Ans of Abdomen

ORGANS OF THE
ABDOMEN
DR. ABDUL RASHAD

SENIOR LECTURER
DPT,MPHILL(OPT) ,MPPTA, MMTC (NZ),
MSTC(AUS), IASTM(GREECE)
UNITED COLLEGE OF PHYSICAL THERAPY
SYSTEMS: URINARY AND
DIGESTIVE
Urinary System
 Kidneys
 Purify blood
 Ureters
 Drain urine from kidney
to bladder
 Urinary Bladder
 Store urine
 Urethra
 Drain urine from
bladder to outside body
Kidneys: major excretory organs
 Remove toxins, metabolic waste, excess
H2O, ions
 Urea, uric acid, creatinin
 Regulates volume + makeup of blood
 Maintains balance between
 Salts and water
 Acids and bases
Kidneys: Gross Anatomy
 Located superior lumbar
region
 Posterior abdominal wall
(T12-L3)
 Retroperitoneal
 Hilus
 Adrenal Gland:
superomedial to kidney
 Renal Artery + Vein
 Innervation: branches of
renal plexus
Kidneys: Gross Anatomy
 Renal Capsule
 Layer of tough CT
 Maintains shape
 Prevents spread of
infection
 Adipose Capsule
 External to renal cap
 Perirenal fat
 Surrounded by fascia
 Keeps in place,
cushions
 Pararenal Fat
 External to adipose cap
 Keeps in place,
cushions
Kidney: Internal Anatomy
 Cortex
 Superficial
 Light, granular
 Part of functional unit
 Medulla
 Deep layer
 Darker
 Pyramid-cone shape
 Contain collecting
tubule collect urine
Kidney: Internal Anatomy
 Medullary Pyramid
 Base: against cortex
 Apex: inward
 Papilla = tip
 Drips urine into minor calyx
 Minor Calyx (calices)
 Cup-shaped divisions of major
calices
 Surround papilla of pyramid
 Major Calyx (calices)
 Larger cup-shaped branches of
renal pelvis
 Renal Pelvis
 Flat expansion of ureter
 Collects urine
Kidney: Microscopic Anatomy
 Functional Unit
 Uriniferous Tubule
 Nephron
 Collecting tubule
 Waste is filtered out
 Waste products
formed
 Located in lobes of
kidneys
Ureters
 Slender tubes transport urine
 Run from kidneys to bladder
 Retroperitoneal
 Continuation of renal pelvis
 Enters bladder at oblique
angle to prevent backflow
 Increased pressure in
bladder closes distal end of
ureter
Ureters: 3 Layers
 External: Adventitia
 CT
 Middle: Muscularis
 Smooth Muscle
 Inner Longitudinal
 Outer Circular
 External longitudinal (on
distal third)
 Peristalsis
 Inner: Mucosa
 Transitional epithelium
Bladder  Muscular sac store and
expel urine
 Location
 On pelvic floor
 Posterior
 Pubic symphysis
 Anterior
 Males = rectum
 Females = vagina, uterus
 Collapses + Expands
 Full  into abdominal cav
 Emptystays in pelvic cav
 Supplied by branches of
internal iliac arteries + veins
 Innervated = branches of
hypogastric plexus
Bladder: Internal Anatomy
trigone
 3 Layers
 Mucosa = transitional epithelium & lamina propria
 Detrusor Muscle: smooth muscle
 Inner/Outer longitudinal, Middle circular
 Fibrous Adventitia = CT
 Parietal peritoneum on superior surface instead
Urethra
 Drains urine from bladder to outside
 Female = short tube
 Males = long tube
 Prostatic, Membranous, Spongy (penile) portions
 Also carries semen
 Internal Urethral Sphincter
 Between bladder + urethra
 Thickening of detrusor (smooth muscle)
 External Urethral Sphincter

 Within urogenital diaphragm
 Skeletal muscle = voluntary control urination
 External Urethral Orifice
 Males = end of penile urethra
 Females = anterior to vaginal opening, posterior to clitoris
Urethra: Female vs. Male
Maturation = Urination
 Emptying bladder
 Stretch receptors in bladder respond when bladder
full
 Parasympathetic signals detrusor muscle to
contract and internal urinary sphincter to open
Other brain receptors can inhibit urination by
relaxing detrusor, and keep external urinary
sphincter closed
 Voluntary contraction of abdominal wall muscles
increases abdominal pressure
 Voluntary relaxation of external urethral sphincter
Digestion System
 Alimentary Canal
 Mouth
 Pharynx
 Esophagus
 Stomach
 Small Intestine
 Large Intestine
 Accessory Organs
 Teeth, Tongue
 Salivary Glands
 Gallbladder
 Liver
 Pancreas
Food Processing Activities
 Ingestion: taking food into mouth
 Propulsion: food moves through gut
 Swallowing + Peristalsis
 Mechanical Digestion: breakdown of food

