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Anatomy_Gray_700 | Anatomy_Gray | The gallbladder is a pear-shaped sac lying on the visceral surface of the right lobe of the liver in a fossa between the right and quadrate lobes (Fig. 4.104). It has: a rounded end (fundus of the gallbladder), which may project from the inferior border of the liver; a major part in the fossa (body of the gallbladder),... | Anatomy_Gray. The gallbladder is a pear-shaped sac lying on the visceral surface of the right lobe of the liver in a fossa between the right and quadrate lobes (Fig. 4.104). It has: a rounded end (fundus of the gallbladder), which may project from the inferior border of the liver; a major part in the fossa (body of the... |
Anatomy_Gray_701 | Anatomy_Gray | The pancreas lies mostly posterior to the stomach (Figs. 4.107 and 4.108). It extends across the posterior abdominal wall from the duodenum, on the right, to the spleen, on the left. The pancreas is (secondarily) retroperitoneal except for a small part of its tail and consists of a head, uncinate process, neck, body, a... | Anatomy_Gray. The pancreas lies mostly posterior to the stomach (Figs. 4.107 and 4.108). It extends across the posterior abdominal wall from the duodenum, on the right, to the spleen, on the left. The pancreas is (secondarily) retroperitoneal except for a small part of its tail and consists of a head, uncinate process,... |
Anatomy_Gray_702 | Anatomy_Gray | The body of the pancreas is elongate and extends from the neck to the tail of the pancreas. The tail of the pancreas passes between layers of the splenorenal ligament. The pancreatic duct begins in the tail of the pancreas (Fig. 4.109). It passes to the right through the body of the pancreas and, after entering the hea... | Anatomy_Gray. The body of the pancreas is elongate and extends from the neck to the tail of the pancreas. The tail of the pancreas passes between layers of the splenorenal ligament. The pancreatic duct begins in the tail of the pancreas (Fig. 4.109). It passes to the right through the body of the pancreas and, after en... |
Anatomy_Gray_703 | Anatomy_Gray | One branch continues to the left, through the head of the pancreas, and may connect with the pancreatic duct at the point where it turns inferiorly. A second branch descends into the lower part of the head of the pancreas, anterior to the pancreatic duct, and ends in the uncinate process. The main and accessory pancrea... | Anatomy_Gray. One branch continues to the left, through the head of the pancreas, and may connect with the pancreatic duct at the point where it turns inferiorly. A second branch descends into the lower part of the head of the pancreas, anterior to the pancreatic duct, and ends in the uncinate process. The main and acc... |
Anatomy_Gray_704 | Anatomy_Gray | The arterial supply to the pancreas (Fig. 4.110) includes the: gastroduodenal artery from the common hepatic artery (a branch of the celiac trunk), anterior superior pancreaticoduodenal artery from the gastroduodenal artery, posterior superior pancreaticoduodenal artery from the gastroduodenal artery, dorsal pancreatic... | Anatomy_Gray. The arterial supply to the pancreas (Fig. 4.110) includes the: gastroduodenal artery from the common hepatic artery (a branch of the celiac trunk), anterior superior pancreaticoduodenal artery from the gastroduodenal artery, posterior superior pancreaticoduodenal artery from the gastroduodenal artery, dor... |
Anatomy_Gray_705 | Anatomy_Gray | The duct system for the passage of bile extends from the liver, connects with the gallbladder, and empties into the descending part of the duodenum (Fig. 4.111). The coalescence of ducts begins in the liver parenchyma and continues until the right and left hepatic ducts are formed. These drain the respective lobes of t... | Anatomy_Gray. The duct system for the passage of bile extends from the liver, connects with the gallbladder, and empties into the descending part of the duodenum (Fig. 4.111). The coalescence of ducts begins in the liver parenchyma and continues until the right and left hepatic ducts are formed. These drain the respect... |
Anatomy_Gray_706 | Anatomy_Gray | The omental foramen is posterior to these structures at this point. The bile duct continues to descend, passing posteriorly to the superior part of the duodenum before joining with the pancreatic duct to enter the descending part of the duodenum at the major duodenal papilla (Fig. 4.111). The spleen develops as part of... | Anatomy_Gray. The omental foramen is posterior to these structures at this point. The bile duct continues to descend, passing posteriorly to the superior part of the duodenum before joining with the pancreatic duct to enter the descending part of the duodenum at the major duodenal papilla (Fig. 4.111). The spleen devel... |
Anatomy_Gray_707 | Anatomy_Gray | Both these ligaments are parts of the greater omentum. The spleen is surrounded by visceral peritoneum except in the area of the hilum on the medial surface of the spleen (Fig. 4.114). The splenic hilum is the entry point for the splenic vessels, and occasionally the tail of the pancreas reaches this area. The arterial... | Anatomy_Gray. Both these ligaments are parts of the greater omentum. The spleen is surrounded by visceral peritoneum except in the area of the hilum on the medial surface of the spleen (Fig. 4.114). The splenic hilum is the entry point for the splenic vessels, and occasionally the tail of the pancreas reaches this area... |
Anatomy_Gray_708 | Anatomy_Gray | Anterior branches of the abdominal aorta The abdominal aorta has anterior, lateral, and posterior branches as it passes through the abdominal cavity. The three anterior branches supply the gastrointestinal viscera: the celiac trunk and the superior mesenteric and inferior mesenteric arteries (Fig. 4.121). The primitive... | Anatomy_Gray. Anterior branches of the abdominal aorta The abdominal aorta has anterior, lateral, and posterior branches as it passes through the abdominal cavity. The three anterior branches supply the gastrointestinal viscera: the celiac trunk and the superior mesenteric and inferior mesenteric arteries (Fig. 4.121).... |
Anatomy_Gray_709 | Anatomy_Gray | The midgut begins just inferior to the major duodenal papilla, in the descending part of the duodenum, and ends at the junction between the proximal two-thirds and distal one-third of the transverse colon. It includes the duodenum (inferior to the major duodenal papilla), jejunum, ileum, cecum, appendix, ascending colo... | Anatomy_Gray. The midgut begins just inferior to the major duodenal papilla, in the descending part of the duodenum, and ends at the junction between the proximal two-thirds and distal one-third of the transverse colon. It includes the duodenum (inferior to the major duodenal papilla), jejunum, ileum, cecum, appendix, ... |
Anatomy_Gray_710 | Anatomy_Gray | The celiac trunk is the anterior branch of the abdominal aorta supplying the foregut. It arises from the abdominal aorta immediately below the aortic hiatus of the diaphragm (Fig. 4.123), anterior to the upper part of vertebra LI. It immediately divides into the left gastric, splenic, and common hepatic arteries. The l... | Anatomy_Gray. The celiac trunk is the anterior branch of the abdominal aorta supplying the foregut. It arises from the abdominal aorta immediately below the aortic hiatus of the diaphragm (Fig. 4.123), anterior to the upper part of vertebra LI. It immediately divides into the left gastric, splenic, and common hepatic a... |
Anatomy_Gray_711 | Anatomy_Gray | The splenic artery, the largest branch of the celiac trunk, takes a tortuous course to the left along the superior border of the pancreas (Fig. 4.123). It travels in the splenorenal ligament and divides into numerous branches, which enter the hilum of the spleen. As the splenic artery passes along the superior border o... | Anatomy_Gray. The splenic artery, the largest branch of the celiac trunk, takes a tortuous course to the left along the superior border of the pancreas (Fig. 4.123). It travels in the splenorenal ligament and divides into numerous branches, which enter the hilum of the spleen. As the splenic artery passes along the sup... |
