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Anatomy_Gray_600 | Anatomy_Gray | Large vessels, nerves, and lymphatics are associated with the posterior abdominal wall along the median axis of the body in the region where, during development, the peritoneum reflects off the wall as the dorsal mesentery, which supports the developing gut tube. As a consequence, branches of the neurovascular structur... | Anatomy_Gray. Large vessels, nerves, and lymphatics are associated with the posterior abdominal wall along the median axis of the body in the region where, during development, the peritoneum reflects off the wall as the dorsal mesentery, which supports the developing gut tube. As a consequence, branches of the neurovas... |
Anatomy_Gray_601 | Anatomy_Gray | The superior aperture of the abdomen is the inferior thoracic aperture, which is closed by the diaphragm (see pp. 126-127). The margin of the inferior thoracic aperture consists of vertebra TXII, rib XII, the distal end of rib XI, the costal margin, and the xiphoid process of the sternum. The musculotendinous diaphragm... | Anatomy_Gray. The superior aperture of the abdomen is the inferior thoracic aperture, which is closed by the diaphragm (see pp. 126-127). The margin of the inferior thoracic aperture consists of vertebra TXII, rib XII, the distal end of rib XI, the costal margin, and the xiphoid process of the sternum. The musculotendi... |
Anatomy_Gray_602 | Anatomy_Gray | Medial and lateral arcuate ligaments cross muscles of the posterior abdominal wall and attach to vertebrae, the transverse processes of vertebra LI and rib XII, respectively. A median arcuate ligament crosses the aorta and is continuous with the crus on each side. The posterior attachment of the diaphragm extends much ... | Anatomy_Gray. Medial and lateral arcuate ligaments cross muscles of the posterior abdominal wall and attach to vertebrae, the transverse processes of vertebra LI and rib XII, respectively. A median arcuate ligament crosses the aorta and is continuous with the crus on each side. The posterior attachment of the diaphragm... |
Anatomy_Gray_603 | Anatomy_Gray | Because of the way in which the sacrum and attached pelvic bones are angled posteriorly on the vertebral column, the pelvic cavity is not oriented in the same vertical plane as the abdominal cavity. Instead, the pelvic cavity projects posteriorly, and the inlet opens anteriorly and somewhat superiorly (Fig. 4.10). The ... | Anatomy_Gray. Because of the way in which the sacrum and attached pelvic bones are angled posteriorly on the vertebral column, the pelvic cavity is not oriented in the same vertical plane as the abdominal cavity. Instead, the pelvic cavity projects posteriorly, and the inlet opens anteriorly and somewhat superiorly (Fi... |
Anatomy_Gray_604 | Anatomy_Gray | The bladder expands superiorly from the pelvic cavity into the abdominal cavity and, during pregnancy, the uterus expands freely superiorly out of the pelvic cavity into the abdominal cavity. The abdomen communicates directly with the thigh through an aperture formed anteriorly between the inferior margin of the abdomi... | Anatomy_Gray. The bladder expands superiorly from the pelvic cavity into the abdominal cavity and, during pregnancy, the uterus expands freely superiorly out of the pelvic cavity into the abdominal cavity. The abdomen communicates directly with the thigh through an aperture formed anteriorly between the inferior margin... |
Anatomy_Gray_605 | Anatomy_Gray | Arrangement of abdominal viscera in the adult A basic knowledge of the development of the gastrointestinal tract is needed to understand the arrangement of viscera and mesenteries in the abdomen (Fig. 4.13). The early gastrointestinal tract is oriented longitudinally in the body cavity and is suspended from surrounding... | Anatomy_Gray. Arrangement of abdominal viscera in the adult A basic knowledge of the development of the gastrointestinal tract is needed to understand the arrangement of viscera and mesenteries in the abdomen (Fig. 4.13). The early gastrointestinal tract is oriented longitudinally in the body cavity and is suspended fr... |
Anatomy_Gray_606 | Anatomy_Gray | Development of the foregut In abdominal regions, the foregut gives rise to the distal end of the esophagus, the stomach, and the proximal part of the duodenum. The foregut is the only part of the gut tube suspended from the wall by both the ventral and dorsal mesenteries. A diverticulum from the anterior aspect of the ... | Anatomy_Gray. Development of the foregut In abdominal regions, the foregut gives rise to the distal end of the esophagus, the stomach, and the proximal part of the duodenum. The foregut is the only part of the gut tube suspended from the wall by both the ventral and dorsal mesenteries. A diverticulum from the anterior ... |
Anatomy_Gray_607 | Anatomy_Gray | At the same time, the duodenum, together with its dorsal mesentery and an appreciable part of the pancreas, swings to the right and fuses to the body wall. Secondary fusion of the duodenum to the body wall, massive growth of the liver in the ventral mesentery, and fusion of the superior surface of the liver to the diap... | Anatomy_Gray. At the same time, the duodenum, together with its dorsal mesentery and an appreciable part of the pancreas, swings to the right and fuses to the body wall. Secondary fusion of the duodenum to the body wall, massive growth of the liver in the ventral mesentery, and fusion of the superior surface of the liv... |
Anatomy_Gray_608 | Anatomy_Gray | Part of the dorsal mesentery that initially forms part of the lesser sac greatly enlarges in an inferior direction, and the two opposing surfaces of the mesentery fuse to form an apron-like structure (the greater omentum). The greater omentum is suspended from the greater curvature of the stomach, lies over other visce... | Anatomy_Gray. Part of the dorsal mesentery that initially forms part of the lesser sac greatly enlarges in an inferior direction, and the two opposing surfaces of the mesentery fuse to form an apron-like structure (the greater omentum). The greater omentum is suspended from the greater curvature of the stomach, lies ov... |
Anatomy_Gray_609 | Anatomy_Gray | Rapid growth of the gastrointestinal system results in a loop of the midgut herniating out of the abdominal cavity and into the umbilical cord. As the body grows in size and the connection with the yolk sac is lost, the midgut returns to the abdominal cavity. While this process is occurring, the two limbs of the midgut... | Anatomy_Gray. Rapid growth of the gastrointestinal system results in a loop of the midgut herniating out of the abdominal cavity and into the umbilical cord. As the body grows in size and the connection with the yolk sac is lost, the midgut returns to the abdominal cavity. While this process is occurring, the two limbs... |
Anatomy_Gray_610 | Anatomy_Gray | Development of the hindgut The distal one-third of the transverse colon, descending colon, sigmoid colon, and superior part of the rectum develop from the hindgut. Proximal parts of the hindgut swing to the left and become the descending colon and sigmoid colon. The descending colon and its dorsal mesentery fuse to the... | Anatomy_Gray. Development of the hindgut The distal one-third of the transverse colon, descending colon, sigmoid colon, and superior part of the rectum develop from the hindgut. Proximal parts of the hindgut swing to the left and become the descending colon and sigmoid colon. The descending colon and its dorsal mesente... |
Anatomy_Gray_611 | Anatomy_Gray | T6 also supplies cutaneous innervation to skin over the xiphoid. Skin and muscle in the inguinal and suprapubic regions of the abdominal wall are innervated by L1 and not by thoracic nerves. Dermatomes of the anterior abdominal wall are indicated in Figure 4.14. In the midline, skin over the infrasternal angle is T6 an... | Anatomy_Gray. T6 also supplies cutaneous innervation to skin over the xiphoid. Skin and muscle in the inguinal and suprapubic regions of the abdominal wall are innervated by L1 and not by thoracic nerves. Dermatomes of the anterior abdominal wall are indicated in Figure 4.14. In the midline, skin over the infrasternal ... |
