HA

• Intraperitoneal Organ - organs covered with peritoneum and held in place by mesentery
• Retroperitoneal Organs - organs situated behind the peritoneum and  without mesenteric attachment
• Intraperitoneal Organs


  Organs covered with peritoneum and held in place by mesentery
• Intraperitoneal Organs


  • spleen
  • bile duct
  • gallbladder
  • small intestine
  • stomach
  • large intestine
  • liver
• Retroperitoneal Organs


  Organs situated behind the peritoneum and without mesenteric attachment
• Retroperitoneal Organs


  • Pancreas
  • ureters
  • kidneys
  • bladder
• Methods of dividing the abdominal cavity

  1. By quadrants

  2. By regions
• Quadrants


  A vertical line from the xiphoid process to the pubic symphysis and a horizontal line across the umbilicus
• Regions


  The vertical lines that extend superiorly from the midpoints of the inguinal ligaments, 2 horizontal lines, one at the level of the edge of the lower ribs and the other at the level of the iliac crest
• Stomach


  1. shaped pouch like organ in the left upper quadrant of the abdomen beneath the diaphragm, lies to the right of the spleen and is partially covered by the liver
• Stomach


  • Functions as a reservoir where the complex mechanical and chemical processes of digestion occurs
  • Breakdown food particles into the molecular form of digestion
• Small Intestine


  Tubular-shaped organ extending from the pyloric sphincter to the ileocecal valve at the opening of the large intestine, can measure from 10 feet to 30 feet
• Segments of Small Intestine


  • duodenum
  • jejunum
  • ileum
• Duodenum


  1st and shortest section, significant role in digestion
• Jejunum


  Composed of circular mucosal folds that provide surface area for nutrient absorption
• Ileum


  Absorbs bile salts, Vitamin B12
• Large Intestine


  Tubular shaped organ extending from the ileocecal valve to the anus, greater diameter than the small intestine
• Segments of Large Intestine


  • ascending
  • transverse
  • descending
• Sigmoid Colon


  Functions to form stool from cellulose, indigestible fibers, fat, bacteria, cellular debris and inorganic materials, carry these intestinal contents to the end of the GIT, absorption of water and electrolytes
• Liver


  Largest solid organ in the body, lies directly below the diaphragm, located in the right upper quadrant but extends across the midline into the left upper quadrant
• Functions of the Liver


  • Storage of carbohydrates, amino acids, blood, vitamins and minerals
  • Detoxification and filtration of drugs, hormones and bacteria
  • Metabolism of carbohydrates, proteins, fats, ammonia to urea
  • Synthesis and secretion of bile production, formation of lymph, bile salts, plasma proteins, fibrinogen, blood-clotting substances and antibodies
• Gallbladder


  Pear-shaped sac located in the right upper quadrant of the abdomen, stores and concentrates bile produced by the liver, contributes to fat digestion and absorption, stores approximately 30 to 50 ml of bile
• Pancreas


  Elongated accessory organ of digestion lies in a transverse position along the posterior abdominal wall
• Functions of the Pancreas

  • Exocrine - secretes bicarbonate and pancreatic enzymes which aid in digestion
  • Endocrine - secretes the hormone insulin, glucagon and gastrin
• Spleen


  Largest lymph of the body oval in shape found at the upper left quadrant of the abdomen, serves as filter and reservoir for red blood cell mass
• Vermiform appendix


  Finger-like shape that extends off the lower cecum in the right lower quadrant
• Kidneys


  Bean-shaped organs that lie tucked against the posterior abdominal wall, get rid of the body waste products, maintain acid base balance, fluid and electrolyte balance, arterial blood pressure
• Ureters


  The passageway of urine from the kidneys
• Bladder


  Stores urine can hold 200 to 400 ml of urine
• Order of Assessment for the Abdomen

  1. Inspection

  2. Auscultation
• Normal Abdominal Contour


  • Flat - the abdominal contour is straight horizontal line from costal margin to symphysis pubis
  • Rounded - convexity of the abdomen from costal margin to symphysis pubis, abdomen should be evenly rounded
• Deviations from Normal Abdominal Contour


  • Generalized protuberant or distended abdomen may be due to obesity, air or fluid accumulation
  • Distended below umbilicus may be due to a full bladder, uterine enlargement, or an ovarian tumor or cyst
  • Distended upper abdomen may be due to masses of pancreas or gastric dilation
• Normal Abdominal Symmetry


  Abdomen should be symmetrical bilaterally
• Deviations from Normal Abdominal Symmetry


  Asymmetry may be seen with organ enlargement, large masses, hernia, diastasis recti, or bowel obstruction
• Normal Abdominal Pigmentation and Color


  Abdominal skin may be paler than the general skin tone because it is seldom exposed to the natural elements
• Deviations from Normal Abdominal Pigmentation and Color


  • Purple discoloration at the flanks (Grey-Turner sign) indicates bleeding within the abdominal wall, possibly from trauma of abdominal organs (pancreas, kidneys, intestines, or from pancreatitis
  • Bruises or areas of discoloration
  • Redness may indicate inflammation
  • Pale, taut skin may be seen with ascites
• Normal Abdominal Scars


  Pale, smooth, minimally raised old scars may be seen
• Deviations from Normal Abdominal Scars

  • Nonhealing wounds, redness, inflammation
  • Deep irregular scars may result from burns
• Normal Abdominal Pulsation


  Ripples of peristalsis may be observed in thin patients, Peristalsis movement slowly traverses the abdomen in a slanting downward direction
• Striae (Stretch Marks)


  Due to past stretching of the reticular skin layers due to fast or prolonged stretching, Pink, bluish in color if new striae, Silvery, white, linear if old striae, Uneven stretch marks from past pregnancies or weight gain