Anatomy_Gray_712 | Anatomy_Gray | The hepatic artery proper ascends toward the liver in the free edge of the lesser omentum. It runs to the left of the bile duct and anterior to the portal vein, and divides into the right and left hepatic arteries near the porta hepatis (Fig. 4.125). As the right hepatic artery nears the liver, it gives off the cystic ... | Anatomy_Gray. The hepatic artery proper ascends toward the liver in the free edge of the lesser omentum. It runs to the left of the bile duct and anterior to the portal vein, and divides into the right and left hepatic arteries near the porta hepatis (Fig. 4.125). As the right hepatic artery nears the liver, it gives o... |
Anatomy_Gray_713 | Anatomy_Gray | The gastroduodenal artery may give off the supraduodenal artery and does give off the posterior superior pancreaticoduodenal artery near the upper border of the superior part of the duodenum. After these branch the gastroduodenal artery continues descending posterior to the superior part of the duodenum. Reaching the l... | Anatomy_Gray. The gastroduodenal artery may give off the supraduodenal artery and does give off the posterior superior pancreaticoduodenal artery near the upper border of the superior part of the duodenum. After these branch the gastroduodenal artery continues descending posterior to the superior part of the duodenum. ... |
Anatomy_Gray_714 | Anatomy_Gray | The anterior superior pancreaticoduodenal artery descends and, along with the posterior superior pancreaticoduodenal artery, supplies the head of the pancreas and the duodenum (Fig. 4.124). These vessels eventually anastomose with the anterior and posterior branches of the inferior pancreaticoduodenal artery. The super... | Anatomy_Gray. The anterior superior pancreaticoduodenal artery descends and, along with the posterior superior pancreaticoduodenal artery, supplies the head of the pancreas and the duodenum (Fig. 4.124). These vessels eventually anastomose with the anterior and posterior branches of the inferior pancreaticoduodenal art... |
Anatomy_Gray_715 | Anatomy_Gray | The superior mesenteric artery is crossed anteriorly by the splenic vein and the neck of the pancreas. Posterior to the artery are the left renal vein, the uncinate process of the pancreas, and the inferior part of the duodenum. After giving off its first branch (the inferior pancreaticoduodenal artery), the superior m... | Anatomy_Gray. The superior mesenteric artery is crossed anteriorly by the splenic vein and the neck of the pancreas. Posterior to the artery are the left renal vein, the uncinate process of the pancreas, and the inferior part of the duodenum. After giving off its first branch (the inferior pancreaticoduodenal artery), ... |
Anatomy_Gray_716 | Anatomy_Gray | The inferior pancreaticoduodenal artery is the first branch of the superior mesenteric artery. It divides immediately into anterior and posterior branches, which ascend on the corresponding sides of the head of the pancreas. Superiorly, these arteries anastomose with anterior and posterior superior pancreaticoduodenal ... | Anatomy_Gray. The inferior pancreaticoduodenal artery is the first branch of the superior mesenteric artery. It divides immediately into anterior and posterior branches, which ascend on the corresponding sides of the head of the pancreas. Superiorly, these arteries anastomose with anterior and posterior superior pancre... |
Anatomy_Gray_717 | Anatomy_Gray | There may be single and then double arcades in the area of the jejunum, with a continued increase in the number of arcades moving into and through the area of the ileum. Extending from the terminal arcade are vasa recta (straight arteries), which provide the final direct vascular supply to the walls of the small intest... | Anatomy_Gray. There may be single and then double arcades in the area of the jejunum, with a continued increase in the number of arcades moving into and through the area of the ileum. Extending from the terminal arcade are vasa recta (straight arteries), which provide the final direct vascular supply to the walls of th... |
Anatomy_Gray_718 | Anatomy_Gray | The middle colic artery is the first of the three branches from the right side of the main trunk of the superior mesenteric artery (Fig. 4.127). Arising as the superior mesenteric artery emerges from beneath the pancreas, the middle colic artery enters the transverse mesocolon and divides into right and left branches. ... | Anatomy_Gray. The middle colic artery is the first of the three branches from the right side of the main trunk of the superior mesenteric artery (Fig. 4.127). Arising as the superior mesenteric artery emerges from beneath the pancreas, the middle colic artery enters the transverse mesocolon and divides into right and l... |
Anatomy_Gray_719 | Anatomy_Gray | Continuing distally along the main trunk of the superior mesenteric artery, the right colic artery is the second of the three branches from the right side of the main trunk of the superior mesenteric artery (Fig. 4.126). It is an inconsistent branch, and passes to the right in a retroperitoneal position to supply the a... | Anatomy_Gray. Continuing distally along the main trunk of the superior mesenteric artery, the right colic artery is the second of the three branches from the right side of the main trunk of the superior mesenteric artery (Fig. 4.126). It is an inconsistent branch, and passes to the right in a retroperitoneal position t... |
Anatomy_Gray_720 | Anatomy_Gray | The inferior branch continues toward the ileocolic junction, dividing into colic, cecal, appendicular, and ileal branches (Fig. 4.127). The specific pattern of distribution and origin of these branches is variable: The colic branch crosses to the ascending colon and passes upward to supply the first part of the ascendi... | Anatomy_Gray. The inferior branch continues toward the ileocolic junction, dividing into colic, cecal, appendicular, and ileal branches (Fig. 4.127). The specific pattern of distribution and origin of these branches is variable: The colic branch crosses to the ascending colon and passes upward to supply the first part ... |
Anatomy_Gray_721 | Anatomy_Gray | The ileal branch passes to the left and ascends to supply the final part of the ileum before anastomosing with the superior mesenteric artery. The inferior mesenteric artery is the anterior branch of the abdominal aorta that supplies the hindgut. It is the smallest of the three anterior branches of the abdominal aorta ... | Anatomy_Gray. The ileal branch passes to the left and ascends to supply the final part of the ileum before anastomosing with the superior mesenteric artery. The inferior mesenteric artery is the anterior branch of the abdominal aorta that supplies the hindgut. It is the smallest of the three anterior branches of the ab... |
Anatomy_Gray_722 | Anatomy_Gray | The left colic artery is the first branch of the inferior mesenteric artery (Fig. 4.128). It ascends retroperitoneally, dividing into ascending and descending branches: The ascending branch passes anteriorly to the left kidney, then enters the transverse mesocolon, and passes superiorly to supply the upper part of the ... | Anatomy_Gray. The left colic artery is the first branch of the inferior mesenteric artery (Fig. 4.128). It ascends retroperitoneally, dividing into ascending and descending branches: The ascending branch passes anteriorly to the left kidney, then enters the transverse mesocolon, and passes superiorly to supply the uppe... |
Anatomy_Gray_723 | Anatomy_Gray | The terminal branch of the inferior mesenteric artery is the superior rectal artery (Fig. 4.128). This vessel descends into the pelvic cavity in the sigmoid mesocolon, crossing the left common iliac vessels. Opposite vertebra SIII, the superior rectal artery divides. The two terminal branches descend on each side of th... | Anatomy_Gray. The terminal branch of the inferior mesenteric artery is the superior rectal artery (Fig. 4.128). This vessel descends into the pelvic cavity in the sigmoid mesocolon, crossing the left common iliac vessels. Opposite vertebra SIII, the superior rectal artery divides. The two terminal branches descend on e... |
Anatomy_Gray_724 | Anatomy_Gray | Venous drainage of the spleen, pancreas, gallbladder, and abdominal part of the gastrointestinal tract, except for the inferior part of the rectum, is through the portal system of veins, which deliver blood from these structures to the liver. Once blood passes through the hepatic sinusoids, it passes through progressiv... | Anatomy_Gray. Venous drainage of the spleen, pancreas, gallbladder, and abdominal part of the gastrointestinal tract, except for the inferior part of the rectum, is through the portal system of veins, which deliver blood from these structures to the liver. Once blood passes through the hepatic sinusoids, it passes thro... |