Anatomy_Gray_612 | Anatomy_Gray | During development, the gonads in both sexes descend from their sites of origin on the posterior abdominal wall into the pelvic cavity in women and the developing scrotum in men (Fig. 4.15). Before descent, a cord of tissue (the gubernaculum) passes through the anterior abdominal wall and connects the inferior pole of ... | Anatomy_Gray. During development, the gonads in both sexes descend from their sites of origin on the posterior abdominal wall into the pelvic cavity in women and the developing scrotum in men (Fig. 4.15). Before descent, a cord of tissue (the gubernaculum) passes through the anterior abdominal wall and connects the inf... |
Anatomy_Gray_613 | Anatomy_Gray | In men, the testis, together with its neurovascular structures and its efferent duct (the ductus deferens) descends into the scrotum along a path, initially defined by the gubernaculum, between the processus vaginalis and the accompanying coverings derived from the abdominal wall. All that remains of the gubernaculum i... | Anatomy_Gray. In men, the testis, together with its neurovascular structures and its efferent duct (the ductus deferens) descends into the scrotum along a path, initially defined by the gubernaculum, between the processus vaginalis and the accompanying coverings derived from the abdominal wall. All that remains of the ... |
Anatomy_Gray_614 | Anatomy_Gray | In women, the gonads descend to a position just inside the pelvic cavity and never pass through the anterior abdominal wall. As a result, the only major structure passing through the inguinal canal is a derivative of the gubernaculum (the round ligament of the uterus). In both men and women, the groin (inguinal region)... | Anatomy_Gray. In women, the gonads descend to a position just inside the pelvic cavity and never pass through the anterior abdominal wall. As a result, the only major structure passing through the inguinal canal is a derivative of the gubernaculum (the round ligament of the uterus). In both men and women, the groin (in... |
Anatomy_Gray_615 | Anatomy_Gray | The transpyloric plane is a horizontal plane that transects the body through the lower aspect of vertebra LI (Fig. 4.16). It: is about midway between the jugular notch and the pubic symphysis, and crosses the costal margin on each side at roughly the ninth costal cartilage; crosses through the opening of the stomach in... | Anatomy_Gray. The transpyloric plane is a horizontal plane that transects the body through the lower aspect of vertebra LI (Fig. 4.16). It: is about midway between the jugular notch and the pubic symphysis, and crosses the costal margin on each side at roughly the ninth costal cartilage; crosses through the opening of ... |
Anatomy_Gray_616 | Anatomy_Gray | of the hila of the kidneys; though because the left kidney is slightly higher than the right, the transpyloric plane crosses through the inferior aspect of the left hilum and the superior part of the right hilum. | Anatomy_Gray. of the hila of the kidneys; though because the left kidney is slightly higher than the right, the transpyloric plane crosses through the inferior aspect of the left hilum and the superior part of the right hilum. |
Anatomy_Gray_617 | Anatomy_Gray | The gastrointestinal system and its derivatives are supplied by three major arteries | Anatomy_Gray. The gastrointestinal system and its derivatives are supplied by three major arteries |
Anatomy_Gray_618 | Anatomy_Gray | Three large unpaired arteries branch from the anterior surface of the abdominal aorta to supply the abdominal part of the gastrointestinal tract and all of the structures (liver, pancreas, and gallbladder) to which this part of the gut gives rise during development (Fig. 4.17). These arteries pass through derivatives o... | Anatomy_Gray. Three large unpaired arteries branch from the anterior surface of the abdominal aorta to supply the abdominal part of the gastrointestinal tract and all of the structures (liver, pancreas, and gallbladder) to which this part of the gut gives rise during development (Fig. 4.17). These arteries pass through... |
Anatomy_Gray_619 | Anatomy_Gray | Venous shunts from left to right All blood returning to the heart from regions of the body other than the lungs flows into the right atrium of the heart. The inferior vena cava is the major systemic vein in the abdomen and drains this region together with the pelvis, perineum, and both lower limbs (Fig. 4.18). The infe... | Anatomy_Gray. Venous shunts from left to right All blood returning to the heart from regions of the body other than the lungs flows into the right atrium of the heart. The inferior vena cava is the major systemic vein in the abdomen and drains this region together with the pelvis, perineum, and both lower limbs (Fig. 4... |
Anatomy_Gray_620 | Anatomy_Gray | Other vessels crossing the midline include the left lumbar veins, which drain the back and posterior abdominal wall on the left side. All venous drainage from the through the liver Blood from abdominal parts of the gastrointestinal system and the spleen passes through a second vascular bed, in the liver, before ultimat... | Anatomy_Gray. Other vessels crossing the midline include the left lumbar veins, which drain the back and posterior abdominal wall on the left side. All venous drainage from the through the liver Blood from abdominal parts of the gastrointestinal system and the spleen passes through a second vascular bed, in the liver, ... |
Anatomy_Gray_621 | Anatomy_Gray | Normally, vascular beds drained by the hepatic portal system interconnect, through small veins, with beds drained by systemic vessels, which ultimately connect directly with either the superior or inferior vena cava. Among the clinically most important regions of overlap between the portal and caval systems are those a... | Anatomy_Gray. Normally, vascular beds drained by the hepatic portal system interconnect, through small veins, with beds drained by systemic vessels, which ultimately connect directly with either the superior or inferior vena cava. Among the clinically most important regions of overlap between the portal and caval syste... |
Anatomy_Gray_622 | Anatomy_Gray | Other regions where portal and caval systems interconnect include: where the liver is in direct contact with the diaphragm (the bare area of the liver); where the wall of the gastrointestinal tract is in direct contact with the posterior abdominal wall (retroperitoneal areas of the large and small intestine); and the p... | Anatomy_Gray. Other regions where portal and caval systems interconnect include: where the liver is in direct contact with the diaphragm (the bare area of the liver); where the wall of the gastrointestinal tract is in direct contact with the posterior abdominal wall (retroperitoneal areas of the large and small intesti... |
Anatomy_Gray_623 | Anatomy_Gray | Blockage of the hepatic portal vein or of vascular channels in the liver Blockage of the hepatic portal vein or of vascular channels in the liver can affect the pattern of venous return from abdominal parts of the gastrointestinal system. Vessels that interconnect the portal and caval systems can become greatly enlarge... | Anatomy_Gray. Blockage of the hepatic portal vein or of vascular channels in the liver Blockage of the hepatic portal vein or of vascular channels in the liver can affect the pattern of venous return from abdominal parts of the gastrointestinal system. Vessels that interconnect the portal and caval systems can become g... |
Anatomy_Gray_624 | Anatomy_Gray | The prevertebral plexus contains sympathetic, parasympathetic, and visceral sensory components: Sympathetic components originate from spinal cord levels T5 to L2. Parasympathetic components are from the vagus nerve [X] and spinal cord levels S2 to S4. Visceral sensory fibers generally parallel the motor pathways. The a... | Anatomy_Gray. The prevertebral plexus contains sympathetic, parasympathetic, and visceral sensory components: Sympathetic components originate from spinal cord levels T5 to L2. Parasympathetic components are from the vagus nerve [X] and spinal cord levels S2 to S4. Visceral sensory fibers generally parallel the motor p... |
Anatomy_Gray_625 | Anatomy_Gray | A horizontal transumbilical plane passing through the umbilicus and the intervertebral disc between vertebrae LIII and LIV and intersecting with the vertical median plane divides the abdomen into four quadrants—the right upper, left upper, right lower, and left lower quadrants (Fig. 4.22). The nine-region pattern is ba... | Anatomy_Gray. A horizontal transumbilical plane passing through the umbilicus and the intervertebral disc between vertebrae LIII and LIV and intersecting with the vertical median plane divides the abdomen into four quadrants—the right upper, left upper, right lower, and left lower quadrants (Fig. 4.22). The nine-region... |
