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Session 1 (90 Minutes)

Topics of the session

Chapter 1:

 The Abdominal Cavity (The Overview of the Abdominal

Cavity )
Content:
1. General description
2. Functions
3. Component parts
4. Relationship to other regions
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 គោលបំណងនៃគ ៉ោ ងសិក្សា (Session Learning Objective)

At the end of this Session, it is expected that each student

will be able to:

1) Describe the General description of the abdominal cavity.

2) Explain the function focuses on the houses and protects
major viscera ,breaching, and changes in intra-abdominal
pressure.
3) Identify the component parts and the relationship to other
regions of the abdominal cavity.

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 The General description
The abdomen is a roughly cylindrical chamber extending from the inferior
margin of the thorax to the superior margin of the pelvis and the lower
limb.
The inferior thoracic aperture forms the superior
opening to the abdomen and is closed by the
diaphragm. Inferiorly, the deep abdominal wall is
continuous with the pelvic wall at the pelvic inlet/
superior aperture of the pelvis. Superficially, the
inferior limit of the abdominal wall is the superior
margin of the lower limb.
The chamber enclosed by the abdominal wall
contains a single large peritoneal cavity, which
freely communicates with the pelvic cavity.

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 Diaphragm
Inferior thoracic aperture

Abdominal Wall
Iliac crest Inguinal ligament

Inguinal ligament Lower limb

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 Gastrointestinal tract
Costal margin

Peritoneal cavity

Left kidney
Mesentery

Right kidney

Inferior vena cava Aorta Muscles

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 Boundaries of the inferior thoracic aperture
▪ Posteriorly: 12th thoracic vertebral body and transverse
processes
▪ Posterolaterally: 11th and 12th ribs
▪ Anterolaterally: the costal margins formed by the
conjoint costal cartilages of 7th to 10th ribs
▪ Anteriorly: xiphisternal joint

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 Abdominal viscera
Abdominal viscera are either suspended in the peritoneal cavity by
mesenteries or positioned between the cavity and the musculoskeletal wall.
Abdominal viscera include:
▪ Major elements of the gastrointestinal system—the caudal end of
the esophagus, stomach, small and large intestines, liver, pancreas,
and gallbladder;
▪ The spleen;
▪ Components of the urinary system—kidneys and ureters;
▪ The suprarenal glands; and
▪ Major neurovascular structures.

https://www.kenhub.com/en/library/anatomy/the-peritoneum
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 The Functions
2.1 Houses and protects major viscera
2.2 Breathing
2.3 Changes in intraabdominal pressure

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2.1 Houses and protects major viscera
The abdomen houses major elements of the gastrointestinal system, the
spleen, and parts of the urinary system.
Much of the liver, gallbladder, stomach, and spleen and parts
of the colon are under the domes of the diaphragm, which
project superiorly above the costal margin of the thoracic wall,
and as a result these abdominal viscera are protected by the
thoracic wall. The superior poles of the kidneys are deep to
the lower ribs.
Viscera not under the domes of the diaphragm
are supported and protected predominantly by
the muscular walls of the abdomen.

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 2.2 Breathing
One of the most important roles of the abdominal wall is to assist in breathing:
▪ It relaxes during inspiration to accommodate expansion of the thoracic cavity and the inferior displacement
of abdominal viscera during contraction of the diaphragm.
▪ During expiration, it contracts to assist in elevating the domes of the diaphragm, thus reducing thoracic
volume.
Material can be expelled from the airway by forced expiration using the abdominal muscles, as in coughing or
sneezing.

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 2.3 Changes in intraabdominal pressure

Contraction of abdominal wall muscles can

dramatically increase intraabdominal pressure
when the diaphragm is in a fixed position. Air is
retained in the lungs by closing valves in the larynx
in the neck. Increased intra-abdominal pressure
assists in voiding the contents of the bladder and
rectum and in giving birth.

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 The Component parts
3.1 Wall
The abdominal wall consists partly
of bone but mainly of muscle.
 Bone of the abdominal Wall
The skeletal elements of the wall
are:
▪ the five lumbar vertebrae and
their intervening intervertebral
discs,
▪ the superior expanded parts of
the pelvic bones, and
▪ bony components of the
inferior thoracic wall, including
the costal margin, rib XII, the
end of rib XI, and the xiphoid
process.
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  Muscle of abdominal Wall
Muscles make up the rest of the abdominal wall:
▪ Lateral to the vertebral column, the quadratus lumborum, psoas
major, and iliacus muscles reinforce the posterior aspect of the wall.
The distal ends of the psoas major and iliacus muscles pass into the
thigh and are major flexors of the hip joint.
▪ Lateral parts of the abdominal wall are predominantly formed by
three layers of muscles, which are similar in orientation to the
intercostal muscles of the thorax— transversus abdominis, internal
oblique, and external oblique.
▪ Anteriorly, a segmented muscle (the rectus abdominis) on each side
spans the distance between the inferior thoracic wall and the pelvis.

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 Quadratus
External lumborum
oblique
Rib XII
Coastal margin Rectus
Iliolumbar Internal abdominis
ligament oblique
Transversus
abdominis

Pelvic inlet

Inguinal ligament Gap between Iliacus muscle

inguinal ligament Psoas major
and pelvic bone

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 3.2 Abdominal cavity
The general organization of the abdominal cavity is one in which a central
gut tube (gastrointestinal system) is suspended from the posterior
abdominal wall and partly from the anterior abdominal wall by thin sheets
of tissue (mesenteries):
▪ a ventral (anterior) mesentery for proximal regions of the gut tube;
▪ a dorsal (posterior) mesentery along the entire length of the system.
Different parts of these two mesenteries are named according to the organs
they suspend or with which they are associated.