Anatomy_Gray_725 | Anatomy_Gray | Ascending toward the liver, the portal vein passes posterior to the superior part of the duodenum and enters the right margin of the lesser omentum. As it passes through this part of the lesser omentum, it is anterior to the omental foramen and posterior to both the bile duct, which is slightly to its right, and the he... | Anatomy_Gray. Ascending toward the liver, the portal vein passes posterior to the superior part of the duodenum and enters the right margin of the lesser omentum. As it passes through this part of the lesser omentum, it is anterior to the omental foramen and posterior to both the bile duct, which is slightly to its rig... |
Anatomy_Gray_726 | Anatomy_Gray | The splenic vein forms from numerous smaller vessels leaving the hilum of the spleen (Fig. 4.132). It passes to the right, passing through the splenorenal ligament with the splenic artery and the tail of the pancreas. Continuing to the right, the large, straight splenic vein is in contact with the body of the pancreas ... | Anatomy_Gray. The splenic vein forms from numerous smaller vessels leaving the hilum of the spleen (Fig. 4.132). It passes to the right, passing through the splenorenal ligament with the splenic artery and the tail of the pancreas. Continuing to the right, the large, straight splenic vein is in contact with the body of... |
Anatomy_Gray_727 | Anatomy_Gray | The superior mesenteric vein drains blood from the small intestine, cecum, ascending colon, and transverse colon (Fig. 4.132). It begins in the right iliac fossa as veins draining the terminal ileum, cecum, and appendix join, and ascends in the mesentery to the right of the superior mesenteric artery. Posterior to the ... | Anatomy_Gray. The superior mesenteric vein drains blood from the small intestine, cecum, ascending colon, and transverse colon (Fig. 4.132). It begins in the right iliac fossa as veins draining the terminal ileum, cecum, and appendix join, and ascends in the mesentery to the right of the superior mesenteric artery. Pos... |
Anatomy_Gray_728 | Anatomy_Gray | Posterior to the neck of the pancreas, the superior mesenteric vein joins the splenic vein to form the portal vein. As a corresponding vein accompanies each branch of the superior mesenteric artery, tributaries to the superior mesenteric vein include jejunal, ileal, ileocolic, right colic, and middle colic veins. Addit... | Anatomy_Gray. Posterior to the neck of the pancreas, the superior mesenteric vein joins the splenic vein to form the portal vein. As a corresponding vein accompanies each branch of the superior mesenteric artery, tributaries to the superior mesenteric vein include jejunal, ileal, ileocolic, right colic, and middle coli... |
Anatomy_Gray_729 | Anatomy_Gray | The inferior mesenteric vein drains blood from the rectum, sigmoid colon, descending colon, and splenic flexure (Fig. 4.132). It begins as the superior rectal vein and ascends, receiving tributaries from the sigmoid veins and the left colic vein. All these veins accompany arteries of the same name. Continuing to ascend... | Anatomy_Gray. The inferior mesenteric vein drains blood from the rectum, sigmoid colon, descending colon, and splenic flexure (Fig. 4.132). It begins as the superior rectal vein and ascends, receiving tributaries from the sigmoid veins and the left colic vein. All these veins accompany arteries of the same name. Contin... |
Anatomy_Gray_730 | Anatomy_Gray | Lymphatic drainage of the abdominal part of the gastrointestinal tract, as low as the inferior part of the rectum, as well as the spleen, pancreas, gallbladder, and liver, is through vessels and nodes that eventually end in large collections of pre-aortic lymph nodes at the origins of the three anterior branches of the... | Anatomy_Gray. Lymphatic drainage of the abdominal part of the gastrointestinal tract, as low as the inferior part of the rectum, as well as the spleen, pancreas, gallbladder, and liver, is through vessels and nodes that eventually end in large collections of pre-aortic lymph nodes at the origins of the three anterior b... |
Anatomy_Gray_731 | Anatomy_Gray | The superior mesenteric artery (i.e., structures that are part of the abdominal midgut) drains to pre-aortic nodes near the origin of the superior mesenteric artery (Fig. 4.134)—these superior mesenteric nodes also receive lymph from the inferior mesenteric groups of pre-aortic nodes, and lymph from the superior mesent... | Anatomy_Gray. The superior mesenteric artery (i.e., structures that are part of the abdominal midgut) drains to pre-aortic nodes near the origin of the superior mesenteric artery (Fig. 4.134)—these superior mesenteric nodes also receive lymph from the inferior mesenteric groups of pre-aortic nodes, and lymph from the s... |
Anatomy_Gray_732 | Anatomy_Gray | Extrinsic innervation involves receiving motor impulses from, and sending sensory information to, the central nervous system. Intrinsic innervation involves the regulation of digestive tract activities by a generally self-sufficient network of sensory and motor neurons (the enteric nervous system). Abdominal viscera re... | Anatomy_Gray. Extrinsic innervation involves receiving motor impulses from, and sending sensory information to, the central nervous system. Intrinsic innervation involves the regulation of digestive tract activities by a generally self-sufficient network of sensory and motor neurons (the enteric nervous system). Abdomi... |
Anatomy_Gray_733 | Anatomy_Gray | The visceral efferent fibers are part of the sympathetic and parasympathetic parts of the autonomic division of the peripheral nervous system. Structural components serving as conduits for these afferent and efferent fibers include posterior and anterior roots of the spinal cord, respectively, spinal nerves, anterior r... | Anatomy_Gray. The visceral efferent fibers are part of the sympathetic and parasympathetic parts of the autonomic division of the peripheral nervous system. Structural components serving as conduits for these afferent and efferent fibers include posterior and anterior roots of the spinal cord, respectively, spinal nerv... |
Anatomy_Gray_734 | Anatomy_Gray | The sympathetic trunks are two parallel nerve cords extending on either side of the vertebral column from the base of the skull to the coccyx (Fig. 4.135). As they pass through the neck, they lie posterior to the carotid sheath. In the upper thorax, they are anterior to the necks of the ribs, while in the lower thorax ... | Anatomy_Gray. The sympathetic trunks are two parallel nerve cords extending on either side of the vertebral column from the base of the skull to the coccyx (Fig. 4.135). As they pass through the neck, they lie posterior to the carotid sheath. In the upper thorax, they are anterior to the necks of the ribs, while in the... |
Anatomy_Gray_735 | Anatomy_Gray | Throughout the extent of the sympathetic trunks, small raised areas are visible. These collections of neuronal cell bodies outside the CNS are the paravertebral sympathetic ganglia. There are usually: three ganglia in the cervical region, eleven or twelve ganglia in the thoracic region, four ganglia in the lumbar regio... | Anatomy_Gray. Throughout the extent of the sympathetic trunks, small raised areas are visible. These collections of neuronal cell bodies outside the CNS are the paravertebral sympathetic ganglia. There are usually: three ganglia in the cervical region, eleven or twelve ganglia in the thoracic region, four ganglia in th... |
Anatomy_Gray_736 | Anatomy_Gray | The splanchnic nerves are important components in the innervation of the abdominal viscera. They pass from the sympathetic trunk or sympathetic ganglia associated with the trunk, to the prevertebral plexus and ganglia anterior to the abdominal aorta. There are two different types of splanchnic nerves, depending on the ... | Anatomy_Gray. The splanchnic nerves are important components in the innervation of the abdominal viscera. They pass from the sympathetic trunk or sympathetic ganglia associated with the trunk, to the prevertebral plexus and ganglia anterior to the abdominal aorta. There are two different types of splanchnic nerves, dep... |