Anatomy_Gray_626 | Anatomy_Gray | The inferior horizontal plane (the intertubercular plane) connects the tubercles of the iliac crests, which are palpable structures 5 cm posterior to the anterior superior iliac spines, and passes through the upper part of the body of vertebra LV. The vertical planes pass from the midpoint of the clavicles inferiorly t... | Anatomy_Gray. The inferior horizontal plane (the intertubercular plane) connects the tubercles of the iliac crests, which are palpable structures 5 cm posterior to the anterior superior iliac spines, and passes through the upper part of the body of vertebra LV. The vertical planes pass from the midpoint of the clavicle... |
Anatomy_Gray_627 | Anatomy_Gray | The abdominal wall covers a large area. It is bounded superiorly by the xiphoid process and costal margins, posteriorly by the vertebral column, and inferiorly by the upper parts of the pelvic bones. Its layers consist of skin, superficial fascia (subcutaneous tissue), muscles and their associated deep fascias, extrape... | Anatomy_Gray. The abdominal wall covers a large area. It is bounded superiorly by the xiphoid process and costal margins, posteriorly by the vertebral column, and inferiorly by the upper parts of the pelvic bones. Its layers consist of skin, superficial fascia (subcutaneous tissue), muscles and their associated deep fa... |
Anatomy_Gray_628 | Anatomy_Gray | The superficial fatty layer of superficial fascia (Camper’s fascia) contains fat and varies in thickness (Figs. 4.25 and 4.26). It is continuous over the inguinal ligament with the superficial fascia of the thigh and with a similar layer in the perineum. In men, this superficial layer continues over the penis and, afte... | Anatomy_Gray. The superficial fatty layer of superficial fascia (Camper’s fascia) contains fat and varies in thickness (Figs. 4.25 and 4.26). It is continuous over the inguinal ligament with the superficial fascia of the thigh and with a similar layer in the perineum. In men, this superficial layer continues over the p... |
Anatomy_Gray_629 | Anatomy_Gray | The deeper membranous layer of superficial fascia (Scarpa’s fascia) is thin and membranous, and contains little or no fat (Fig. 4.25). Inferiorly, it continues into the thigh, but just below the inguinal ligament, it fuses with the deep fascia of the thigh (the fascia lata; Fig. 4.26). In the midline, it is firmly atta... | Anatomy_Gray. The deeper membranous layer of superficial fascia (Scarpa’s fascia) is thin and membranous, and contains little or no fat (Fig. 4.25). Inferiorly, it continues into the thigh, but just below the inguinal ligament, it fuses with the deep fascia of the thigh (the fascia lata; Fig. 4.26). In the midline, it ... |
Anatomy_Gray_630 | Anatomy_Gray | In men, the deeper membranous layer of superficial fascia blends with the superficial layer as they both pass over the penis, forming the superficial fascia of the penis, before they continue into the scrotum where they form the dartos fascia (Fig. 4.25). Also in men, extensions of the deeper membranous layer of superf... | Anatomy_Gray. In men, the deeper membranous layer of superficial fascia blends with the superficial layer as they both pass over the penis, forming the superficial fascia of the penis, before they continue into the scrotum where they form the dartos fascia (Fig. 4.25). Also in men, extensions of the deeper membranous l... |
Anatomy_Gray_631 | Anatomy_Gray | There are five muscles in the anterolateral group of abdominal wall muscles: three flat muscles whose fibers begin posterolaterally, pass anteriorly, and are replaced by an aponeurosis as the muscle continues toward the midline—the external oblique, internal oblique, and transversus abdominis muscles; two vertical musc... | Anatomy_Gray. There are five muscles in the anterolateral group of abdominal wall muscles: three flat muscles whose fibers begin posterolaterally, pass anteriorly, and are replaced by an aponeurosis as the muscle continues toward the midline—the external oblique, internal oblique, and transversus abdominis muscles; two... |
Anatomy_Gray_632 | Anatomy_Gray | In addition, contraction of these muscles assists in both quiet and forced expiration by pushing the viscera upward (which helps push the relaxed diaphragm further into the thoracic cavity) and in coughing and vomiting. All these muscles are also involved in any action that increases intraabdominal pressure, including ... | Anatomy_Gray. In addition, contraction of these muscles assists in both quiet and forced expiration by pushing the viscera upward (which helps push the relaxed diaphragm further into the thoracic cavity) and in coughing and vomiting. All these muscles are also involved in any action that increases intraabdominal pressu... |
Anatomy_Gray_633 | Anatomy_Gray | The lower border of the external oblique aponeurosis forms the inguinal ligament on each side (Fig. 4.27). This thickened reinforced free edge of the external oblique aponeurosis passes between the anterior superior iliac spine laterally and the pubic tubercle medially (Fig. 4.28). It folds under itself forming a troug... | Anatomy_Gray. The lower border of the external oblique aponeurosis forms the inguinal ligament on each side (Fig. 4.27). This thickened reinforced free edge of the external oblique aponeurosis passes between the anterior superior iliac spine laterally and the pubic tubercle medially (Fig. 4.28). It folds under itself f... |
Anatomy_Gray_634 | Anatomy_Gray | Additional fibers extend from the lacunar ligament along the pecten pubis of the pelvic brim to form the pectineal (Cooper’s) ligament. Deep to the external oblique muscle is the internal oblique muscle, which is the second of the three flat muscles (Fig. 4.30, Table 4.1). This muscle is smaller and thinner than the ex... | Anatomy_Gray. Additional fibers extend from the lacunar ligament along the pecten pubis of the pelvic brim to form the pectineal (Cooper’s) ligament. Deep to the external oblique muscle is the internal oblique muscle, which is the second of the three flat muscles (Fig. 4.30, Table 4.1). This muscle is smaller and thinn... |
Anatomy_Gray_635 | Anatomy_Gray | Each of the three flat muscles is covered on its anterior and posterior surfaces by a layer of deep (or investing) fascia. In general, these layers are unremarkable except for the layer deep to the transversus abdominis muscle (the transversalis fascia), which is better developed. The transversalis fascia is a continuo... | Anatomy_Gray. Each of the three flat muscles is covered on its anterior and posterior surfaces by a layer of deep (or investing) fascia. In general, these layers are unremarkable except for the layer deep to the transversus abdominis muscle (the transversalis fascia), which is better developed. The transversalis fascia... |
Anatomy_Gray_636 | Anatomy_Gray | After attaching to the crest of the ilium, the transversalis fascia blends with the fascia covering the muscles associated with the upper regions of the pelvic bones and with similar fascia covering the muscles of the pelvic cavity. At this point, it is referred to as the parietal pelvic (or endopelvic) fascia. There i... | Anatomy_Gray. After attaching to the crest of the ilium, the transversalis fascia blends with the fascia covering the muscles associated with the upper regions of the pelvic bones and with similar fascia covering the muscles of the pelvic cavity. At this point, it is referred to as the parietal pelvic (or endopelvic) f... |
Anatomy_Gray_637 | Anatomy_Gray | The two vertical muscles in the anterolateral group of abdominal wall muscles are the large rectus abdominis and the small pyramidalis (Fig. 4.32, Table 4.1). The rectus abdominis is a long, flat muscle and extends the length of the anterior abdominal wall. It is a paired muscle, separated in the midline by the linea a... | Anatomy_Gray. The two vertical muscles in the anterolateral group of abdominal wall muscles are the large rectus abdominis and the small pyramidalis (Fig. 4.32, Table 4.1). The rectus abdominis is a long, flat muscle and extends the length of the anterior abdominal wall. It is a paired muscle, separated in the midline ... |