 Chewing, Churning, Segmentation
 Chemical Digestion: chemical breakdown

 Enzymes
 Absorption: Digestive end products into blood

 Defecation: Removal of waste products
Alimentary Canal Wall
 Internal = Mucosa + Submucosa
 Epithelium
 Lamina propria:
 contains MALT: mucosa-associated lymphoid tissue
 Muscularis mucosae
 Submucosa = CT w/elastic fibers, nerves, vessels
 Middle = Muscularis Externa
 Inner circular layer
 Outer longitudinal layer
 Creates sphincters
 Outer = Serosa or Adventitia
Innervation of Alimentary Canal
 2 Plexuses: Myenteric & Submucosal
 Parasympathetic, Sympathetic, Visceral Sensory
fibers
 Enteric Nervous System
 100 million neurons in walls of alimentary canal =
internal system
 Within above plexuses
 Independent reflex arcs
 Controls glandular secretion, peristalsis,
segmentation
 Autonomic Nervous System speeds up or slows
activity controlled by enteric system
 “J” shape
Stomach  Cardiac Region
 Junction esophagus
 Cardiac sphincter
(Gastroesophageal)
 Fundus (“dome”)
 Under diaphragm
 Body
 Large, middle part
 Pylorus
 Distal portion
 Pyloric sphincter
 Greater Curvature
 Lesser Curvature
Internal Anatomy of Stomach
 Mucosa
 Rugae: mucosal folds allow expansion
 Many intrinsic glands
 Goblet cells
 Gastric glands
 Typical Submucosa
 Muscularis externa
 Oblique layer
 Circular layer
 Pyloric sphincter
 Longitudinal layer
 Serosa
Function of Stomach
 Temporary storage of chyme
 Breakdown begins
 Churn, segmentation
 Pepsin
 Absorption
 H2O, electrolytes
 Alcohol, other drugs
 Stays about 4 hours

 Hold from1.5-4 liters
Small Intestine: Parts + Functions
 Parts
 Duodenum = proximal (5%)
 Jejunum = middle (~40%)
 Ileum = distal (~55%)
 Majority of enzymatic digestion
 Bile: emulsifier (gallbladder, liver)
 Enzymes (pancreas)
 Almost all nutrient absorption
 Segmentation
 Moves chyme around to increase contact with intestine walls
 Food takes about 3-6 hours to move through
 2.7- 6 meters
Small Intestine: Internal Features
 Intestinal flora: produce vitamin K
 Simple columnar epithelium w/many
modifications for absorption
 Lymph tissue in submucosa
 Muscularis externa has 2 layers
 Some parasympathetic innervation from
vagus
 Arterial supply:
 Superior mesenteric
 Rt (cranial) pancreaticoduodenal
Small Intestine: Modifications of
Epithelium for absorption
 Length
 Increase surface area
 Plicae circularis
 Transverse ridges of mucosa
 Slow movement of chyme
 Villi
 Move chyme, increase contact
 Contain lacteals: remove fat
 Microvilli:
 Modifications decrease distally
Small Intestine
 Duodenum:
 short, straight
 Mostly retroperitoneal
 Jejunum & Ileum:
 Highly coiled
 Fewer modifications
 Hang by mesentery in
peritoneal cavity
 Mesentery Arcades
 Arteries + veins
 Nerves
 Store fat
Large Intestine
 Cecum
 Vermiform appendix
 Colon
 Ascending
 Transverse
 Descending
 Sigmoid
 Rectum
 Anal Canal
Large Intestine
 Functions:
 Absorb water and electrolytes
 Form, store and expel feces from body
 Internal Features:
 Intestinal flora
 No intestinal villi or modifications for absorption
 Many goblet cells
 Simple columnar epithelium except lower half of anal canal
 Significant Lymph tissue in mucosa & submucosa
 Muscularis mucosae has 2 layers
 Some parasympathetic innervation from vagus
Colon: External Features
 Taeniae coli
 3 longitudinal strips
 thickening of
longitudinal muscle
 maintain muscle tone
 create haustra
 Haustra
 saclike divisions
 Epiploic Appendages
 fat-filled pouches
 significance unknown
Cecum + Vermiform Appendix
 Cecum
 sac-like, blind pouch
 Ileocecal valve
 raised edges of mucosa
 prevents feces going back
into ileum
 Vermiform Appendix
 same layers
 blind tube opens into
cecum
 masses of lymph tissue
 Ascending colon
Colon  Right side
 Hepatic flexure
(= right colic flexure)
 Transverse colon
 Across cavity
 Descending colon
 Left side
 Splenic flexure
(= left colic flexure )
 Sigmoid colon
 Enters pelvis
 “S” shape
Colon: Function
 Absorb H2O and electrolytes
 Some digestion by bacteria
 Mass Peristaltic Movements (2-3x day)
 Moves through in 12-24 hours
 1.5 meters
Rectum +  Rectum
 descends into pelvis
Anal Canal  no teniae coli
 longitudinal muscle layer
complete
 rectal valves
 Anal Canal
 passes through levator ani
muscle
 releases mucus to lubricate
feces
 Internal anal sphincter
 involuntary, smooth m.
 External anal sphincter
 voluntary, skeletal m.
 Stratified squamosal
epithelium at lower half
Defecation Reflex
 Stretching of rectum wall initiates reflex
 Spinal cord - parasympathetic signals sigmoid
colon + rectum to contract + anal sphincter to
relax (involuntary)
 If not ready-reflex ends- rectum relaxes
 Reflex initiated again until you go!
 Contraction of abdominal muscles, levator ani
+ diaphragm assists defecation (voluntary)
Liver pg 610
 Largest gland (3 lbs)