Anatomy_Gray_737 | Anatomy_Gray | Three thoracic splanchnic nerves pass from sympathetic ganglia along the sympathetic trunk in the thorax to the prevertebral plexus and ganglia associated with the abdominal aorta in the abdomen (Fig. 4.136): The greater splanchnic nerve arises from the fifth to the ninth (or tenth) thoracic ganglia and travels to the ... | Anatomy_Gray. Three thoracic splanchnic nerves pass from sympathetic ganglia along the sympathetic trunk in the thorax to the prevertebral plexus and ganglia associated with the abdominal aorta in the abdomen (Fig. 4.136): The greater splanchnic nerve arises from the fifth to the ninth (or tenth) thoracic ganglia and t... |
Anatomy_Gray_738 | Anatomy_Gray | There are usually two to four lumbar splanchnic nerves, which pass from the lumbar part of the sympathetic trunk or associated ganglia and enter the prevertebral plexus (Fig. 4.136). Similarly, the sacral splanchnic nerves pass from the sacral part of the sympathetic trunk or associated ganglia and enter the inferior h... | Anatomy_Gray. There are usually two to four lumbar splanchnic nerves, which pass from the lumbar part of the sympathetic trunk or associated ganglia and enter the prevertebral plexus (Fig. 4.136). Similarly, the sacral splanchnic nerves pass from the sacral part of the sympathetic trunk or associated ganglia and enter ... |
Anatomy_Gray_739 | Anatomy_Gray | The pelvic splanchnic nerves (parasympathetic root) are unique. They are the only splanchnic nerves that carry parasympathetic fibers. In other words, they do not originate from the sympathetic trunks. Rather, they originate directly from the anterior rami of S2 to S4. Preganglionic parasympathetic fibers originating i... | Anatomy_Gray. The pelvic splanchnic nerves (parasympathetic root) are unique. They are the only splanchnic nerves that carry parasympathetic fibers. In other words, they do not originate from the sympathetic trunks. Rather, they originate directly from the anterior rami of S2 to S4. Preganglionic parasympathetic fibers... |
Anatomy_Gray_740 | Anatomy_Gray | The abdominal prevertebral plexus is a collection of nerve fibers that surrounds the abdominal aorta and is continuous onto its major branches. Scattered throughout the length of the abdominal prevertebral plexus are cell bodies of postganglionic sympathetic fibers. Some of these cell bodies are organized into distinct... | Anatomy_Gray. The abdominal prevertebral plexus is a collection of nerve fibers that surrounds the abdominal aorta and is continuous onto its major branches. Scattered throughout the length of the abdominal prevertebral plexus are cell bodies of postganglionic sympathetic fibers. Some of these cell bodies are organized... |
Anatomy_Gray_741 | Anatomy_Gray | The aortic plexus consists of nerve fibers and associated ganglia on the anterior and lateral surfaces of the abdominal aorta extending from just below the origin of the superior mesenteric artery to the bifurcation of the aorta into the two common iliac arteries. The major ganglion in this plexus is the inferior mesen... | Anatomy_Gray. The aortic plexus consists of nerve fibers and associated ganglia on the anterior and lateral surfaces of the abdominal aorta extending from just below the origin of the superior mesenteric artery to the bifurcation of the aorta into the two common iliac arteries. The major ganglion in this plexus is the ... |
Anatomy_Gray_742 | Anatomy_Gray | The superior hypogastric plexus contains numerous small ganglia and is the final part of the abdominal prevertebral plexus before the prevertebral plexus continues into the pelvic cavity. Each of these major plexuses gives origin to a number of secondary plexuses, which may also contain small ganglia. These plexuses ar... | Anatomy_Gray. The superior hypogastric plexus contains numerous small ganglia and is the final part of the abdominal prevertebral plexus before the prevertebral plexus continues into the pelvic cavity. Each of these major plexuses gives origin to a number of secondary plexuses, which may also contain small ganglia. The... |
Anatomy_Gray_743 | Anatomy_Gray | The abdominal prevertebral plexus receives: preganglionic parasympathetic and visceral afferent fibers from the vagus nerves [X], preganglionic sympathetic and visceral afferent fibers from the thoracic and lumbar splanchnic nerves, and preganglionic parasympathetic fibers from the pelvic splanchnic nerves. Parasympath... | Anatomy_Gray. The abdominal prevertebral plexus receives: preganglionic parasympathetic and visceral afferent fibers from the vagus nerves [X], preganglionic sympathetic and visceral afferent fibers from the thoracic and lumbar splanchnic nerves, and preganglionic parasympathetic fibers from the pelvic splanchnic nerve... |
Anatomy_Gray_744 | Anatomy_Gray | The vagus nerves [X] enter the abdomen associated with the esophagus as the esophagus passes through the diaphragm (Fig. 4.138) and provide parasympathetic innervation to the foregut and midgut. After entering the abdomen as the anterior and posterior vagal trunks, they send branches to the abdominal prevertebral plexu... | Anatomy_Gray. The vagus nerves [X] enter the abdomen associated with the esophagus as the esophagus passes through the diaphragm (Fig. 4.138) and provide parasympathetic innervation to the foregut and midgut. After entering the abdomen as the anterior and posterior vagal trunks, they send branches to the abdominal prev... |
Anatomy_Gray_745 | Anatomy_Gray | The enteric system is a division of the visceral part of the nervous system and is a local neuronal circuit in the wall of the gastrointestinal tract. It consists of motor and sensory neurons organized into two interconnected plexuses (the myenteric and submucosal plexuses) between the layers of the gastrointestinal wa... | Anatomy_Gray. The enteric system is a division of the visceral part of the nervous system and is a local neuronal circuit in the wall of the gastrointestinal tract. It consists of motor and sensory neurons organized into two interconnected plexuses (the myenteric and submucosal plexuses) between the layers of the gastr... |
Anatomy_Gray_746 | Anatomy_Gray | Sympathetic innervation of the stomach The pathway of sympathetic innervation of the stomach is as follows: A preganglionic sympathetic fiber originating at the T6 level of the spinal cord enters an anterior root to leave the spinal cord. At the level of the intervertebral foramen, the anterior root (which contains the... | Anatomy_Gray. Sympathetic innervation of the stomach The pathway of sympathetic innervation of the stomach is as follows: A preganglionic sympathetic fiber originating at the T6 level of the spinal cord enters an anterior root to leave the spinal cord. At the level of the intervertebral foramen, the anterior root (whic... |
Anatomy_Gray_747 | Anatomy_Gray | The greater splanchnic nerve passes through the crura of the diaphragm and enters the celiac ganglion. In the celiac ganglion, the preganglionic fiber synapses with a postganglionic neuron. The postganglionic fiber joins the plexus of nerve fibers surrounding the celiac trunk and continues along its branches. The postg... | Anatomy_Gray. The greater splanchnic nerve passes through the crura of the diaphragm and enters the celiac ganglion. In the celiac ganglion, the preganglionic fiber synapses with a postganglionic neuron. The postganglionic fiber joins the plexus of nerve fibers surrounding the celiac trunk and continues along its branc... |
Anatomy_Gray_748 | Anatomy_Gray | This input from the sympathetic system may modify the activities of the gastrointestinal tract controlled by the enteric nervous system. The posterior abdominal region is posterior to the abdominal part of the gastrointestinal tract, the spleen, and the pancreas (Fig. 4.140). This area, bounded by bones and muscles mak... | Anatomy_Gray. This input from the sympathetic system may modify the activities of the gastrointestinal tract controlled by the enteric nervous system. The posterior abdominal region is posterior to the abdominal part of the gastrointestinal tract, the spleen, and the pancreas (Fig. 4.140). This area, bounded by bones a... |
Anatomy_Gray_749 | Anatomy_Gray | Lumbar vertebrae and the sacrum Projecting into the midline of the posterior abdominal area are the bodies of the five lumbar vertebrae (Fig. 4.141). The prominence of these structures in this region is due to the secondary curvature (a forward convexity) of the lumbar part of the vertebral column. The lumbar vertebrae... | Anatomy_Gray. Lumbar vertebrae and the sacrum Projecting into the midline of the posterior abdominal area are the bodies of the five lumbar vertebrae (Fig. 4.141). The prominence of these structures in this region is due to the secondary curvature (a forward convexity) of the lumbar part of the vertebral column. The lu... |