Anatomy_Gray_638 | Anatomy_Gray | The rectus abdominis and pyramidalis muscles are enclosed in an aponeurotic tendinous sheath (the rectus sheath) formed by a unique layering of the aponeuroses of the external and internal oblique, and transversus abdominis muscles (Fig. 4.33). The rectus sheath completely encloses the upper three-quarters of the rectu... | Anatomy_Gray. The rectus abdominis and pyramidalis muscles are enclosed in an aponeurotic tendinous sheath (the rectus sheath) formed by a unique layering of the aponeuroses of the external and internal oblique, and transversus abdominis muscles (Fig. 4.33). The rectus sheath completely encloses the upper three-quarter... |
Anatomy_Gray_639 | Anatomy_Gray | The anterior wall consists of the aponeurosis of the external oblique and half of the aponeurosis of the internal oblique, which splits at the lateral margin of the rectus abdominis. The posterior wall of the rectus sheath consists of the other half of the aponeurosis of the internal oblique and the aponeurosis of the ... | Anatomy_Gray. The anterior wall consists of the aponeurosis of the external oblique and half of the aponeurosis of the internal oblique, which splits at the lateral margin of the rectus abdominis. The posterior wall of the rectus sheath consists of the other half of the aponeurosis of the internal oblique and the apone... |
Anatomy_Gray_640 | Anatomy_Gray | Deep to the transversalis fascia is a layer of connective tissue, the extraperitoneal fascia, which separates the transversalis fascia from the peritoneum (Fig. 4.34). Containing varying amounts of fat, this layer not only lines the abdominal cavity but is also continuous with a similar layer lining the pelvic cavity. ... | Anatomy_Gray. Deep to the transversalis fascia is a layer of connective tissue, the extraperitoneal fascia, which separates the transversalis fascia from the peritoneum (Fig. 4.34). Containing varying amounts of fat, this layer not only lines the abdominal cavity but is also continuous with a similar layer lining the p... |
Anatomy_Gray_641 | Anatomy_Gray | In the description of specific surgical procedures, the terminology used to describe the extraperitoneal fascia is further modified. The fascia toward the anterior side of the body is described as preperitoneal (or, less commonly, properitoneal) and the fascia toward the posterior side of the body has been described as... | Anatomy_Gray. In the description of specific surgical procedures, the terminology used to describe the extraperitoneal fascia is further modified. The fascia toward the anterior side of the body is described as preperitoneal (or, less commonly, properitoneal) and the fascia toward the posterior side of the body has bee... |
Anatomy_Gray_642 | Anatomy_Gray | The continuous lining of the abdominal walls by the parietal peritoneum forms a sac. This sac is closed in men but has two openings in women where the uterine tubes provide a passage to the outside. The closed sac in men and the semiclosed sac in women is called the peritoneal cavity. The skin, muscles, and parietal pe... | Anatomy_Gray. The continuous lining of the abdominal walls by the parietal peritoneum forms a sac. This sac is closed in men but has two openings in women where the uterine tubes provide a passage to the outside. The closed sac in men and the semiclosed sac in women is called the peritoneal cavity. The skin, muscles, a... |
Anatomy_Gray_643 | Anatomy_Gray | The intercostal nerves (T7 to T11) leave their intercostal spaces, passing deep to the costal cartilages, and continue onto the anterolateral abdominal wall between the internal oblique and transversus abdominis muscles (Fig. 4.37). Reaching the lateral edge of the rectus sheath, they enter the rectus sheath and pass p... | Anatomy_Gray. The intercostal nerves (T7 to T11) leave their intercostal spaces, passing deep to the costal cartilages, and continue onto the anterolateral abdominal wall between the internal oblique and transversus abdominis muscles (Fig. 4.37). Reaching the lateral edge of the rectus sheath, they enter the rectus she... |
Anatomy_Gray_644 | Anatomy_Gray | Along their course, nerves T7 to T12 and L1 supply branches to the anterolateral abdominal wall muscles and the underlying parietal peritoneum. All terminate by supplying skin: Nerves T7 to T9 supply the skin from the xiphoid process to just above the umbilicus. T10 supplies the skin around the umbilicus. T11, T12, and... | Anatomy_Gray. Along their course, nerves T7 to T12 and L1 supply branches to the anterolateral abdominal wall muscles and the underlying parietal peritoneum. All terminate by supplying skin: Nerves T7 to T9 supply the skin from the xiphoid process to just above the umbilicus. T10 supplies the skin around the umbilicus.... |
Anatomy_Gray_645 | Anatomy_Gray | Additionally, the ilio-inguinal nerve (a branch of L1) supplies the anterior surface of the scrotum or labia majora, and sends a small cutaneous branch to the thigh. Numerous blood vessels supply the anterolateral abdominal wall. Superficially: the superior part of the wall is supplied by branches from the musculophren... | Anatomy_Gray. Additionally, the ilio-inguinal nerve (a branch of L1) supplies the anterior surface of the scrotum or labia majora, and sends a small cutaneous branch to the thigh. Numerous blood vessels supply the anterolateral abdominal wall. Superficially: the superior part of the wall is supplied by branches from th... |
Anatomy_Gray_646 | Anatomy_Gray | At a deeper level: the superior part of the wall is supplied by the superior epigastric artery, a terminal branch of the internal thoracic artery; the lateral part of the wall is supplied by branches of the tenth and eleventh intercostal arteries and the subcostal artery; and the inferior part of the wall is supplied b... | Anatomy_Gray. At a deeper level: the superior part of the wall is supplied by the superior epigastric artery, a terminal branch of the internal thoracic artery; the lateral part of the wall is supplied by branches of the tenth and eleventh intercostal arteries and the subcostal artery; and the inferior part of the wall... |
Anatomy_Gray_647 | Anatomy_Gray | Veins of similar names follow the arteries and are responsible for venous drainage. Lymphatic drainage of the anterolateral abdominal wall follows the basic principles of lymphatic drainage: Superficial lymphatics above the umbilicus pass in a superior direction to the axillary nodes, while drainage below the umbilicus... | Anatomy_Gray. Veins of similar names follow the arteries and are responsible for venous drainage. Lymphatic drainage of the anterolateral abdominal wall follows the basic principles of lymphatic drainage: Superficial lymphatics above the umbilicus pass in a superior direction to the axillary nodes, while drainage below... |
Anatomy_Gray_648 | Anatomy_Gray | The groin (inguinal region) is the area of junction between the anterior abdominal wall and the thigh. In this area, the abdominal wall is weakened from changes that occur during development and a peritoneal sac or diverticulum, with or without abdominal contents, can therefore protrude through it, creating an inguinal... | Anatomy_Gray. The groin (inguinal region) is the area of junction between the anterior abdominal wall and the thigh. In this area, the abdominal wall is weakened from changes that occur during development and a peritoneal sac or diverticulum, with or without abdominal contents, can therefore protrude through it, creati... |
Anatomy_Gray_649 | Anatomy_Gray | The transversalis fascia forms its deepest covering. The second covering is formed by the musculature of the internal oblique (a covering from the transversus abdominis muscle is not acquired because the processus vaginalis passes under the arching fibers of this abdominal wall muscle). Its most superficial covering is... | Anatomy_Gray. The transversalis fascia forms its deepest covering. The second covering is formed by the musculature of the internal oblique (a covering from the transversus abdominis muscle is not acquired because the processus vaginalis passes under the arching fibers of this abdominal wall muscle). Its most superfici... |
Anatomy_Gray_650 | Anatomy_Gray | The processus vaginalis is immediately anterior to the gubernaculum within the inguinal canal. In men, as the testes descend, the testes and their accompanying vessels, ducts, and nerves pass through the inguinal canal and are therefore surrounded by the same fascial layers of the abdominal wall. Testicular descent com... | Anatomy_Gray. The processus vaginalis is immediately anterior to the gubernaculum within the inguinal canal. In men, as the testes descend, the testes and their accompanying vessels, ducts, and nerves pass through the inguinal canal and are therefore surrounded by the same fascial layers of the abdominal wall. Testicul... |