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  Abdominal cavity (Con’t)
Different parts of these two mesenteries are named according to the organs they
suspend or with which they are associated.
Major viscera, such as the kidneys, that are not suspended in the abdominal cavity by
mesenteries are associated with the abdominal wall.
The abdominal cavity is lined by peritoneum, which consists of an epithelial-like
single layer of cells (the mesothelium) together with a supportive layer of connective
tissue. Peritoneum is similar to the pleura and serous pericardium in the thorax.
The peritoneum reflects off the abdominal wall to become a component of the
mesenteries that suspend the viscera.
▪ Parietal peritoneum lines the abdominal wall.
▪ Visceral peritoneum covers suspended organs.

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  Abdominal cavity (Con’t)
Normally, elements of the gastrointestinal tract and its derivatives
completely fill the abdominal cavity, making the peritoneal cavity a
potential space, and visceral peritoneum on organs and parietal
peritoneum on the adjacent abdominal wall slide freely against one
another. Abdominal viscera are either intraperitoneal or
retroperitoneal:
▪ Intraperitoneal structures, such as elements of the gastrointestinal
system, are suspended from the abdominal wall by mesenteries;
▪ Structures that are not suspended in the abdominal cavity by a
mesentery and that lie between the parietal peritoneum and
abdominal wall are retroperitoneal in position.

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  Abdominal cavity (Con’t)
Large vessels, nerves, and lymphatics are
associated with the posterior abdominal wall along
the median axis of the body in the region where,
during development, the peritoneum reflects off
the wall as the dorsal mesentery, which supports
the developing gut tube.
As a consequence, branches of the neurovascular
structures that pass to parts of the gastrointestinal
system are unpaired, originate from the anterior
aspects of their parent structures, and travel in
mesenteries or pass retroperitoneally in areas
where the mesenteries secondarily fuse to the
wall.
Generally, vessels, nerves, and lymphatics to the
abdominal wall and to organs that originate as
retroperitoneal structures branch laterally from the
central neurovascular structures and are usually
paired, one on each side.

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 3.3 Inferior thoracic aperture
The superior aperture of the abdomen is the inferior thoracic
aperture, which is closed by the diaphragm (see pp. 126-127).
The margin of the inferior thoracic aperture consists of
vertebra TXII, rib XII, the distal end of rib XI, the costal margin,
and the xiphoid process of the sternum.

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 3.4 Diaphragm
The musculotendinous diaphragm separates the abdomen
from the thorax.
The diaphragm attaches to the margin of the inferior thoracic
aperture, but the attachment is complex posteriorly and
extends into the lumbar area of the vertebral column .

On each side, a muscular extension (crus) firmly anchors the

diaphragm to the anterolateral surface of the vertebral column
as far down as vertebra LIII on the right and vertebra LII on the
left.

Because the costal margin is not complete posteriorly, the

diaphragm is anchored to arch-shaped (arcuate) ligaments,
which span the distance between available bony points and the
intervening soft tissues:

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  Diaphragm (Con’t)
▪ Medial and lateral arcuate ligaments cross
muscles of the posterior abdominal wall and
attach to vertebrae, the transverse processes of
vertebra LI and rib XII, respectively.
▪ A median arcuate ligament crosses the aorta and
is continuous with the crus on each side.

The posterior attachment of the diaphragm extends

much farther inferiorly than the anterior
attachment. Consequently, the diaphragm is an
important component of the posterior abdominal
wall, to which a number of viscera are related.

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  Pelvic Inlet
The abdominal wall is continuous with the
pelvic wall at the pelvic inlet, and the
abdominal cavity is continuous with the
pelvic cavity.
The circular margin of the pelvic inlet is
formed entirely by bone:

▪ posteriorly by the sacrum,

▪ anteriorly by the pubic symphysis, and
▪ laterally, on each side, by a distinct
bony rim on the pelvic bone.

Because of the way in which the sacrum and

attached pelvic bones are angled posteriorly
on the vertebral column, the pelvic cavity is
not oriented in the same vertical plane as
the abdominal cavity. Instead, the pelvic
cavity projects posteriorly, and the inlet
opens anteriorly and somewhat superiorly.

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 The Relationship to other regions

 Thorax
The abdomen is separated from the thorax by the diaphragm.
Structures pass between the two regions through or posterior
to the diaphragm.

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  Pelvis
The pelvic inlet opens directly into the abdomen and structures
pass between the abdomen and pelvis through it.
The peritoneum lining the abdominal cavity is continuous with
the peritoneum in the pelvis.
Consequently, the abdominal cavity is entirely continuous with
the pelvic cavity .
Infections in one region can therefore freely spread into the
other.
The bladder expands superiorly from the pelvic cavity into the
abdominal cavity and, during pregnancy, the uterus expands
freely superiorly out of the pelvic cavity into the abdominal
cavity.

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  Lower limb
The abdomen communicates directly with the thigh through an
aperture formed anteriorly between the inferior margin of the
abdominal wall (marked by the inguinal ligament) and the
pelvic bone (Fig. 4.12). Structures that pass through this
aperture are:
▪ the major artery and vein of the lower limb;
▪ the femoral nerve, which innervates the quadriceps femoris
muscle, which extends the knee;
▪ lymphatics; and
▪ the distal ends of psoas major and iliacus muscles, which
flex the thigh at the hip joint.
As vessels pass inferior to the inguinal ligament, their names
change—the external iliac artery and vein of the abdomen
become the femoral artery and vein of the thigh.

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 The Muscle of abdominal Wall

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 (S.1) Summary
▪ Abdominal chamber/cavity boundary
(Superior, and Inferior margin).
▪ Boundaries of the inferior thoracic aperture.
▪ Abdominal viscera.
▪ Functions of Abdominal cavity.
▪ Component parts of the abdomen.
▪ Relationship to other regions

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