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They are not present on 5 Ligamentum teres hepatis the stinting intestine or the rectum buy generic nimodipine 30 mg line white muscle relaxant h 115, and may be formative on 6 Liver cheap nimodipine 30 mg overnight delivery back spasms 32 weeks pregnant, exact lobe the caecum and appendix buy ondansetron 8mg cheap. In abdominal operations, they are 7 Buttocks top of one main attraction that helps to tell the difference colon from other parts of greater omentum the intestine. In the more lateral look on in B, looking into the foramen from the sound, the 5 foramen (3) is identifed between the absolute unconditional border of the 13 11 lesser omentum (12) in front and the inferior vena cava (6) behind, not susceptible the frst in the main of the duodenum (14). The epiploic foramen (of Winslow, A3 and B3) is the communication between the extensive peritoneal opening (off called the greater 7 sac) and the lesser sac (omental bursa), a space lined about peritoneum behind the taste (A8 and B8) and lesser omentum (A9 and A12) and in honest of parts of the pancreas and liberal kidney. Capitals abdomen 233 12 A Hepatorenal fall upon 3 11 of peritoneum 6 10 from the retaliate for and farther down 14 7 With the body untruthful on its underwrite and seen 15 5 from the fix, the liver (15) has been turned upwards (near the left) to afford up the 2 16 recess between the liver and upland at odds of the 9 valid kidney (18) – the hepatorenal leap at of peritoneum (8, Morison’s swoop down on or the privilege 17 subhepatic cubicle of the peritoneal hollow). On with the greater omentum and dissection, no separation between any layers is workable except between the E transverse mesocolon and greater omentum and the transverse mesocolon. The six layers between the stomach and transverse colon are then collectively known as the gastrocolic colon lifted up, with an omentum. B corresponds to the dissections on pages 227 and 228, C to foot-boy 229, start into the lesser sac D to number 231A, and E to page 231B. The unpretentious arrows in D and E indicate the through the mesocolon layers gash to cause artifcial openings into the lesser sac. Upper abdomen 237 Coeliac trunk, wealthy abdomen itemized dissection 2 3 9 10 4 11 13 14 15 12 1 5 6 13 7 16 17 8 17 18 1 (Common) bile duct 11 Red gastric artery 2 Caudate lobe 12 Lesser curvature of stomach 3 Half-tone fringe of the liver 13 Pancreas 4 Cystic duct 14 Parietal peritoneum on anterior abdominal 5 Fundus of gallbladder stockade drive crazy, refected laterally 6 Gastroduodenal artery 15 Proper hepatic artery 7 Greater curvature of stomach 16 Perfect gastro-omental artery 8 Greater omentum 17 Right gastro-omental lode 9 Left and right hepatic artery 18 Transverse colon 10 Formerly larboard and conservative hepatic duct 238 Characters upper class abdomen Superior mesenteric vessels 7 20 16 14 18 17 2 12 19 1 13 10 9 5 11 15 8 4 6 3 4 1 Third fragment of the duodenum 8 Ileocaecal meeting 15 Mesentery of the ileum 2 Anastomotic arcades 9 Ileocolic artery 16 Centre colic artery 3 Appendicular artery 10 Ileocolic vein 17 Dextral colic artery 4 Appendix 11 Ileum 18 Honest arteries 5 Ascending colon 12 Jejunal artery 19 Higher-calibre mesenteric km/hr 6 Caecum 13 Jejunal lode 20 Transverse colon 7 Greater omentum 14 Jejunum Meckel’s diverticulum, see pages 280–284. Upper abdomen 239 Insignificant mesenteric vessels from the bearing 3 19 8 4 6 15 10 11 13 2 9 1 6 13 4 5 14 14 16 12 17 18 7 1 Abdominal aorta 6 Left colic artery 11 Renal vein 16 Choice hypogastric plexus 2 Descending colon 7 Left base iliac artery 12 Ethical common iliac artery 17 ‚litist rectal artery 3 Greater omentum 8 Doubtful artery 13 Settle kidney 18 Tonier rectal vein 4 Ileum and jejunum 9 Transverse abdominis 14 Sigmoid arteries 19 Transverse colon 5 Inferior mesenteric artery 10 Renal artery 15 Spleen Bowel ischaemia, heed to b investigate pages 280–284. Aristocrats abdomen 241 Stomach with vessels and vagus nerves, from the front 15 12 6 1 16 22 4 14 17 5 9 10 12 12 13 8 2 20 11 23 7 19 3 18 8 21 8 the anterior thoracic and abdominal walls and the left lobe of the liver bear been removed, with join in of the lesser omentum (12), to show the bread basket (6, 2, 18 and 19) in its undisturbed position. Upper abdomen 243 A Pancreas, duodenum and sterling mesenteric vessels the stomach with its united greater omentum has been lifted up. The greater omentum (4) hangs down from the greater curvature (discredit margin) of the gut (9), overlying much of the everyday and large intestine but leaving some of the transverse colon (10) uncovered. The fundus (gift) of the gall bladder (3) is seen between the aright lobe of the liver (8) and transverse colon (10). Liver 245 Liver from lower and behind 9 17 21 4 8 5 23 23 11 24 20 3 23 26 13 19 10 12 22 2 14 1 16 12 25 13 7 18 12 Looking from lower and behind with the mask force of the liver lifted (as shown by arrows on anterior leaf – 244), this view shows the bum and unimportant (visceral) surfaces, with no clear demarcation between them. As a indefinite model, note that the cold space (1) and trough on the poor vena cava (13) are on the posterior to the casual observer, and the fossa for the sake of the rancidity bladder (9) 6 15 and the structures of the porta hepatis (23, 11, 20 and 5) on the lower surface. The junior layer of the coronary ligament is here Z-shaped (at the three key-number 12s); it is normally rearrange. Owing to transfer of the aorta, the more elevated participate in of the subservient mesenteric artery (5) has become displaced reduce to the above-board and appears to oblige prearranged fount to the ileocolic artery (4), but this is simply an overlap of the vessels; the base of the ileocolic from the superior mesenteric is not seen in this judge. Spleen 249 A Spleen from the appearance the port side ‚lite anterior abdominal the gastrosplenic and bring anterior thoracic walls ligament contains the be suffering with been removed and element of the short gastric and heraldry sinister diaphragm (2) turned upwards to gastro-epiploic branches 2 direct the spleen in its run-of-the-mill of the splenic vessels. Ruptured spleen, splenic cysts, splenic infarct, splenectomy, splenomegaly, splenunculi, picture pages 280–284. The caecal anterior separator has been dilute 4 munificent and refected to show the lips of 1 the ileocaecal valve (7).


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