Anatomy_Gray_651 | Anatomy_Gray | The development sequence is concluded in both sexes when the processus vaginalis obliterates. If this does not occur or is incomplete, a potential weakness exists in the anterior abdominal wall and an inguinal hernia may develop. In males, only proximal regions of the processus vaginalis obliterate. The distal end expa... | Anatomy_Gray. The development sequence is concluded in both sexes when the processus vaginalis obliterates. If this does not occur or is incomplete, a potential weakness exists in the anterior abdominal wall and an inguinal hernia may develop. In males, only proximal regions of the processus vaginalis obliterate. The d... |
Anatomy_Gray_652 | Anatomy_Gray | The inguinal canal is a slit-like passage that extends in a downward and medial direction, just above and parallel to the lower half of the inguinal ligament. It begins at the deep inguinal ring and continues for approximately 4 cm, ending at the superficial inguinal ring (Fig. 4.42). The contents of the canal are the ... | Anatomy_Gray. The inguinal canal is a slit-like passage that extends in a downward and medial direction, just above and parallel to the lower half of the inguinal ligament. It begins at the deep inguinal ring and continues for approximately 4 cm, ending at the superficial inguinal ring (Fig. 4.42). The contents of the ... |
Anatomy_Gray_653 | Anatomy_Gray | The deep (internal) inguinal ring is the beginning of the inguinal canal and is at a point midway between the anterior superior iliac spine and the pubic symphysis (Fig. 4.43). It is just above the inguinal ligament and immediately lateral to the inferior epigastric vessels. Although sometimes referred to as a defect o... | Anatomy_Gray. The deep (internal) inguinal ring is the beginning of the inguinal canal and is at a point midway between the anterior superior iliac spine and the pubic symphysis (Fig. 4.43). It is just above the inguinal ligament and immediately lateral to the inferior epigastric vessels. Although sometimes referred to... |
Anatomy_Gray_654 | Anatomy_Gray | The superficial (external) inguinal ring is the end of the inguinal canal and is superior to the pubic tubercle (Fig. 4.44). It is a triangular opening in the aponeurosis of the external oblique, with its apex pointing superolaterally and its base formed by the pubic crest. The two remaining sides of the triangle (the ... | Anatomy_Gray. The superficial (external) inguinal ring is the end of the inguinal canal and is superior to the pubic tubercle (Fig. 4.44). It is a triangular opening in the aponeurosis of the external oblique, with its apex pointing superolaterally and its base formed by the pubic crest. The two remaining sides of the ... |
Anatomy_Gray_655 | Anatomy_Gray | The anterior wall of the inguinal canal is formed along its entire length by the aponeurosis of the external oblique muscle (Fig. 4.44). It is also reinforced laterally by the lower fibers of the internal oblique that originate from the lateral two-thirds of the inguinal ligament (Fig. 4.45). This adds an additional co... | Anatomy_Gray. The anterior wall of the inguinal canal is formed along its entire length by the aponeurosis of the external oblique muscle (Fig. 4.44). It is also reinforced laterally by the lower fibers of the internal oblique that originate from the lateral two-thirds of the inguinal ligament (Fig. 4.45). This adds an... |
Anatomy_Gray_656 | Anatomy_Gray | The posterior wall of the inguinal canal is formed along its entire length by the transversalis fascia (see Fig. 4.43). It is reinforced along its medial one-third by the conjoint tendon (inguinal falx; Fig. 4.45). This tendon is the combined insertion of the transversus abdominis and internal oblique muscles into the ... | Anatomy_Gray. The posterior wall of the inguinal canal is formed along its entire length by the transversalis fascia (see Fig. 4.43). It is reinforced along its medial one-third by the conjoint tendon (inguinal falx; Fig. 4.45). This tendon is the combined insertion of the transversus abdominis and internal oblique mus... |
Anatomy_Gray_657 | Anatomy_Gray | The floor (inferior wall) of the inguinal canal is formed by the medial one-half of the inguinal ligament. This rolled-under, free margin of the lowest part of the aponeurosis of the external oblique forms a gutter or trough on which the contents of the inguinal canal are positioned. The lacunar ligament reinforces mos... | Anatomy_Gray. The floor (inferior wall) of the inguinal canal is formed by the medial one-half of the inguinal ligament. This rolled-under, free margin of the lowest part of the aponeurosis of the external oblique forms a gutter or trough on which the contents of the inguinal canal are positioned. The lacunar ligament ... |
Anatomy_Gray_658 | Anatomy_Gray | These structures enter the inguinal canal through the deep inguinal ring and exit it through the superficial inguinal ring. Additionally, the ilio-inguinal nerve (L1) passes through part of the inguinal canal. This nerve is a branch of the lumbar plexus, enters the abdominal wall posteriorly by piercing the internal su... | Anatomy_Gray. These structures enter the inguinal canal through the deep inguinal ring and exit it through the superficial inguinal ring. Additionally, the ilio-inguinal nerve (L1) passes through part of the inguinal canal. This nerve is a branch of the lumbar plexus, enters the abdominal wall posteriorly by piercing t... |
Anatomy_Gray_659 | Anatomy_Gray | The structures in the spermatic cord include: the ductus deferens, the artery to the ductus deferens (from the inferior vesical artery), the testicular artery (from the abdominal aorta), the pampiniform plexus of veins (testicular veins), the cremasteric artery and vein (small vessels associated with the cremasteric fa... | Anatomy_Gray. The structures in the spermatic cord include: the ductus deferens, the artery to the ductus deferens (from the inferior vesical artery), the testicular artery (from the abdominal aorta), the pampiniform plexus of veins (testicular veins), the cremasteric artery and vein (small vessels associated with the ... |
Anatomy_Gray_660 | Anatomy_Gray | Three fascias enclose the contents of the spermatic cord: The internal spermatic fascia, which is the deepest layer, arises from the transversalis fascia and is attached to the margins of the deep inguinal ring. The cremasteric fascia with the associated cremasteric muscle, which is the middle fascial layer, arises fro... | Anatomy_Gray. Three fascias enclose the contents of the spermatic cord: The internal spermatic fascia, which is the deepest layer, arises from the transversalis fascia and is attached to the margins of the deep inguinal ring. The cremasteric fascia with the associated cremasteric muscle, which is the middle fascial lay... |
Anatomy_Gray_661 | Anatomy_Gray | Round ligament of the uterus The round ligament of the uterus is a cord-like structure that passes from the uterus to the deep inguinal ring where it enters the inguinal canal (Fig. 4.47B). It passes down the inguinal canal and exits through the superficial inguinal ring. At this point, it has changed from a cord-like ... | Anatomy_Gray. Round ligament of the uterus The round ligament of the uterus is a cord-like structure that passes from the uterus to the deep inguinal ring where it enters the inguinal canal (Fig. 4.47B). It passes down the inguinal canal and exits through the superficial inguinal ring. At this point, it has changed fro... |
Anatomy_Gray_662 | Anatomy_Gray | The round ligament of the uterus is the long distal part of the original gubernaculum in the fetus that extends from the ovary to the labioscrotal swellings. From its attachment to the uterus, the round ligament of the uterus continues to the ovary as the ligament of the ovary that develops from the short proximal end ... | Anatomy_Gray. The round ligament of the uterus is the long distal part of the original gubernaculum in the fetus that extends from the ovary to the labioscrotal swellings. From its attachment to the uterus, the round ligament of the uterus continues to the ovary as the ligament of the ovary that develops from the short... |
