Ligamentous apparatus and peritoneal structures
The inner surface of the abdominal walls is lined with the parietal peritoneum (peritoneum parietale), which transitions onto the organs to form a complex fixation system.
Main peritoneal structures include:
- Liver ligaments: hepatogastric ligament (lig. hepatogastricum) and hepatoduodenal ligament (lig. hepatoduodenale).
- Colic ligaments: phrenicocolic ligament (lig. phrenicocolicum).
- Mesenteries: root of the mesentery (radix mesenterii), transverse mesocolon (mesocolon transversum), and sigmoid mesocolon (mesocolon sigmoideum).
The peritoneum also forms important spaces: the omental bursa (bursa omentalis), which is accessed through the omental foramen (foramen epiploicum). In addition, a number of recesses are distinguished: splenic recess (recessus lienalis), superior duodenal recess (recessus duodenalis superior), and superior ileocecal recess (recessus ileocaecalis superior).
Topography of the liver, spleen, and pancreas
During the examination of the upper abdomen, the liver (hepar) is visualized, in the structure of which the caudate lobe (lobus caudatus) is distinguished. The gallbladder (vesica fellea) is located directly adjacent to the liver. The biliary tract is represented by the cystic duct (ductus cysticus) and the common bile duct (ductus choledochus).
Also located in this region are the spleen (lien) and the pancreas (pancreas), in which the body and tail are clearly defined from this perspective (without the stomach).
Arrangement of intestinal parts
The intestine occupies a significant part of the abdominal cavity and pelvic cavity (cavum pelvis).
The small intestine is represented by:
- The duodenum (duodenum): its ascending part (pars ascendens) and duodenojejunal flexure (flexura duodenojejunalis) are distinguished.
- The terminal part of the ileum (ileum).
The large intestine has a more complex configuration:
- Cecum (caecum) with the vermiform appendix (appendix vermiformis).
- Ascending colon (colon ascendens).
- Right and left colic flexures (flexura coli dextra et sinistra).
- Transverse colon (colon transversum).
- Descending colon (colon descendens).
- Sigmoid colon (colon sigmoideum).
- Rectum (rectum).
Organs of the urinary system
The organs of the urinary system visualized in the abdominal cavity and lesser pelvis include the right and left kidneys (ren dexter et ren sinister), as well as the urinary bladder (vesica urinaria).
Briefly: answers to topical questions
What anatomical structures bound the omental foramen?
The omental foramen is bounded anteriorly by the hepatoduodenal ligament, posteriorly by the parietal peritoneum covering the inferior vena cava and the hepatorenal ligament. Superiorly it is bounded by the caudate lobe of the liver, and inferiorly by the duodenorenal ligament and the superior part of the duodenum.
- Hepatoduodenal ligament (lig. hepatoduodenale) — anteriorly
- Hepatorenal ligament (lig. hepatorenale) — posteriorly
- Caudate lobe of the liver (lobus caudatus) — superiorly
- Duodenorenal ligament (lig. duodenorenale) — inferiorly
What peritoneal recesses are located in the ileocecal angle?
In the region of the ileocecal angle are the superior and inferior ileocecal recesses, as well as the retrocecal recess. The superior ileocecal recess is located between the upper margin of the ileum and the inner surface of the ascending colon, and the inferior one is between the lower surface of the ileum and the wall of the cecum.
- Superior ileocecal recess (recessus ileocaecalis superior) — between the ileum and ascending colon
- Inferior ileocecal recess (recessus ileocaecalis inferior) — between the ileum and cecum
- Retrocecal recess (recessus retrocaecalis) — posterior to the cecum
What elements form the portal triad within the hepatoduodenal ligament?
The hepatoduodenal ligament contains three main elements: the proper hepatic artery, the common bile duct, and the portal vein. The proper hepatic artery is located on the left, the common bile duct on the right, and the portal vein between them and posteriorly.
- Proper hepatic artery (a. hepatica propria) — occupies the left position
- Common bile duct (ductus choledochus) — occupies the right position
- Portal vein (v. portae) — located between them and posteriorly
Which parts of the large intestine have their own mesentery?
The transverse colon and the sigmoid colon have their own mesentery. Sources also indicate that the vermiform appendix has its own mesentery.
- Transverse colon (colon transversum) — has a mesentery (mesocolon transversum)
- Sigmoid colon (colon sigmoideum) — has a mesentery (mesocolon sigmoideum)
- Vermiform appendix (appendix vermiformis) — has a mesentery (mesoappendix)
The fusion of which ducts forms the common bile duct?
The common bile duct is formed by the union of the cystic duct and the common hepatic duct. The common hepatic duct is formed at the porta hepatis by the union of the right and left hepatic ducts.
- Common hepatic duct (ductus hepaticus communis) — is formed at the porta hepatis
- Cystic duct (ductus cysticus) — drains into the common hepatic duct
Which organs of the urinary system are projected in the abdominal cavity and pelvic cavity?
The right and left kidneys are projected in the abdominal cavity, while the urinary bladder is located in the pelvic cavity.
- Left/right kidney (ren sinister/dexter) — abdominal organs
- Urinary bladder (vesica urinaria) — located in the pelvic cavity
What anatomical parts is the duodenum divided into?
The provided materials mention the ascending part of the duodenum, the superior part of the duodenum, and the descending part of the duodenum.
- Ascending part (pars ascendens) — a part of the duodenum
- Superior part (pars superior duodeni) — the upper section of the intestine
- Descending part (pars descendens duodeni) — the descending section of the intestine
Which ligaments fix the liver to the diaphragm and the anterior abdominal wall?
According to the sources, the ligamentous apparatus of the liver includes the falciform, coronary, right and left triangular, and round ligaments of the liver.
- Falciform ligament (lig. falciforme hepatis) — stretched between the diaphragm and the superior surface of the liver
- Coronary ligament (lig. coronarium hepatis) — transition of the parietal peritoneum of the diaphragm into the visceral peritoneum of the liver
- Triangular ligaments (ligg. triangularia dextrum et sinistrum) — formed by the fusion of the layers of the coronary ligament on the right and left
- Round ligament of the liver (lig. teres hepatis) — extends from the umbilicus to the porta hepatis and merges with the anterior part of the falciform ligament
Class and exam questions
Through which structure is access to the omental bursa gained?
The entrance to the omental bursa (bursa omentalis) is through the omental foramen (foramen epiploicum).
Which parts of the pancreas are visible after removal of the stomach?
After resection of the stomach, the body and tail of the pancreas (pancreas) are clearly visualized.
Which liver ligaments belong to the peritoneal apparatus in this region?
These include the hepatogastric ligament (lig. hepatogastricum) and the hepatoduodenal ligament (lig. hepatoduodenale).
What else to study on this topic
- Boundaries and walls of the omental bursa (bursa omentalis)
- Topography of the duodenojejunal flexure (flexura duodenojejunalis)
- Course of the biliary tract: ductus cysticus and ductus choledochus
- Structure of the root of the mesentery (radix mesenterii)
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