The Infracolic Compartment
Ⅰ. Location
It lies between the transverse colon with
its mesocolon and the superior aperture of
the lesser pelvis.
Ⅱ. Contents
the jejunum, ileum, vermiform appendix,
colon and other viscera.
Ⅲ. The vermiform appendix
The features
--- a narrow, worm-shaped, blind tube.
---about 5~7cm long.
---diameter is 0.5~1.0cm.
---intraperitoneal organ,
has a triangular
mesentery.
The position
---the root joins with the posteromedial wall
of the cecum.
---the 3 colic bands focus at the root.
---the projection of the root
of the vermiform
appendix
*The McBurngy’s point
at the junction of the lateral
and middle thirds of the line
between the right superior
iliac spine and the umbilicus.
---it is variable in position
A. the pelvic position: 41.3%;
B. the retrocecoal or retrocolic position:29.4%;
C. the subcecal position:17.4%;
D. the pre-ileal position: 7.4%;
E. the post-ileal position:4.4%.
(III) The appendix artery and vein
I) the artery arises from the ileocolic a. and
usually is single.
II) the vein drains into the hepatic portal vein.
the appendicular v.
the ileocolic v.
the superior mesenteric
v.
hepatic portal v.
appendicitis the bacterial
emboli enter the liver by the
course and lead to hepatic
abscess.
The blood supply of colon
----the superior and inferior mesenteric arteries
Ⅳ. The hepatic portal vein
---a shorter and thicker venous trunk.
---about 6~8cm long and 1~1.2 cm in diameter
---drains the venous blood from the single
viscera(except the liver) in the abdominal
cavity.
---is the functional blood vessel of the liver.
(Ⅰ) Formation
It is formed by the union
of the superior mesenteric
and splenic veins behind the
neck of the pancreas.
three types:
type 1 (51.2%)
portal v.
splenic v.
type 2(15.3%)
inf. mesenteric v.
sup. mesenteric v.
type 3 (32.7%)
(Ⅱ)Relationship
The hepatic portal vein ascends behind the head
of the pancreas and the sup. part of the
duodenum, towards the right and upwards,enters
the hepatoduodenal ligament.It ascends in the
ligament and divides into right and left branches
at the porta hepatis. The common bile duct is
right and anterior toit and the proper hepatic
artery is left and anterior.
(Ⅲ)
Tributaries
splenic vein
superior mesenteric vein
inferior mesenteric vein
left gastric vein
right gastric vein
systic vein
paraumbilical vein
(Ⅳ) Communications
between hepatic portal
and systemic veins
1. Esophageal venous
plexus
2. Rectal venous
plexus
3. Paraumbilical
venous plexus
The retroperitoneal space
Ⅰ. Location
The space lies between the parietal peritoneum
and the fascia and musculature of the posterior
abdominal wall.
It extends superiorly from the diaphragm, and
inferiorly to the sacral promontory and the pelvis
inlet.
Ⅱ. Communication
superiorly continuous with the posterior
mediastinum
inferiorly
continuous
with pelvic retroperitoneal
space.
Ⅲ. Contents
kidneys, suprarenal glands, abdoinal part
of the ureters, pancreas, duodenum, blood
vessels, lymph nodes, and nerves.
Ⅳ. The kidneys
1. Position
The kidneys lie on each side of the lumbar part
of the vertebral column. The left kidney is about
1.5cm higher than the right one.
L kidney
R Kidney
Upper pole
T11th
T12th
Lower pole
L2nd
L3nd
The 12th rib crosses obliquely the upper
third of the posterior surface of the right kidney;
but the middle part of the left one.
the renal angle: the lateral border of the
erector spinae crosses 12th rib. The hilum of the
kidneys is at the angle.
The projection of the kidneys
on the each side of the posterior surface of the
body, 2 vertical lines and 2 horizontal line form
a quadrilateral area, in which the kidney lies.
medial vertical line
2.5cm apart from the post. median line
lateral vertical line
7.5cm
Upper horizontal line
(passing the spine of T11th)
Lower horizontal line
(passing the spine of the L3rd)
2.Relation
The upper pole
gland.
relation
upper
Ant. middle
lower
Post.
covered by the suprarenal
L kidney
R kidney
stomach,spleen
right lobe of liver
tail of pancreas
descending part
of the duodenum
colis of jejunum right colic
Left colic flexure flexure
diaphragm above,psoas major,quadratus lumborum,transverse
abdominis
3. The hilum, sinus and pedicle of the kidney
The hilum
at the medial border, it’s the
entrance of the sinus.
The sinus a hollow recess in the kidney.
The pedicle The structures, which enter or
leave the hilum, form the pedicle. It contains
mainly the renal artery,renal vein and pelvis.
arrangement of the pedicle
from anterior to posterior is: V, A and P.
from above downwards is: A,V and P.
4. Renal capsule
From outside inwards,the are renal fascia,
adipose capsule and fibrous capsule.
1) The renal fascia
anterior layer
2 layers
posterior layer
2) The adipose capsule
supports and protects the kidney
3) The fibrous capsule