Anatomy_Gray_750 | Anatomy_Gray | Between each lumbar vertebra is an intervertebral disc, which completes this part of the midline boundary of the posterior abdominal wall. The midline boundary of the posterior abdominal wall, inferior to the lumbar vertebrae, consists of the upper margin of the sacrum (Fig. 4.141). The sacrum is formed by the fusion o... | Anatomy_Gray. Between each lumbar vertebra is an intervertebral disc, which completes this part of the midline boundary of the posterior abdominal wall. The midline boundary of the posterior abdominal wall, inferior to the lumbar vertebrae, consists of the upper margin of the sacrum (Fig. 4.141). The sacrum is formed b... |
Anatomy_Gray_751 | Anatomy_Gray | Superiorly, ribs XI and XII complete the bony framework of the posterior abdominal wall (Fig. 4.141). These ribs are unique in that they do not articulate with the sternum or other ribs, they have a single articular facet on their heads, and they do not have necks or tubercles. Rib XI is posterior to the superior part ... | Anatomy_Gray. Superiorly, ribs XI and XII complete the bony framework of the posterior abdominal wall (Fig. 4.141). These ribs are unique in that they do not articulate with the sternum or other ribs, they have a single articular facet on their heads, and they do not have necks or tubercles. Rib XI is posterior to the ... |
Anatomy_Gray_752 | Anatomy_Gray | Medially, the psoas major muscles cover the anterolateral surface of the bodies of the lumbar vertebrae, filling in the space between the vertebral bodies and the transverse processes (Fig. 4.142). Each of these muscles arises from the bodies of vertebra TXII and all five lumbar vertebrae, from the intervertebral discs... | Anatomy_Gray. Medially, the psoas major muscles cover the anterolateral surface of the bodies of the lumbar vertebrae, filling in the space between the vertebral bodies and the transverse processes (Fig. 4.142). Each of these muscles arises from the bodies of vertebra TXII and all five lumbar vertebrae, from the interv... |
Anatomy_Gray_753 | Anatomy_Gray | Associated with the psoas major muscle is the psoas minor muscle, which is sometimes absent. Lying on the surface of the psoas major when present, this slender muscle arises from vertebrae TXII and LI and the intervening intervertebral disc; its long tendon inserts into the pectineal line of the pelvic brim and the ili... | Anatomy_Gray. Associated with the psoas major muscle is the psoas minor muscle, which is sometimes absent. Lying on the surface of the psoas major when present, this slender muscle arises from vertebrae TXII and LI and the intervening intervertebral disc; its long tendon inserts into the pectineal line of the pelvic br... |
Anatomy_Gray_754 | Anatomy_Gray | Each quadratus lumborum muscle arises from the transverse process of vertebra LV, the iliolumbar ligament, and the adjoining part of the iliac crest. The muscle attaches superiorly to the transverse process of the first four lumbar vertebrae and the inferior border of rib XII. The quadratus lumborum muscles depress and... | Anatomy_Gray. Each quadratus lumborum muscle arises from the transverse process of vertebra LV, the iliolumbar ligament, and the adjoining part of the iliac crest. The muscle attaches superiorly to the transverse process of the first four lumbar vertebrae and the inferior border of rib XII. The quadratus lumborum muscl... |
Anatomy_Gray_755 | Anatomy_Gray | Like the psoas major muscle, the iliacus flexes the thigh at the hip joint when the trunk is stabilized and flexes the trunk against gravity when the body is supine. It is innervated by branches of the femoral nerve. Superiorly, the diaphragm forms the boundary of the posterior abdominal region. This musculotendinous s... | Anatomy_Gray. Like the psoas major muscle, the iliacus flexes the thigh at the hip joint when the trunk is stabilized and flexes the trunk against gravity when the body is supine. It is innervated by branches of the femoral nerve. Superiorly, the diaphragm forms the boundary of the posterior abdominal region. This musc... |
Anatomy_Gray_756 | Anatomy_Gray | Similarly, the left crus is attached to vertebrae LI and LII and the associated intervertebral disc. The crura are connected across the midline by a tendinous arch (the median arcuate ligament), which passes anterior to the aorta (Fig. 4.144). Lateral to the crura, a second tendinous arch is formed by the fascia coveri... | Anatomy_Gray. Similarly, the left crus is attached to vertebrae LI and LII and the associated intervertebral disc. The crura are connected across the midline by a tendinous arch (the median arcuate ligament), which passes anterior to the aorta (Fig. 4.144). Lateral to the crura, a second tendinous arch is formed by the... |
Anatomy_Gray_757 | Anatomy_Gray | The medial and lateral arcuate ligaments serve as points of origin for some of the muscular components of the diaphragm. Structures passing through or around the diaphragm Numerous structures pass through or around the diaphragm (Fig. 4.143): The aorta passes posterior to the diaphragm and anterior to the vertebral bod... | Anatomy_Gray. The medial and lateral arcuate ligaments serve as points of origin for some of the muscular components of the diaphragm. Structures passing through or around the diaphragm Numerous structures pass through or around the diaphragm (Fig. 4.143): The aorta passes posterior to the diaphragm and anterior to the... |
Anatomy_Gray_758 | Anatomy_Gray | Passing through the esophageal hiatus with the esophagus are the anterior and posterior vagal trunks, the esophageal branches of the left gastric artery and vein, and a few lymphatic vessels. The third large opening in the diaphragm is the caval opening, through which the inferior vena cava passes from the abdominal ca... | Anatomy_Gray. Passing through the esophageal hiatus with the esophagus are the anterior and posterior vagal trunks, the esophageal branches of the left gastric artery and vein, and a few lymphatic vessels. The third large opening in the diaphragm is the caval opening, through which the inferior vena cava passes from th... |
Anatomy_Gray_759 | Anatomy_Gray | The greater, lesser, and least (when present) splanchnic nerves pass through the crura, on either side. The hemi-azygos vein passes through the left crus. Passing posterior to the medial arcuate ligament, on either side, are the sympathetic trunks. Passing anterior to the diaphragm, just deep to the ribs, are the super... | Anatomy_Gray. The greater, lesser, and least (when present) splanchnic nerves pass through the crura, on either side. The hemi-azygos vein passes through the left crus. Passing posterior to the medial arcuate ligament, on either side, are the sympathetic trunks. Passing anterior to the diaphragm, just deep to the ribs,... |
Anatomy_Gray_760 | Anatomy_Gray | The domes are produced by: the liver on the right, with some contribution from the right kidney and the right suprarenal gland, and the fundus of the stomach and spleen on the left, with contributions from the left kidney and the left suprarenal gland. Although the height of these domes varies during breathing, a reaso... | Anatomy_Gray. The domes are produced by: the liver on the right, with some contribution from the right kidney and the right suprarenal gland, and the fundus of the stomach and spleen on the left, with contributions from the left kidney and the left suprarenal gland. Although the height of these domes varies during brea... |
Anatomy_Gray_761 | Anatomy_Gray | There is blood supply to the diaphragm on its superior and inferior surfaces: Superiorly, the musculophrenic and pericardiacophrenic arteries, both branches of the internal thoracic artery, and the superior phrenic artery, a branch of the thoracic aorta, supply the diaphragm. Inferiorly, the inferior phrenic arteries, ... | Anatomy_Gray. There is blood supply to the diaphragm on its superior and inferior surfaces: Superiorly, the musculophrenic and pericardiacophrenic arteries, both branches of the internal thoracic artery, and the superior phrenic artery, a branch of the thoracic aorta, supply the diaphragm. Inferiorly, the inferior phre... |