 Location
 Upper Right Quadrant
 Mostly under ribcage
 Highly vascular
 Some functions
 produce bile
 pick up glucose
 detoxify poison, drugs
 make blood proteins
Liver: External Features
 Diaphragmatic
surface
 Right lobe (larger)
 Left lobe
 Falciform ligament
 Fissure between
 Visceral surface
 Quadrate lobe
 Caudate lobe
 Both part of left lobe
Liver: Visceral Surface
 Hepatic Vein (into inferior
vena cava)
 Porta Hepatis
 Hepatic Artery (from
abdominal aorta )
 Hepatic Portal Vein
 Carries nutrient-rich blood from
stomach + intestines to liver
 Portal system = 2 capillary
beds!
 Hepatic Ducts (carry bile)
Gallbladder  Muscular sac
 Between right +
quadrate liver lobes
 Bile is stored +
concentrated
 Bile: breaks down fats
= emulsification
 Bile
 Produced by liver
 Stored in gallbladder
Gallbladder continued
 Mucosa & lamina
propria
 Simple columnar
epithelium
 Expandable mucosal
folds
 Smooth muscle layer
 Thick connective tissue
 Covered by serosa in
places
Bile Ducts
 Cystic duct
 carries bile from
gallbladder
 Hepatic duct
 carries bile from liver
 Common Bile duct
 joins cystic and
hepatic
 carries bile into
duodenum
Movement of Bile
 Bile secreted by liver
continuously
 Hepatopancreatic
(Vater) ampulla
 common bile + main
pancreatic duct meet
and enter duodenum
 Sphincter of Oddi
around it
 closed when bile not
needed for digestion
 Bile then backs up into
gallbladder via cystic
duct
 When needed
gallbladder contracts,
sphincters open
Pancreas  Retroperitoneal
 Gland
 Exocrine
 digestive enzymes
 Endocrine
 hormone insulin
 hormone
glucagon
 Location
 curve of
duodenum
 extends to spleen
Ducts of Pancreas
 Main Pancreatic
duct
 joins common bile
duct
 enters duodenum
 Hepatopancreatic
(Vater) ampulla
 Accessory
Pancreatic duct
 enters duodenum in
other location
Spleen
 Largest lymph organ
 Highly vascular
 Function
 remove blood-borne
antigens (immune)
 remove and destroy
old/damaged blood
cells
 stores blood platelets
 In fetus: site of
hematopoiesis
Arterial Blood Supply to
Abdominal Viscera
 All branches of Abdominal Aorta
 Anastomoses
 Left + Middle colic
 Left + Right gastric
 Left + Right gastroepiploic
 Cranial + Caudal pancreaticoduodenal
 Deep Iliac Circumflex + Adrenolumbar
 STUDY HAND OUT! MUST KNOW WHAT
SUPPLIES WHAT!!
Names give hints!
 Hepato = liver  Epiploic =
 Pancreatico = membrane-covered
pancreas  Mesenteric =
 Cystic = gallbladder mesentery
 Gastro = stomach  Duodenal =
duodenum
 Splenic = spleen
 Ileo = ileum
 Adreno = adrenal gl
 Colic = colon
 Lumbar = lumbar
 Rectal = rectum
region

Ans of Abdomen

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ORGANS OF THE

DR. ABDUL RASHAD

 External Urethral Sphincter

 Mechanical Digestion: breakdown of food

 Chemical Digestion: chemical breakdown

 Absorption: Digestive end products into blood

 Stays about 4 hours

 Largest gland (3 lbs)

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