Anatomy_Gray_663 | Anatomy_Gray | Inguinal hernias are therefore classified as either indirect or direct. The indirect inguinal hernia is the most common of the two types of inguinal hernia and is much more common in men than in women (Fig. 4.48). It occurs because some part, or all, of the embryonic processus vaginalis remains open or patent. It is th... | Anatomy_Gray. Inguinal hernias are therefore classified as either indirect or direct. The indirect inguinal hernia is the most common of the two types of inguinal hernia and is much more common in men than in women (Fig. 4.48). It occurs because some part, or all, of the embryonic processus vaginalis remains open or pa... |
Anatomy_Gray_664 | Anatomy_Gray | The protruding peritoneal sac enters the inguinal canal by passing through the deep inguinal ring, just lateral to the inferior epigastric vessels. The extent of its excursion down the inguinal canal depends on the amount of processus vaginalis that remains patent. If the entire processus vaginalis remains patent, the ... | Anatomy_Gray. The protruding peritoneal sac enters the inguinal canal by passing through the deep inguinal ring, just lateral to the inferior epigastric vessels. The extent of its excursion down the inguinal canal depends on the amount of processus vaginalis that remains patent. If the entire processus vaginalis remain... |
Anatomy_Gray_665 | Anatomy_Gray | A peritoneal sac that enters the medial end of the inguinal canal directly through a weakened posterior wall is a direct inguinal hernia (Fig. 4.49). It is usually described as acquired because it develops when abdominal musculature has been weakened, and is commonly seen in mature men. The bulging occurs medial to the... | Anatomy_Gray. A peritoneal sac that enters the medial end of the inguinal canal directly through a weakened posterior wall is a direct inguinal hernia (Fig. 4.49). It is usually described as acquired because it develops when abdominal musculature has been weakened, and is commonly seen in mature men. The bulging occurs... |
Anatomy_Gray_666 | Anatomy_Gray | A thin membrane (the peritoneum) lines the walls of the abdominal cavity and covers much of the viscera. The parietal peritoneum lines the walls of the cavity and the visceral peritoneum covers the viscera. Between the parietal and visceral layers of peritoneum is a potential space (the peritoneal cavity). Abdominal vi... | Anatomy_Gray. A thin membrane (the peritoneum) lines the walls of the abdominal cavity and covers much of the viscera. The parietal peritoneum lines the walls of the cavity and the visceral peritoneum covers the viscera. Between the parietal and visceral layers of peritoneum is a potential space (the peritoneal cavity)... |
Anatomy_Gray_667 | Anatomy_Gray | Innervation of the peritoneum The parietal peritoneum associated with the abdominal wall is innervated by somatic afferents carried in branches of the associated spinal nerves and is therefore sensitive to well-localized pain. The visceral peritoneum is innervated by visceral afferents that accompany autonomic nerves (... | Anatomy_Gray. Innervation of the peritoneum The parietal peritoneum associated with the abdominal wall is innervated by somatic afferents carried in branches of the associated spinal nerves and is therefore sensitive to well-localized pain. The visceral peritoneum is innervated by visceral afferents that accompany auto... |
Anatomy_Gray_668 | Anatomy_Gray | The omental bursa is a smaller subdivision of the peritoneal cavity posterior to the stomach and liver and is continuous with the greater sac through an opening, the omental (epiploic) foramen (Fig. 4.55). Surrounding the omental (epiploic) foramen are numerous structures covered with peritoneum. They include the porta... | Anatomy_Gray. The omental bursa is a smaller subdivision of the peritoneal cavity posterior to the stomach and liver and is continuous with the greater sac through an opening, the omental (epiploic) foramen (Fig. 4.55). Surrounding the omental (epiploic) foramen are numerous structures covered with peritoneum. They inc... |
Anatomy_Gray_669 | Anatomy_Gray | The omenta consist of two layers of peritoneum, which pass from the stomach and the first part of the duodenum to other viscera. There are two: the greater omentum, derived from the dorsal mesentery, and the lesser omentum, derived from the ventral mesentery. The greater omentum is a large, apron-like, peritoneal fold ... | Anatomy_Gray. The omenta consist of two layers of peritoneum, which pass from the stomach and the first part of the duodenum to other viscera. There are two: the greater omentum, derived from the dorsal mesentery, and the lesser omentum, derived from the ventral mesentery. The greater omentum is a large, apron-like, pe... |
Anatomy_Gray_670 | Anatomy_Gray | Usually a thin membrane, the greater omentum always contains an accumulation of fat, which may become substantial in some individuals. Additionally, there are two arteries and accompanying veins, the right and left gastro-omental vessels, between this double-layered peritoneal apron just inferior to the greater curvatu... | Anatomy_Gray. Usually a thin membrane, the greater omentum always contains an accumulation of fat, which may become substantial in some individuals. Additionally, there are two arteries and accompanying veins, the right and left gastro-omental vessels, between this double-layered peritoneal apron just inferior to the g... |
Anatomy_Gray_671 | Anatomy_Gray | The hepatoduodenal ligament ends laterally as a free margin and serves as the anterior border of the omental foramen (Fig. 4.55). Enclosed in this free edge are the hepatic artery proper, the bile duct, and the portal vein. Additionally, the right and left gastric vessels are between the layers of the lesser omentum ne... | Anatomy_Gray. The hepatoduodenal ligament ends laterally as a free margin and serves as the anterior border of the omental foramen (Fig. 4.55). Enclosed in this free edge are the hepatic artery proper, the bile duct, and the portal vein. Additionally, the right and left gastric vessels are between the layers of the les... |
Anatomy_Gray_672 | Anatomy_Gray | All of these are derivatives of the dorsal mesentery. The mesentery is a large, fan-shaped, double-layered fold of peritoneum that connects the jejunum and ileum to the posterior abdominal wall (Fig. 4.61). Its superior attachment is at the duodenojejunal junction, just to the left of the upper lumbar part of the verte... | Anatomy_Gray. All of these are derivatives of the dorsal mesentery. The mesentery is a large, fan-shaped, double-layered fold of peritoneum that connects the jejunum and ileum to the posterior abdominal wall (Fig. 4.61). Its superior attachment is at the duodenojejunal junction, just to the left of the upper lumbar par... |
Anatomy_Gray_673 | Anatomy_Gray | The transverse mesocolon is a fold of peritoneum that connects the transverse colon to the posterior abdominal wall (Fig. 4.61). Its two layers of peritoneum leave the posterior abdominal wall across the anterior surface of the head and body of the pancreas and pass outward to surround the transverse colon. Between its... | Anatomy_Gray. The transverse mesocolon is a fold of peritoneum that connects the transverse colon to the posterior abdominal wall (Fig. 4.61). Its two layers of peritoneum leave the posterior abdominal wall across the anterior surface of the head and body of the pancreas and pass outward to surround the transverse colo... |
Anatomy_Gray_674 | Anatomy_Gray | The sigmoid mesocolon is an inverted, V-shaped peritoneal fold that attaches the sigmoid colon to the abdominal wall (Fig. 4.61). The apex of the V is near the division of the left common iliac artery into its internal and external branches, with the left limb of the descending V along the medial border of the left pso... | Anatomy_Gray. The sigmoid mesocolon is an inverted, V-shaped peritoneal fold that attaches the sigmoid colon to the abdominal wall (Fig. 4.61). The apex of the V is near the division of the left common iliac artery into its internal and external branches, with the left limb of the descending V along the medial border o... |
Anatomy_Gray_675 | Anatomy_Gray | The abdominal esophagus represents the short distal part of the esophagus located in the abdominal cavity. Emerging through the right crus of the diaphragm, usually at the level of vertebra TX, it passes from the esophageal hiatus to the cardial orifice of the stomach just left of the midline (Fig. 4.62). Associated wi... | Anatomy_Gray. The abdominal esophagus represents the short distal part of the esophagus located in the abdominal cavity. Emerging through the right crus of the diaphragm, usually at the level of vertebra TX, it passes from the esophageal hiatus to the cardial orifice of the stomach just left of the midline (Fig. 4.62).... |
