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Abdomen-Part 3

Abdomen-Part 3. Marilyn Rose. Anatomy of a Kidney. Urinary System. Kidneys, ureters, bladder, urethra Kidneys- retroperitoneal, bean-shaped Oblique orientation, paravertebral gutters along posterior abdominal wall One on each side of spine at the level of T12 – L4

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Abdomen-Part 3

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  1. Abdomen-Part 3 Marilyn Rose

  2. Anatomy of a Kidney

  3. Urinary System • Kidneys, ureters, bladder, urethra • Kidneys- retroperitoneal, bean-shaped • Oblique orientation, paravertebral gutters along posterior abdominal wall • One on each side of spine at the • level of T12 – L4 • Surrounded by perirenal fat, and Gerota’s fascia • Composed of • outer cortex- functional subunit- nephrons- filter urine • inner renal medulla- pyramids, Loops of Henle

  4. Kidney on X-Ray

  5. Kidney on CT Mass on CT recon of Horseshoe Kidney

  6. Kidney on MRI

  7. Kidney on Ultrasound

  8. Urinary Bladder

  9. Kidney TX

  10. Kid TX- Ultrasound

  11. Abnormal Kidneys- Polycystic

  12. Adrenal Glands

  13. Adrenal Glands • Retroperitoneal, paired, suprarenal, y shaped • Rt adrenal- posterior to IVC, medial to Rt hepatic lobe, lateral to Rtcrus of diaphragm. • Lt adrenal- in “triangle” of the aorta, pancreatic tail, and Lt kidney- borders Lt crus of diaphragm • Outer cortex- produce steroids • Corticosteroids • glucocorticoids, mineralocorticoids and androgens • Inner medulla • Hormones • Epinephrine and norepinephrine- fight or flight

  14. Adrenal Gland- Abnormal Neuroblastoma Of Lt adrenal gland

  15. Abnormal Adrenal Adrenal Hemorrhage Neuroblastoma

  16. Adrenal in Pediatrics

  17. GI System • Stomach- food reservoir and early digestion • Located under Lt dome of diaphragm • Superior portion- joins esophagus at cardiac orifice (cardiac sphincter) • Boder- lesser and greater curvature • Inferior portion- pyloric antrum -> duodenum • Anterior surface- contact with diaphragm, anterio abdominal wall and Lt lobe of liver • Lining of stomach = rugae • Gastric juices= mucus, hydrochloric acid, intrinsic factor and pepsinogen and lipase • Very vascular organ

  18. Stomach

  19. Stomach on CT CT scan of chest & upper abdomen (coronal section); herniation of stomach & splenic flexure of colon, along with collapse of lung and mediastinal shifting

  20. Pylorus

  21. Intestines • Small bowel • between pylorus and ileocecal valve • 6-7 meters in length • Duodenum • Pylorus- head of panc- retroperitoneal • 4 portions • First- superior-duodenal bulb • Second- descend- ampulla of Vater • Third- horizontal- L3- ant to SVC, AO • Fourth- ascending- Lt of AO at L2 meets with Jejunum • jejunum– duodenojejunal flexure • ligament of Treitz- suspensory lig-around celiac axis • Entry of small bowel into peritoneal cavity • Lt upper abdomen/ umbilical region- absorption occurs- folds?? • Ileum • Longest portion, RL abdomen- terminate at ileocecal valve- CECUM • Often this is the site of intussusception / inflammation and WHAT?

  22. Intestines- Small bowel

  23. Bowel Issues! Intussesseption hernia

  24. Large Intestine • Inferior to stomach and liver • Larger diameter, haustra and bands called taenia coli • The appendix attaches to posteromedial surface of cecum • Ascending- • retroperitoneal, cecum to liver- hepatic flexure • Transverse • Peritoneal, horizontal, toward spleen, splenic flexure • Descending • Retroperitoneal, Lt lat abd to sigmoid • Sigmoid

  25. Colon

  26. APPY!!!

  27. Lymph Nodes • Chains along branches of arteries of intestine and AO • Small, oblong, soft and difficult to visualize –unless ABNORMAL • Enlarged= greater than 1 cm in short axis and 2 cm in long axis. • Abdominoaortic nodal groups- surround AO/IVC • Visceral –drain adjacent organs • Lymph drains from abdominal cavity into lumbar trunk, and intestinal in to intestinal trunk and both trunks join the thoracic duct and then the venous system

  28. Lymph Nodes

  29. Lymph Nodes PTLD????

  30. Muscles • Diaphragm • Quadratuslumborum • Lg portion of posterior abdominal wall • Iliac crest- inferior 12th rib • Psoas • Lateral surpaces of lumbar vertebrae • Insert into greater trochanter of femur • Rectus abdominis • Anterior surface of abd/pelvis • Linea alba • Xiphoid- symphysis pubis- midline and interlacing

  31. Muscles

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