Anatomy_Gray_762 | Anatomy_Gray | Fig. 4.143). Additional sensory fibers are supplied to the peripheral areas of the diaphragm by intercostal nerves. The bean-shaped kidneys are retroperitoneal in the posterior abdominal region (Fig. 4.149). They lie in the extraperitoneal connective tissue immediately lateral to the vertebral column. In the supine pos... | Anatomy_Gray. Fig. 4.143). Additional sensory fibers are supplied to the peripheral areas of the diaphragm by intercostal nerves. The bean-shaped kidneys are retroperitoneal in the posterior abdominal region (Fig. 4.149). They lie in the extraperitoneal connective tissue immediately lateral to the vertebral column. In ... |
Anatomy_Gray_763 | Anatomy_Gray | A small part of the superior pole is covered by the right suprarenal gland. Moving inferiorly, a large part of the rest of the upper part of the anterior surface is against the liver and is separated from it by a layer of peritoneum. Medially, the descending part of the duodenum is retroperitoneal and contacts the kidn... | Anatomy_Gray. A small part of the superior pole is covered by the right suprarenal gland. Moving inferiorly, a large part of the rest of the upper part of the anterior surface is against the liver and is separated from it by a layer of peritoneum. Medially, the descending part of the duodenum is retroperitoneal and con... |
Anatomy_Gray_764 | Anatomy_Gray | The rest of the superior pole is covered by the intraperitoneal stomach and spleen. Moving inferiorly, the retroperitoneal pancreas covers the middle part of the kidney. On its lateral side, the lower half of the kidney is covered by the left colic flexure and the beginning of the descending colon, and, on its medial s... | Anatomy_Gray. The rest of the superior pole is covered by the intraperitoneal stomach and spleen. Moving inferiorly, the retroperitoneal pancreas covers the middle part of the kidney. On its lateral side, the lower half of the kidney is covered by the left colic flexure and the beginning of the descending colon, and, o... |
Anatomy_Gray_765 | Anatomy_Gray | Also passing posterior to the kidneys are the subcostal vessels and nerves and the iliohypogastric and ilio-inguinal nerves. The kidneys are enclosed in and associated with a unique arrangement of fascia and fat. Immediately outside the renal capsule, there is an accumulation of extraperitoneal fat—the perinephric fat ... | Anatomy_Gray. Also passing posterior to the kidneys are the subcostal vessels and nerves and the iliohypogastric and ilio-inguinal nerves. The kidneys are enclosed in and associated with a unique arrangement of fascia and fat. Immediately outside the renal capsule, there is an accumulation of extraperitoneal fat—the pe... |
Anatomy_Gray_766 | Anatomy_Gray | Above each suprarenal gland, the anterior and posterior layers of the renal fascia fuse and blend with the fascia that covers the diaphragm. Medially, the anterior layer of the renal fascia continues over the vessels in the hilum and fuses with the connective tissue associated with the abdominal aorta and the inferior ... | Anatomy_Gray. Above each suprarenal gland, the anterior and posterior layers of the renal fascia fuse and blend with the fascia that covers the diaphragm. Medially, the anterior layer of the renal fascia continues over the vessels in the hilum and fuses with the connective tissue associated with the abdominal aorta and... |
Anatomy_Gray_767 | Anatomy_Gray | Each kidney has a smooth anterior and posterior surface covered by a fibrous capsule, which is easily removable except during disease. On the medial margin of each kidney is the hilum of the kidney, which is a deep vertical slit through which renal vessels, lymphatics, and nerves enter and leave the substance of the ki... | Anatomy_Gray. Each kidney has a smooth anterior and posterior surface covered by a fibrous capsule, which is easily removable except during disease. On the medial margin of each kidney is the hilum of the kidney, which is a deep vertical slit through which renal vessels, lymphatics, and nerves enter and leave the subst... |
Anatomy_Gray_768 | Anatomy_Gray | The bases of the renal pyramids are directed outward, toward the renal cortex, while the apex of each renal pyramid projects inward, toward the renal sinus. The apical projection (renal papilla) contains the openings of the papillary ducts draining the renal tubules and is surrounded by a minor calyx. The minor calices... | Anatomy_Gray. The bases of the renal pyramids are directed outward, toward the renal cortex, while the apex of each renal pyramid projects inward, toward the renal sinus. The apical projection (renal papilla) contains the openings of the papillary ducts draining the renal tubules and is surrounded by a minor calyx. The... |
Anatomy_Gray_769 | Anatomy_Gray | A single large renal artery, a lateral branch of the abdominal aorta, supplies each kidney. These vessels usually arise just inferior to the origin of the superior mesenteric artery between vertebrae LI and LII (Fig. 4.154). The left renal artery usually arises a little higher than the right, and the right renal artery... | Anatomy_Gray. A single large renal artery, a lateral branch of the abdominal aorta, supplies each kidney. These vessels usually arise just inferior to the origin of the superior mesenteric artery between vertebrae LI and LII (Fig. 4.154). The left renal artery usually arises a little higher than the right, and the righ... |
Anatomy_Gray_770 | Anatomy_Gray | Multiple renal veins contribute to the formation of the left and right renal veins, both of which are anterior to the renal arteries (Fig. 4.154A). Importantly, the longer left renal vein crosses the midline anterior to the abdominal aorta and posterior to the superior mesenteric artery and can be compressed by an aneu... | Anatomy_Gray. Multiple renal veins contribute to the formation of the left and right renal veins, both of which are anterior to the renal arteries (Fig. 4.154A). Importantly, the longer left renal vein crosses the midline anterior to the abdominal aorta and posterior to the superior mesenteric artery and can be compres... |
Anatomy_Gray_771 | Anatomy_Gray | The renal pelvis narrows as it passes inferiorly through the hilum of the kidney and becomes continuous with the ureter at the ureteropelvic junction (Fig. 4.155). Inferior to this junction, the ureters descend retroperitoneally on the medial aspect of the psoas major muscle. At the pelvic brim, the ureters cross eithe... | Anatomy_Gray. The renal pelvis narrows as it passes inferiorly through the hilum of the kidney and becomes continuous with the ureter at the ureteropelvic junction (Fig. 4.155). Inferior to this junction, the ureters descend retroperitoneally on the medial aspect of the psoas major muscle. At the pelvic brim, the urete... |
Anatomy_Gray_772 | Anatomy_Gray | The ureters receive arterial branches from adjacent vessels as they pass toward the bladder (Fig. 4.155): The renal arteries supply the upper end. The middle part may receive branches from the abdominal aorta, the testicular or ovarian arteries, and the common iliac arteries. In the pelvic cavity, the ureters are suppl... | Anatomy_Gray. The ureters receive arterial branches from adjacent vessels as they pass toward the bladder (Fig. 4.155): The renal arteries supply the upper end. The middle part may receive branches from the abdominal aorta, the testicular or ovarian arteries, and the common iliac arteries. In the pelvic cavity, the ure... |
Anatomy_Gray_773 | Anatomy_Gray | Ureteric innervation is from the renal, aortic, superior hypogastric, and inferior hypogastric plexuses through nerves that follow the blood vessels. Visceral efferent fibers come from both sympathetic and parasympathetic sources, whereas visceral afferent fibers return to T11 to L2 spinal cord levels. Ureteric pain, w... | Anatomy_Gray. Ureteric innervation is from the renal, aortic, superior hypogastric, and inferior hypogastric plexuses through nerves that follow the blood vessels. Visceral efferent fibers come from both sympathetic and parasympathetic sources, whereas visceral afferent fibers return to T11 to L2 spinal cord levels. Ur... |
Anatomy_Gray_774 | Anatomy_Gray | Anterior to the right suprarenal gland is part of the right lobe of the liver and the inferior vena cava, whereas anterior to the left suprarenal gland is part of the stomach, pancreas, and, on occasion, the spleen. Parts of the diaphragm are posterior to both glands. The suprarenal glands are surrounded by the perinep... | Anatomy_Gray. Anterior to the right suprarenal gland is part of the right lobe of the liver and the inferior vena cava, whereas anterior to the left suprarenal gland is part of the stomach, pancreas, and, on occasion, the spleen. Parts of the diaphragm are posterior to both glands. The suprarenal glands are surrounded ... |
