
Understanding the anatomy of these structures allows us to better understand the unique clinical conditions that affect them.
Let’s start off by reviewing the innervation of visceral and somatic pain in the abdomen. The peritoneum is made up of two continuous layers, the visceral peritoneum and parietal peritoneum.
The inner visceral layer mainly covers the abdominal organs and has a visceral nerve supply, where the outer parietal layer mainly covers the internal surface of the abdominopelvic walls and has a somatic nerve supply.
Furthermore, both the visceral and somatic nerve supply of the peritoneum sense pain during different clinical conditions; however, the way in which they sense pain is different.
The visceral peritoneum is innervated by the autonomic nervous system. When the visceral peritoneum is irritated, pain sensation is detected by visceral afferent fibers which travel with the autonomic nerves, mainly sympathetic nerve fibers, back to the spinal cord.
Visceral pain is typically sensed as a diffuse, dull pain which is not very well localized, and the pain is often referred to the midline region of the dermatomal areas of the same spinal level as the autonomic nerve supply.
Typically, pain sensed by the foregut visceral peritoneum is referred to the epigastric region, midgut visceral pain is referred to the umbilical region, and hindgut visceral pain is referred to the hypogastric region.
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