Anatomy_Gray_676 | Anatomy_Gray | The arterial supply to the abdominal esophagus (Fig. 4.63) includes: esophageal branches from the left gastric artery (from the celiac trunk), and esophageal branches from the left inferior phrenic artery (from the abdominal aorta). The stomach is the most dilated part of the gastrointestinal tract and has a J-like sha... | Anatomy_Gray. The arterial supply to the abdominal esophagus (Fig. 4.63) includes: esophageal branches from the left gastric artery (from the celiac trunk), and esophageal branches from the left inferior phrenic artery (from the abdominal aorta). The stomach is the most dilated part of the gastrointestinal tract and ha... |
Anatomy_Gray_677 | Anatomy_Gray | The most distal portion of the pyloric part of the stomach is the pylorus (Fig. 4.64). It is marked on the surface of the organ by the pyloric constriction and contains a thickened ring of gastric circular muscle, the pyloric sphincter, that surrounds the distal opening of the stomach, the pyloric orifice (Figs. 4.64 a... | Anatomy_Gray. The most distal portion of the pyloric part of the stomach is the pylorus (Fig. 4.64). It is marked on the surface of the organ by the pyloric constriction and contains a thickened ring of gastric circular muscle, the pyloric sphincter, that surrounds the distal opening of the stomach, the pyloric orifice... |
Anatomy_Gray_678 | Anatomy_Gray | The arterial supply to the stomach (Fig. 4.63) includes: the left gastric artery from the celiac trunk, the right gastric artery, often from the hepatic artery proper, the right gastro-omental artery from the gastroduodenal artery, the left gastro-omental artery from the splenic artery, and the posterior gastric artery... | Anatomy_Gray. The arterial supply to the stomach (Fig. 4.63) includes: the left gastric artery from the celiac trunk, the right gastric artery, often from the hepatic artery proper, the right gastro-omental artery from the gastroduodenal artery, the left gastro-omental artery from the splenic artery, and the posterior ... |
Anatomy_Gray_679 | Anatomy_Gray | The first part of the small intestine is the duodenum. This C-shaped structure, adjacent to the head of the pancreas, is 20 to 25 cm long and is above the level of the umbilicus; its lumen is the widest of the small intestine (Fig. 4.66). It is retroperitoneal except for its beginning, which is connected to the liver b... | Anatomy_Gray. The first part of the small intestine is the duodenum. This C-shaped structure, adjacent to the head of the pancreas, is 20 to 25 cm long and is above the level of the umbilicus; its lumen is the widest of the small intestine (Fig. 4.66). It is retroperitoneal except for its beginning, which is connected ... |
Anatomy_Gray_680 | Anatomy_Gray | The descending part (second part) of the duodenum is just to the right of midline and extends from the neck of the gallbladder to the lower border of vertebra LIII. Its anterior surface is crossed by the transverse colon, posterior to it is the right kidney, and medial to it is the head of the pancreas. This part of th... | Anatomy_Gray. The descending part (second part) of the duodenum is just to the right of midline and extends from the neck of the gallbladder to the lower border of vertebra LIII. Its anterior surface is crossed by the transverse colon, posterior to it is the right kidney, and medial to it is the head of the pancreas. T... |
Anatomy_Gray_681 | Anatomy_Gray | The ascending part (fourth part) of the duodenum passes upward on, or to the left of, the aorta to approximately the upper border of vertebra LII and terminates at the duodenojejunal flexure. This duodenojejunal flexure is surrounded by a fold of peritoneum containing muscle fibers called the suspensory muscle (ligamen... | Anatomy_Gray. The ascending part (fourth part) of the duodenum passes upward on, or to the left of, the aorta to approximately the upper border of vertebra LII and terminates at the duodenojejunal flexure. This duodenojejunal flexure is surrounded by a fold of peritoneum containing muscle fibers called the suspensory m... |
Anatomy_Gray_682 | Anatomy_Gray | This duodenojejunal flexure is surrounded by a fold of peritoneum containing muscle fibers called the suspensory muscle (ligament) of duodenum (ligament of Treitz). The arterial supply to the duodenum (Fig. 4.67) includes: branches from the gastroduodenal artery, the supraduodenal artery from the gastroduodenal artery,... | Anatomy_Gray. This duodenojejunal flexure is surrounded by a fold of peritoneum containing muscle fibers called the suspensory muscle (ligament) of duodenum (ligament of Treitz). The arterial supply to the duodenum (Fig. 4.67) includes: branches from the gastroduodenal artery, the supraduodenal artery from the gastrodu... |
Anatomy_Gray_683 | Anatomy_Gray | The jejunum and ileum make up the last two sections of the small intestine (Fig. 4.68). The jejunum represents the proximal two-fifths. It is mostly in the left upper quadrant of the abdomen and is larger in diameter and has a thicker wall than the ileum. Additionally, the inner mucosal lining of the jejunum is charact... | Anatomy_Gray. The jejunum and ileum make up the last two sections of the small intestine (Fig. 4.68). The jejunum represents the proximal two-fifths. It is mostly in the left upper quadrant of the abdomen and is larger in diameter and has a thicker wall than the ileum. Additionally, the inner mucosal lining of the jeju... |
Anatomy_Gray_684 | Anatomy_Gray | The ileum opens into the large intestine, where the cecum and ascending colon join together. Two flaps projecting into the lumen of the large intestine (the ileocecal fold) surround the opening (Fig. 4.70). The flaps of the ileocecal fold come together at their end, forming ridges. Musculature from the ileum continues ... | Anatomy_Gray. The ileum opens into the large intestine, where the cecum and ascending colon join together. Two flaps projecting into the lumen of the large intestine (the ileocecal fold) surround the opening (Fig. 4.70). The flaps of the ileocecal fold come together at their end, forming ridges. Musculature from the il... |
Anatomy_Gray_685 | Anatomy_Gray | Beginning in the right groin as the cecum, with its associated appendix, the large intestine continues upward as the ascending colon through the right flank and into the right hypochondrium (Fig. 4.81). Just below the liver, it bends to the left, forming the right colic flexure (hepatic flexure), and crosses the abdome... | Anatomy_Gray. Beginning in the right groin as the cecum, with its associated appendix, the large intestine continues upward as the ascending colon through the right flank and into the right hypochondrium (Fig. 4.81). Just below the liver, it bends to the left, forming the right colic flexure (hepatic flexure), and cros... |
Anatomy_Gray_686 | Anatomy_Gray | It enters the upper part of the pelvic cavity as the sigmoid colon, continues on the posterior wall of the pelvic cavity as the rectum, and terminates as the anal canal. The general characteristics of most of the large intestine (Fig. 4.79) are: its large internal diameter compared to that of the small intestine; perit... | Anatomy_Gray. It enters the upper part of the pelvic cavity as the sigmoid colon, continues on the posterior wall of the pelvic cavity as the rectum, and terminates as the anal canal. The general characteristics of most of the large intestine (Fig. 4.79) are: its large internal diameter compared to that of the small in... |
Anatomy_Gray_687 | Anatomy_Gray | The cecum is continuous with the ascending colon at the entrance of the ileum and is usually in contact with the anterior abdominal wall. It may cross the pelvic brim to lie in the true pelvis. The appendix is attached to the posteromedial wall of the cecum, just inferior to the end of the ileum (Fig. 4.82). | Anatomy_Gray. The cecum is continuous with the ascending colon at the entrance of the ileum and is usually in contact with the anterior abdominal wall. It may cross the pelvic brim to lie in the true pelvis. The appendix is attached to the posteromedial wall of the cecum, just inferior to the end of the ileum (Fig. 4.8... |