Anatomy_Gray_775 | Anatomy_Gray | Inferior branches (inferior suprarenal arteries) from the renal arteries pass upward to the suprarenal glands. In contrast to this multiple arterial supply is the venous drainage, which usually consists of a single vein leaving the hilum of each gland. On the right side, the right suprarenal vein is short and almost im... | Anatomy_Gray. Inferior branches (inferior suprarenal arteries) from the renal arteries pass upward to the suprarenal glands. In contrast to this multiple arterial supply is the venous drainage, which usually consists of a single vein leaving the hilum of each gland. On the right side, the right suprarenal vein is short... |
Anatomy_Gray_776 | Anatomy_Gray | The abdominal aorta begins at the aortic hiatus of the diaphragm as a midline structure at approximately the lower level of vertebra TXII (Fig. 4.164). It passes downward on the anterior surface of the bodies of vertebrae LI to LIV, ending just to the left of midline at the lower level of vertebra LIV. At this point, i... | Anatomy_Gray. The abdominal aorta begins at the aortic hiatus of the diaphragm as a midline structure at approximately the lower level of vertebra TXII (Fig. 4.164). It passes downward on the anterior surface of the bodies of vertebrae LI to LIV, ending just to the left of midline at the lower level of vertebra LIV. At... |
Anatomy_Gray_777 | Anatomy_Gray | Anterior to the abdominal aorta, as it descends, are the pancreas and splenic vein, the left renal vein, and the inferior part of the duodenum. Several left lumbar veins cross it posteriorly as they pass to the inferior vena cava. On its right side are the cisterna chyli, thoracic duct, azygos vein, right crus of the d... | Anatomy_Gray. Anterior to the abdominal aorta, as it descends, are the pancreas and splenic vein, the left renal vein, and the inferior part of the duodenum. Several left lumbar veins cross it posteriorly as they pass to the inferior vena cava. On its right side are the cisterna chyli, thoracic duct, azygos vein, right... |
Anatomy_Gray_778 | Anatomy_Gray | The paired visceral branches of the abdominal aorta (Fig. 4.164) include: the middle suprarenal arteries—small, lateral branches of the abdominal aorta arising just above the renal arteries that are part of the multiple vascular supply to the suprarenal gland; the renal arteries—lateral branches of the abdominal aorta ... | Anatomy_Gray. The paired visceral branches of the abdominal aorta (Fig. 4.164) include: the middle suprarenal arteries—small, lateral branches of the abdominal aorta arising just above the renal arteries that are part of the multiple vascular supply to the suprarenal gland; the renal arteries—lateral branches of the ab... |
Anatomy_Gray_779 | Anatomy_Gray | The inferior phrenic arteries arise immediately inferior to the aortic hiatus of the diaphragm either directly from the abdominal aorta, as a common trunk from the abdominal aorta, or from the base of the celiac trunk (Fig. 4.164). Whatever their origin, they pass upward, provide some arterial supply to the suprarenal ... | Anatomy_Gray. The inferior phrenic arteries arise immediately inferior to the aortic hiatus of the diaphragm either directly from the abdominal aorta, as a common trunk from the abdominal aorta, or from the base of the celiac trunk (Fig. 4.164). Whatever their origin, they pass upward, provide some arterial supply to t... |
Anatomy_Gray_780 | Anatomy_Gray | The final posterior branch is the median sacral artery (Fig. 4.164). This vessel arises from the posterior surface of the abdominal aorta just superior to the bifurcation and passes in an inferior direction, first over the anterior surface of the lower lumbar vertebrae and then over the anterior surface of the sacrum a... | Anatomy_Gray. The final posterior branch is the median sacral artery (Fig. 4.164). This vessel arises from the posterior surface of the abdominal aorta just superior to the bifurcation and passes in an inferior direction, first over the anterior surface of the lower lumbar vertebrae and then over the anterior surface o... |
Anatomy_Gray_781 | Anatomy_Gray | During its course, the anterior surface of the inferior vena cava is crossed by the right common iliac artery, the root of the mesentery, the right testicular or ovarian artery, the inferior part of the duodenum, the head of the pancreas, the superior part of the duodenum, the bile duct, the portal vein, and the liver,... | Anatomy_Gray. During its course, the anterior surface of the inferior vena cava is crossed by the right common iliac artery, the root of the mesentery, the right testicular or ovarian artery, the inferior part of the duodenum, the head of the pancreas, the superior part of the duodenum, the bile duct, the portal vein, ... |
Anatomy_Gray_782 | Anatomy_Gray | Of the venous tributaries mentioned above, the lumbar veins are unique in their connections and deserve special attention. Not all of the lumbar veins drain directly into the inferior vena cava (Fig. 4.167): The fifth lumbar vein generally drains into the iliolumbar vein, a tributary of the common iliac vein. The third... | Anatomy_Gray. Of the venous tributaries mentioned above, the lumbar veins are unique in their connections and deserve special attention. Not all of the lumbar veins drain directly into the inferior vena cava (Fig. 4.167): The fifth lumbar vein generally drains into the iliolumbar vein, a tributary of the common iliac v... |
Anatomy_Gray_783 | Anatomy_Gray | If the inferior vena cava becomes blocked, the ascending lumbar veins become important collateral channels between the lower and upper parts of the body. Lymphatic drainage from most deep structures and regions of the body below the diaphragm converges mainly on collections of lymph nodes and vessels associated with th... | Anatomy_Gray. If the inferior vena cava becomes blocked, the ascending lumbar veins become important collateral channels between the lower and upper parts of the body. Lymphatic drainage from most deep structures and regions of the body below the diaphragm converges mainly on collections of lymph nodes and vessels asso... |
Anatomy_Gray_784 | Anatomy_Gray | Table 4.4 (also see Chapter 1, pp. 27–28, for discussion of lymphatics in general). Approaching the aortic bifurcation, the collections of lymphatics associated with the two common iliac arteries and veins merge, and multiple groups of lymphatic vessels and nodes associated with the abdominal aorta and inferior vena ca... | Anatomy_Gray. Table 4.4 (also see Chapter 1, pp. 27–28, for discussion of lymphatics in general). Approaching the aortic bifurcation, the collections of lymphatics associated with the two common iliac arteries and veins merge, and multiple groups of lymphatic vessels and nodes associated with the abdominal aorta and in... |
Anatomy_Gray_785 | Anatomy_Gray | The pre-aortic nodes are organized around the three anterior branches of the abdominal aorta that supply the abdominal part of the gastrointestinal tract, as well as the spleen, pancreas, gallbladder, and liver. They are divided into celiac, superior mesenteric, and inferior mesenteric nodes, and receive lymph from the... | Anatomy_Gray. The pre-aortic nodes are organized around the three anterior branches of the abdominal aorta that supply the abdominal part of the gastrointestinal tract, as well as the spleen, pancreas, gallbladder, and liver. They are divided into celiac, superior mesenteric, and inferior mesenteric nodes, and receive ... |
Anatomy_Gray_786 | Anatomy_Gray | Nervous system in the posterior Several important components of the nervous system are in the posterior abdominal region. These include the sympathetic trunks and associated splanchnic nerves, the plexus of nerves and ganglia associated with the abdominal aorta, and the lumbar plexus of nerves. The sympathetic trunks p... | Anatomy_Gray. Nervous system in the posterior Several important components of the nervous system are in the posterior abdominal region. These include the sympathetic trunks and associated splanchnic nerves, the plexus of nerves and ganglia associated with the abdominal aorta, and the lumbar plexus of nerves. The sympat... |
Anatomy_Gray_787 | Anatomy_Gray | Also associated with the sympathetic trunks in the posterior abdominal region are the lumbar splanchnic nerves (Fig. 4.169). These components of the nervous system pass from the sympathetic trunks to the plexus of nerves and ganglia associated with the abdominal aorta. Usually two to four lumbar splanchnic nerves carry... | Anatomy_Gray. Also associated with the sympathetic trunks in the posterior abdominal region are the lumbar splanchnic nerves (Fig. 4.169). These components of the nervous system pass from the sympathetic trunks to the plexus of nerves and ganglia associated with the abdominal aorta. Usually two to four lumbar splanchni... |
