Viscera of the GI system and Abdomen

SpleenSpleen is an ovoid, purplish, delicate, vascular

mass about the size and shape of one’s fist. It is covered with fibroelastic capsule on which it

is entirely sorrounded by peritonium except at the hilum

Located at the left upper quadrant or L. hypochondrium.

Most delicate organ and vulnerable organ,even though it is protected by the lower thoracic ribs.

Although it is a mobile organ, it does not descend below the costal region

It rests on the left colic fexure

Functions of spleenPrenatally it was a hematopoitic organ,In adults it functions as a site ofLymphocyte proliferation,Removing/destroying expended RBCs and

plateletsRecycling ironBlood Resorvoir storing RBCs and platelets

It is sorrounded anteriorly by stomach Posteriorly, left part of

diaphragm,ribs 9-11 Inferiorly, left colic flexure Medially, left kidney connected to the posterior wall of greater

curvature of stomach by gastrospleenic ligament

Left kidney by splenorenal ligament

Spleenic artery, the largest branch of celiac trunk which inturn divides into 5 branches to supply the spleen.

Severe blows on the left side,Fracturing the ribs,Blunt trauma to the abdomen

causing an increase in intra-abdominal pressure

May cause the rupture of thin capsule and peritonium disrupting its soft parenchyma.

Spleenomegaly may result because of spleenic disease or hypertension.

Repair of a ruptured spleen is difficult. So sub-total or total splenectomy is performed to prevent profuse bleeding and in cases of severe untreatable spleenomegaly

In adults, spleen is not a vital organ

liverLargest glandAfter skin, largest

single organ. It occupies the R.

hypochondrium and it extends into epigastric region and also the L. hypochondrium.

Functions of liverIn the late fetus, it serves as a

hematopoietic organ.In adults,Production and secretion of bileFiltration of blood removing bacteria,

metabolizing various foreign substances and detoxifying

Stores glycogen

The liver L. & R. lobes by falciform ligament

R.lobe quadrate lobe and a caudate lobe by the presence of gallbladder,fissure of ligamentum teres and inferior vena cava in the groove.

These are functional lobes which have separate R. & L. branches of hepatic artery, portal vein and the hepaic ducts

Porta hepatis, hilum of liver opens on the posteroinferior surface and lies between the caudate and quadrae lobes

Liver has dual blood supply.The hepatic artery brings oxygenated

blood to the liver and the portal vein brings venous blood rich in

products of digestion.

The liver is made up of liver lobules.

The central vein of each lobule is a tributary of the sinusoids.

In spaces between lobules are portal canals, which contains the brances of hepatic artery, portal vein and a tributary of bile duct.

The hepatic artery and portal venal blood passes thru sinusoids, which are ultimately drained into central vein.

Interlobar tributaries of the bile ducts, situated in the portal canals receive bile from canaliculi

R.hepaic duct drains from R.lobe and L.hepatic duct from L., caudate and quadrate lobes

R. and L. ducts emerge thru the porta hepatis and join into common hepatic duct which joins with the cystic duct from the gall bladder to form the bile duct

The bile duct enters into the descending duodenum thru the hepatopancreatic ampulla (ampulla of vater) which is guarded by sphinchter of oddi.

Gall BladderGall bladder is a

pear-shaped sac lying on the undersurface of liver.

Gall bladder stores and concenterates bile

When digestion does not happen, the sphincter of oddi remains closed and the bile accumulates in the gall bladder.

The fatty foods entry into duodenum stimulates the contraction of the gall bladder and relaxation of sphincter of oddi which causes the emptying of bile.

Cystic artery, a branch of R. hepatic artery supplies the gall bladder

PancreasPancreas is an elongated gland that lies in

the epigastrium and the left upper quadrant.

Pancreas is both an exocrine and endocrine glandular function

Exocrine gland secretes pepsin and other enzymes which hydrolyzes proteins

Endocrine gland secretes insulin and glucagon which plays a key role in carbohydrate metabolism.

The hepatic duct joins with the bile duct and opens into the ampulla of vater.

The splenic and the superior and inferior pancreaticoduodenal arteries supply the pancreas.