Anatomy_Gray_688 | Anatomy_Gray | The appendix is a narrow, hollow, blind-ended tube connected to the cecum. It has large aggregations of lymphoid tissue in its walls and is suspended from the terminal ileum by the mesoappendix (Fig. 4.83), which contains the appendicular vessels. Its point of attachment to the cecum is consistent with the highly visib... | Anatomy_Gray. The appendix is a narrow, hollow, blind-ended tube connected to the cecum. It has large aggregations of lymphoid tissue in its walls and is suspended from the terminal ileum by the mesoappendix (Fig. 4.83), which contains the appendicular vessels. Its point of attachment to the cecum is consistent with th... |
Anatomy_Gray_689 | Anatomy_Gray | The surface projection of the base of the appendix is at the junction of the lateral and middle one-third of a line from the anterior superior iliac spine to the umbilicus (McBurney’s point). People with appendicular problems may describe pain near this location. The arterial supply to the cecum and appendix (Fig. 4.85... | Anatomy_Gray. The surface projection of the base of the appendix is at the junction of the lateral and middle one-third of a line from the anterior superior iliac spine to the umbilicus (McBurney’s point). People with appendicular problems may describe pain near this location. The arterial supply to the cecum and appen... |
Anatomy_Gray_690 | Anatomy_Gray | At the junction of the ascending and transverse colon is the right colic flexure, which is just inferior to the right lobe of the liver (Fig. 4.89). A similar, but more acute bend (the left colic flexure) occurs at the junction of the transverse and descending colon. This bend is just inferior to the spleen, is higher ... | Anatomy_Gray. At the junction of the ascending and transverse colon is the right colic flexure, which is just inferior to the right lobe of the liver (Fig. 4.89). A similar, but more acute bend (the left colic flexure) occurs at the junction of the transverse and descending colon. This bend is just inferior to the sple... |
Anatomy_Gray_691 | Anatomy_Gray | Immediately lateral to the ascending and descending colon are the right and left paracolic gutters (Fig. 4.88). These depressions are formed between the lateral margins of the ascending and descending colon and the posterolateral abdominal wall and are gutters through which material can pass from one region of the peri... | Anatomy_Gray. Immediately lateral to the ascending and descending colon are the right and left paracolic gutters (Fig. 4.88). These depressions are formed between the lateral margins of the ascending and descending colon and the posterolateral abdominal wall and are gutters through which material can pass from one regi... |
Anatomy_Gray_692 | Anatomy_Gray | The final segment of the colon (the sigmoid colon) begins above the pelvic inlet and extends to the level of vertebra SIII, where it is continuous with the rectum (Fig. 4.88). This S-shaped structure is quite mobile except at its beginning, where it continues from the descending colon, and at its end, where it continue... | Anatomy_Gray. The final segment of the colon (the sigmoid colon) begins above the pelvic inlet and extends to the level of vertebra SIII, where it is continuous with the rectum (Fig. 4.88). This S-shaped structure is quite mobile except at its beginning, where it continues from the descending colon, and at its end, whe... |
Anatomy_Gray_693 | Anatomy_Gray | The arterial supply to the transverse colon (Fig. 4.90) includes: the right colic artery from the superior mesenteric artery, the middle colic artery from the superior mesenteric artery, and the left colic artery from the inferior mesenteric artery. The arterial supply to the descending colon (Fig. 4.90) includes the l... | Anatomy_Gray. The arterial supply to the transverse colon (Fig. 4.90) includes: the right colic artery from the superior mesenteric artery, the middle colic artery from the superior mesenteric artery, and the left colic artery from the inferior mesenteric artery. The arterial supply to the descending colon (Fig. 4.90) ... |
Anatomy_Gray_694 | Anatomy_Gray | The anal canal is the continuation of the large intestine inferior to the rectum. The arterial supply to the rectum and anal canal (Fig. 4.92) includes: the superior rectal artery from the inferior mesenteric artery, the middle rectal artery from the internal iliac artery, and the inferior rectal artery from the intern... | Anatomy_Gray. The anal canal is the continuation of the large intestine inferior to the rectum. The arterial supply to the rectum and anal canal (Fig. 4.92) includes: the superior rectal artery from the inferior mesenteric artery, the middle rectal artery from the internal iliac artery, and the inferior rectal artery f... |
Anatomy_Gray_695 | Anatomy_Gray | Surfaces of the liver include: a diaphragmatic surface in the anterior, superior, and posterior directions; and a visceral surface in the inferior direction (Fig. 4.102). The diaphragmatic surface of the liver, which is smooth and domed, lies against the inferior surface of the diaphragm (Fig. 4.103). Associated with i... | Anatomy_Gray. Surfaces of the liver include: a diaphragmatic surface in the anterior, superior, and posterior directions; and a visceral surface in the inferior direction (Fig. 4.102). The diaphragmatic surface of the liver, which is smooth and domed, lies against the inferior surface of the diaphragm (Fig. 4.103). Ass... |
Anatomy_Gray_696 | Anatomy_Gray | The subphrenic and hepatorenal recesses are continuous anteriorly. The visceral surface of the liver is covered with visceral peritoneum except in the fossa for the gallbladder and at the porta hepatis (gateway to the liver; Fig. 4.104), and structures related to it include the following (Fig. 4.105): esophagus, right ... | Anatomy_Gray. The subphrenic and hepatorenal recesses are continuous anteriorly. The visceral surface of the liver is covered with visceral peritoneum except in the fossa for the gallbladder and at the porta hepatis (gateway to the liver; Fig. 4.104), and structures related to it include the following (Fig. 4.105): eso... |
Anatomy_Gray_697 | Anatomy_Gray | The porta hepatis serves as the point of entry into the liver for the hepatic arteries and the portal vein, and the exit point for the hepatic ducts (Fig. 4.104). The liver is attached to the anterior abdominal wall by the falciform ligament and, except for a small area of the liver against the diaphragm (the bare area... | Anatomy_Gray. The porta hepatis serves as the point of entry into the liver for the hepatic arteries and the portal vein, and the exit point for the hepatic ducts (Fig. 4.104). The liver is attached to the anterior abdominal wall by the falciform ligament and, except for a small area of the liver against the diaphragm ... |
Anatomy_Gray_698 | Anatomy_Gray | The anterior boundary of the bare area is indicated by a reflection of peritoneum—the anterior coronary ligament. The posterior boundary of the bare area is indicated by a reflection of peritoneum—the posterior coronary ligament. Where the coronary ligaments come together laterally, they form the right and left triangu... | Anatomy_Gray. The anterior boundary of the bare area is indicated by a reflection of peritoneum—the anterior coronary ligament. The posterior boundary of the bare area is indicated by a reflection of peritoneum—the posterior coronary ligament. Where the coronary ligaments come together laterally, they form the right an... |
Anatomy_Gray_699 | Anatomy_Gray | The quadrate lobe is visible on the anterior part of the visceral surface of the liver and is bounded on the left by the fissure for the ligamentum teres and on the right by the fossa for the gallbladder. Functionally, it is related to the left lobe of the liver. The caudate lobe is visible on the posterior part of the... | Anatomy_Gray. The quadrate lobe is visible on the anterior part of the visceral surface of the liver and is bounded on the left by the fissure for the ligamentum teres and on the right by the fossa for the gallbladder. Functionally, it is related to the left lobe of the liver. The caudate lobe is visible on the posteri... |
Subsets and Splits
Textbook Content Analysis
Provides useful aggregations showing document length statistics grouped by title, helping identify variations in content length across different documents.
Textbook Chunk Counts
Identifies the most frequently occurring titles in the training dataset, which could reveal common themes or topics that dominate the data.
Short Textbook Content Examples
Retrieves short content entries from the training dataset, useful for identifying very brief samples but providing limited analytical value beyond basic filtering.