CLINICAL ANATOMY is the Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. Download Citation on ResearchGate | On Sep 1, , Jennifer K. Brueckner and others published Grant’s Dissector, 13th Edition by Patrick W. Tank }. PDF | On Jan 1, , G H Sperber and others published Grant’s Dissector. ), the publication of the 13th edition of this classic. ‘cook book’ of human.
|Published (Last):||28 June 2013|
|PDF File Size:||1.67 Mb|
|ePub File Size:||3.71 Mb|
|Price:||Free* [*Free Regsitration Required]|
Enviado por Andrade flag Denunciar. The left gastric artery forms an anastomosis with the right gastric artery along the lesser curvature of the stom- ach. Branches of the gastric arteries distribute to the anterior and posterior surfaces of the stomach.
Follow the splenic artery to the left for approxi- mately 5 cm and verify that it lies against the posterior abdominal wall. The splenic artery courses along the superior border of the pancreas and may be partially imbedded in it.
Do not dissect the splenic artery from the pancreas at this time. Note that short gastric ar- teries arise from the splenic artery to supply the fun- dus of the stomach Fig. Find the left gastro-omental gastroepiploic ar- tery in the greater omentum approximately 2 cm from the greater curvature of the stomach Fig.
The left gastro-omental artery is a branch of the splenic ar- tery. Find the right gastro-omental artery in the greater omentum near the right end of the greater curvature of the stomach.
The right gastro-omental artery anas- tomoses with the left gastro-omental artery. Follow the right gastro-omental artery to the right to find its origin 13fh the gastroduodenal branch of the com- mon hepatic artery.
Return to the hepatoduodenal ligament and identify the hepatic portal vein. The hepatic portal vein lies posterior to both the hepatic artery proper and the bile duct Fig. Follow the hepatic portal vein su- periorly and observe that it passes into the porta he- patis where it divides into right and left portal veins. The hepatic portal vein usually receives the left and right gastric veins as tributaries. Inferiorly, the he- patic portal vein passes posterior to the first part of the duodenum.
Its size and weight may vary considerably depending upon the blood volume that it contains. The spleen is covered by visceral peritoneum except at the hilum where the splenic vessels enter and leave.
Use your left hand to pull the fundus of the stomach to the right. Use your right hand to gently pull the spleen anteriorly. Observe that the spleen has a smooth diaphragmatic surface. The spleen has sharp anterior, inferior, and superior borders.
The superior border of the spleen is often notched. The visceral surface of the spleen is related to four organs: The diaphragmatic surface of the spleen is related through the diaphragm to ribs 9, 10, and 11 Fig.
Spleen The relationship of the spleen to ribs 9, 10, and 11 is of clinical importance in evaluating rib fractures and penetrating wounds. A lacerated spleen bleeds profusely into the abdominal cavity and may have to be removed surgically splenectomy. It must be emphasized that there is a risk of puncturing the spleen during thoracocentesis pleural tap.
Grant’s Dissector 13th Ed
An enlarged spleen splenomegaly may be encountered during physical examination. The spleen is considered enlarged when it can be palpated inferior to the costal margin. Relationships of the spleen to the thoracic wall. A penetrating wound through the ninth intercostal space, just posterior to the midaxillary line, will penetrate the pleural cavity, diaphragm, peritoneal cavity, and spleen. To study the surface features of the liver, it must be detached from the diaphragm. Review the falciform ligament and the coronary liga- ment of the liver.
Use scissors to cut the falciform ligament along its at- tachment to the anterior abdominal wall. Extend the cut superiorly and cut the right and left triangular lig- aments along the inferior surface of the diaphragm. Insert your fingers between the liver and the di- aphragm and free the connective tissue attachment of the liver to the diaphragm.
Cut the posterior layer of the coronary ligament. Use editiion to cut the inferior vena cava between the liver and the diaphragm. Elevate the inferior border of the liver and cut the inferior vena cava again, as close to rgant inferior surface of the liver as possible. These two cuts will leave a short segment of the inferior vena cava within the liver Fig. The liver should now be freely mobile but attached to the other abdominal viscera by the bile duct, hepatic artery proper, and hepatic portal vein.
Move the liver carefully to avoid tearing these structures.
GRANT’S DISSECTOR 13TH EDITION [AN] – $ : Skeletons And More!
Posterior views of the liver. Fissures and sulci define the four lobes of the liver right, left, quadrate, and caudate. Structures located in the H-shaped fissures. Examine the liver and note that the right lobe is six times larger than the left lobe.
The sharp inferior border of the rdition separates the visceral surface from the diaphragmatic surface. Identify the bare area on the posterior aspect of the diaphragmatic surface.
Here, the liver was adjacent to the diaphragm and not covered by peritoneum.
Around the bare area, note the cut edges of the coro- nary ligament. Examine the visceral surface of the liver Fig. An H-shaped set of fissures and fossae defines four lobes. Identify the right lobe, left lobe, caudate lobe, and quadrate lobe. Identify the porta hepatis. Examine the small segment of the inferior vena cava that is attached to the liver.
Note that several hepatic veins drain directly into the inferior vena cava Fig. Use a textbook to study the two conventions by which the liver may be divided into lobes. The falciform lig- ament divides the liver into right and left anatomical lobes.
The pattern of its bile drainage and vascular supply are used to divide the liver into right and left functional lobes. The liver has a substantial lymphatic drainage. At the porta hepatis, small lymph vessels drain into hepatic lymph nodes. From the hepatic lymph nodes, lym- phatic vessels follow the hepatic arteries to celiac lymph nodes located around the celiac trunk.
Liver The liver may undergo pathologic changes that could be en- countered during dissection. The liver may be enlarged. This happens in liver congestion because of cardiac insufficiency cardiac liver. In contrast, the liver may be small and have fi- brous nodules. Such a finding may indicate cirrhosis of the liver. Because the liver is essentially a capillary bed.