1. In the name of Allah

2. Pancreas Grayish – pink 12-15 cm Situation - - Epigastric - - Lt hypochondriac - - Umbilical

3. Pancreas Consists: - - Head, Uncinate process - - Neck, Constricted part - - Body & Triangular - - Tail In the splenorenal

4. Pancreas Relations: Anterior; - - Duodenum, - - Sup. Mesentric VV., - - Sup. & inf. Pancreaticoduodenal AA - - Transeverse colon, - - Transeverse mesocolon - - Jejunum - - Stomach - - Lt. colic flexure …………….. - - Celiac trunk - - Splenic art. - -

5. Pancreas Relations: Posterior; - - Bile duct, - - Prtal vein - - Splenic vein - - IVC, - - Aorta, - - Sup. Mesentric VV., - - Left suprarenal gland - - Left kidney - - Renal vein,

6. Pancreas Tail - - In (splenorenal) lienorenal lig. Main pancreatic duct Accessory duct ascending in front of main

8. Liver (hepar) Occupying: Occupying: - Rt. Hypochodrium - Epigastrium - Lt. Hypochodrium weigh: weigh: - 1.4- 1.8 kg ♂ - 1.2- 1.4 kg ♀ - Average 1- 2.5kg - ?% of body weight

9. Liver Reddish brown Reddish brown Easily lacerated Easily lacerated Its position maintained by intra-abdominal pressure, ligaments and vessels Its position maintained by intra-abdominal pressure, ligaments and vessels Liver is attached to the: Liver is attached to the: - ant. Abdominal wall - Diaphragm - Stomach & 1 st part of duodenum

10. Liver Peritoneal connection Peritoneal connection - Is almost completely covered by peritonium and has: - falciform lig. - Coronary lig - Triangular ligs. - Lesser omentum

11. Liver Surface Surface Diaphragmatic Diaphragmatic - Anterior - Superior - Right - Posterior Visceral (Inferior ) Visceral (Inferior )

12. Liver Anterior surface Anterior surface - Triangular - Relations: - Diaphragm - Ant abdominal wall wall - Xiphoid

13. Liver ant. surface Lines LinesSuperior - Rt. 4 th intercostal space - Xiphisternal joint - Lt. 5 th intercostal space -

14. Liver ant. surface Lines LinesInferior - Rt. 10 th costal cartilage - Lt. 8 th costal cartilage - Crossing midline at transepyloric plane - Gallbladder notch (4-5cm right to midline) - Ligamentum teres Notch Right - Rt. 4 th intercostal space - Rt. 10 th rib

15. کلاس جبرانی فردا 93/7/16 ساعت 10-8 طبق برنامه تنظیمی در همین مکان برگزار می گردد

17. Liver superior surface Cardiac impression Cardiac impression - Relations: Rt. Pleura, lung Rt. Pleura, lung

18. Liver posterior surface - Bare area - Groove for vertebral column - Caval groove - Caudate lob, - Fissure for lig. Venosum - Oesophageal impression

19. Liver right surface 1/3 upper: diaphragm, pleura, lung 1/3 upper: diaphragm, pleura, lung - 1/3 middle: diaphragm, pleura - 1/3 inferior: diaphragm

21. Liver visceral surface - Fissure for lig teres - Lig. Venosum - Fossa for gallbladder - Gastric impression - Duodenum - Colic impression - Renal impression - caudate process - Porta hepatis -

22. Liver Lobation Lobation Anatomically Anatomically - Right - Left Functionally Functionally - Right - Left - Quadrate - Caudate

23. Liver Segmentation Left Left - Medial superior - Medial inferior - Lateral superior - Lateral inferior Right Right - Superior anterior - Superior posterior - Inferior anterior - Inferior posterior

24. Waterfall of Margoon (winter)

25. Biliary system Intrahepatic Extrahepatic - - Rt. & Lt. hepatic ducts - - Common hepatic duct - - Gallbladder - - Cystic duct - - Bile duct

26. Biliary system Common hepatic duct: - Rt. hepatic duct - Lt. hepatic duct - 3 cm

27. Biliary system Gallbladder Gallbladder - Flask-shaped sac - Sunk in fossa - Extend to the inf. border of liver

28. Biliary system Gallbladder Gallbladder - Occasionally has mesentery - 7-10cm, - 30-50ml

29. Biliary system Gallbladder Gallbladder - Has: - Fundus - Body - Neck

30. Biliary system Related to the: transverse colon Duodenumliver

31. Biliary system - neck Up forward, back, downward

32. Biliary system Gallbladder fundus Surface marking: - - Opposite of the tip of ninth right costal cartilage - - Where the lateral border of rectus abdominis crosses ninth rib. - - Where the transpyloric plane crosses right midclavicular plane -

33. Biliary system Cystic duct - 3-4cm long - Back, down, left - Has spiral mucosal folds

34. Biliary system Common bile duct Common bile duct - Cystic + common hepatic ducts - 6-8 cm - Diameter 6 mm

35. Biliary system Common bile duct Common bile duct - Behind first part of duodenum & head of pancreas - Ant. to the IVC - Forms hepatopancreatic (Vater) ampulla with main pancreatic duct

37. spleen Situation Situation - Between gastric fundus and diaphragm - Upper left posterior quadrant - Long axis follows 10 th rib - Posterior extremity 4cm from mid-dorsal line at the level of T10 - Ant. Extremity midaxillary line

38. Spleen Size 12* 7* 3.5 cm Size 12* 7* 3.5 cm Wt. 150, 80-300 g. Wt. 150, 80-300 g. Has; Has; - Upper & lower pole - Anterior and posterior border - Diaphragmatic and visceral surfaces - Hilum

39. Spleen Related to the; Related to the; - 9 th – 11 th ribs - Lt. pleura, lung - Lt. kidney - Stomach - Lt. colic flexure - Pancreas - Phrenicocolic lig.

40. Spleen - Covered by peritoneum - Ligs. Gastrosplenic Splenorenal (Lienorenal )