Anatomy_Gray_788 | Anatomy_Gray | Continuing inferiorly, the plexus of nerve fibers extending from just below the superior mesenteric artery to the aortic bifurcation is the abdominal aortic plexus (Fig. 4.170). At the bifurcation of the abdominal aorta, the abdominal prevertebral plexus continues inferiorly as the superior hypogastric plexus. Througho... | Anatomy_Gray. Continuing inferiorly, the plexus of nerve fibers extending from just below the superior mesenteric artery to the aortic bifurcation is the abdominal aortic plexus (Fig. 4.170). At the bifurcation of the abdominal aorta, the abdominal prevertebral plexus continues inferiorly as the superior hypogastric pl... |
Anatomy_Gray_789 | Anatomy_Gray | Associated with the abdominal prevertebral plexus are clumps of nervous tissue (the prevertebral ganglia), which are collections of postganglionic sympathetic neuronal cell bodies in recognizable aggregations along the abdominal prevertebral plexus; they are usually named after the nearest branch of the abdominal aorta... | Anatomy_Gray. Associated with the abdominal prevertebral plexus are clumps of nervous tissue (the prevertebral ganglia), which are collections of postganglionic sympathetic neuronal cell bodies in recognizable aggregations along the abdominal prevertebral plexus; they are usually named after the nearest branch of the a... |
Anatomy_Gray_790 | Anatomy_Gray | The lumbar plexus is formed by the anterior rami of nerves L1 to L3 and most of the anterior ramus of L4 (Fig. 4.173 and Table 4.6). It also receives a contribution from the T12 (subcostal) nerve. Branches of the lumbar plexus include the iliohypogastric, ilio-inguinal, and genitofemoral nerves, the lateral cutaneous n... | Anatomy_Gray. The lumbar plexus is formed by the anterior rami of nerves L1 to L3 and most of the anterior ramus of L4 (Fig. 4.173 and Table 4.6). It also receives a contribution from the T12 (subcostal) nerve. Branches of the lumbar plexus include the iliohypogastric, ilio-inguinal, and genitofemoral nerves, the later... |
Anatomy_Gray_791 | Anatomy_Gray | The iliohypogastric and ilio-inguinal nerves arise as a single trunk from the anterior ramus of nerve L1 (Fig. 4.173). Either before or soon after emerging from the lateral border of the psoas major muscle, this single trunk divides into the iliohypogastric and the ilio-inguinal nerves. The iliohypogastric nerve passes... | Anatomy_Gray. The iliohypogastric and ilio-inguinal nerves arise as a single trunk from the anterior ramus of nerve L1 (Fig. 4.173). Either before or soon after emerging from the lateral border of the psoas major muscle, this single trunk divides into the iliohypogastric and the ilio-inguinal nerves. The iliohypogastri... |
Anatomy_Gray_792 | Anatomy_Gray | The remaining part of the iliohypogastric nerve (the anterior cutaneous branch) continues in an anterior direction, piercing the internal oblique just medial to the anterior superior iliac spine as it continues in an obliquely downward and medial direction. Becoming cutaneous, just above the superficial inguinal ring, ... | Anatomy_Gray. The remaining part of the iliohypogastric nerve (the anterior cutaneous branch) continues in an anterior direction, piercing the internal oblique just medial to the anterior superior iliac spine as it continues in an obliquely downward and medial direction. Becoming cutaneous, just above the superficial i... |
Anatomy_Gray_793 | Anatomy_Gray | The ilio-inguinal nerve emerges through the superficial inguinal ring, along with the spermatic cord, and provides cutaneous innervation to the upper medial thigh, the root of the penis, and the anterior surface of the scrotum in men, or the mons pubis and labium majus in women (Fig. 4.175). Throughout its course, it a... | Anatomy_Gray. The ilio-inguinal nerve emerges through the superficial inguinal ring, along with the spermatic cord, and provides cutaneous innervation to the upper medial thigh, the root of the penis, and the anterior surface of the scrotum in men, or the mons pubis and labium majus in women (Fig. 4.175). Throughout it... |
Anatomy_Gray_794 | Anatomy_Gray | The genital branch continues downward and enters the inguinal canal through the deep inguinal ring. It continues through the canal and: in men, innervates the cremasteric muscle and terminates on the skin in the upper anterior part of the scrotum, and in women, accompanies the round ligament of the uterus and terminate... | Anatomy_Gray. The genital branch continues downward and enters the inguinal canal through the deep inguinal ring. It continues through the canal and: in men, innervates the cremasteric muscle and terminates on the skin in the upper anterior part of the scrotum, and in women, accompanies the round ligament of the uterus... |
Anatomy_Gray_795 | Anatomy_Gray | Lateral cutaneous nerve of thigh (L2 and L3) The lateral cutaneous nerve of the thigh arises from the anterior rami of nerves L2 and L3 (Fig. 4.173). It emerges from the lateral border of the psoas major muscle, passing obliquely downward across the iliacus muscle toward the anterior superior iliac spine (Fig. 4.175). ... | Anatomy_Gray. Lateral cutaneous nerve of thigh (L2 and L3) The lateral cutaneous nerve of the thigh arises from the anterior rami of nerves L2 and L3 (Fig. 4.173). It emerges from the lateral border of the psoas major muscle, passing obliquely downward across the iliacus muscle toward the anterior superior iliac spine ... |
Anatomy_Gray_796 | Anatomy_Gray | In the area of the obturator canal, the obturator nerve divides into anterior and posterior branches. On entering the medial compartment of the thigh, the two branches are separated by the obturator externus and adductor brevis muscles. Throughout their course through the medial compartment, these two branches supply: ... | Anatomy_Gray. In the area of the obturator canal, the obturator nerve divides into anterior and posterior branches. On entering the medial compartment of the thigh, the two branches are separated by the obturator externus and adductor brevis muscles. Throughout their course through the medial compartment, these two bra... |
Anatomy_Gray_797 | Anatomy_Gray | Femoral nerve (L2 to L4) The femoral nerve arises from the anterior rami of nerves L2 to L4 (Fig. 4.173). It descends through the substance of the psoas major muscle, emerging from the lower lateral border of the psoas major (Fig. 4.174). Continuing its descent, the femoral nerve lies between the lateral border of the ... | Anatomy_Gray. Femoral nerve (L2 to L4) The femoral nerve arises from the anterior rami of nerves L2 to L4 (Fig. 4.173). It descends through the substance of the psoas major muscle, emerging from the lower lateral border of the psoas major (Fig. 4.174). Continuing its descent, the femoral nerve lies between the lateral ... |
Anatomy_Gray_798 | Anatomy_Gray | Muscular branches innervate the iliacus, pectineus, sartorius, rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis muscles. Articular branches supply the hip and knee joints. Visualization of the position of abdominal viscera is fundamental to a physical examination. Some of these viscera or their... | Anatomy_Gray. Muscular branches innervate the iliacus, pectineus, sartorius, rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis muscles. Articular branches supply the hip and knee joints. Visualization of the position of abdominal viscera is fundamental to a physical examination. Some of these vi... |
Anatomy_Gray_799 | Anatomy_Gray | The costal margin is readily palpable and separates the abdominal wall from the thoracic wall. A line between the anterior superior iliac spine and the pubic tubercle marks the position of the inguinal ligament, which separates the anterior abdominal wall above from the thigh of the lower limb below. The iliac crest se... | Anatomy_Gray. The costal margin is readily palpable and separates the abdominal wall from the thoracic wall. A line between the anterior superior iliac spine and the pubic tubercle marks the position of the inguinal ligament, which separates the anterior abdominal wall above from the thigh of the lower limb below. The ... |
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