Gross Anatomy- 3rd Shift
AY 2016-2017
ANATOMY PRACS 5:
ORAL CAVITY, ABDOMINAL WALL,
ABDOMINAL CAVITY, INGUINAL CANAL
ABDOMINAL WALL
- Skin
o Layer immediately after: Superficial
Fascia
Campers fascia- yellow, fatty
Scarpas fascia- fibrous
o Rectus sheath below superficial fascia
in the midline
Fibrous covering the rectus
abdominis muscle
Contributed by the aponeuroses of
the ff:
External Oblique
Internal Oblique
Transversus Abdominis
At the level btw. subcostal and ASIS
Anterior Rectus Sheath-
aponeurosis of EO and IO
Posterior Rectus Sheath-
aponeurosis of IO and TA
At the level below ASIS
All aponeurosis of the EO IO
and TA goes anteriorly
Posterior is deficient
Below is the fascia
transversalis (thinner
compared to posterior rectus
sheath above ASIS)
o Entrance of the inferior
epigastric artery
o Linea a5rcuata
- Muscles of the anterolateral wall (for
respiration and contraction of the abdominal
wall)
o External Oblique
O: lower ribs
I: becomes an aponeurosis before
inserting into linea alba
N: Intercostal nerves 7-12,
branches from L1(ilioinguinal and
iliohypogastric)
Orientation of muscle fibers: like
putting hands in pocket
Blood Supply:
Intercostal vessels
Lumbar vessels
Superficial arteries
o Superficial circumflex iliac
o Superficial epigastric
artery
Supply the superficial
fascia
o Internal Oblique
Fibers oriented in a fan-shape
N: Intercostal nerves 7-12,
branches from L1(ilioinguinal and
iliohypogastric)
o Transversus Abdominis
Fibers horizontally oriented
Deficient on the lower part of the
abdominal wall
N: Intercostal nerves 7-12,
branches from L1(ilioinguinal and
iliohypogastric)
o Rectus Abdominis
On the midline
One on each side of the linea alba
Covered by the rectus sheath
Has interdigitations
Blood Supply:
Epigastric arteries are right
below the rectus muscle
Superior epigastric artery
o Terminal branch of the
internal thoracic artery
Inferior epigastric artery
- Folds
o Median umbilical ligament (1)
Previously houses the urachus
Connected to the apex of the
urinary bladder
o Medial umbilical ligament (2)
Previously has the umbilical artery
o Lateral umbilical ligament (2)
Contains the inferior epigastric
vessels
INGUINAL CANAL
- Female- contains the round ligament of the
uterus
- Male- contains the spermatic cord
- Like a tunnel
- Borders
o Anterior: External Oblique aponeurosis
o Roof: Internal Oblique and Transversus
abdominis
o Posterior: Fascia Transversalis (lateral
part); fibers of the IO and TA become
the conjoined tendon (medial part)
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Gross Anatomy- 3rd Shift
AY 2016-2017
o Inferior: External Oblique rolls up to
itself, forms a thickening= inguinal
ligament
Attachments: pubic tubercle and
ASIS
- Spermatic Cord
o Enters 2 openings:
Internal Ring = Deep Inguinal
Ring
Immediately below the
arching fibers of the IO
Defect in the fascia
transversalis
External Ring
Inferior portion there is a
defect
Going to the scrotal area
o Contents:
Vas deferens
Testicular artery and vein
Lymphatics
Autonomics
Cremaster muscle
Derivative of the IO
ABDOMINAL CAVITY
- Boundaries
o Superiorly: respiratory diaphragm
o Inferiorly: pelvic diaphragm
o Posterior: lumbar, sacral, coccygeal part
of vertebra, psoas muscle, quadratus
lumborum
o Anterior and Lateral: anterolateral wall
muscles (RA, EO, IO, TA)
GASTROINTESTINAL TRACT
Esophagus
- Hollow muscular tube
- Commences at the level of CV6 in the neck
below the cricoid cartilage posterior to the
trachea and thyroid gland
- Constrictions
o 1st: Made up by the clasping fibers of the
cricopharyngeus muscle
o 2nd: Arch of the aorta and the left
bronchus
o 3rd: Made as it passes the respiratory
diaphragm at TV 10
Left and right vagus nerve
accompanies it as it enters the
diaphragm and becomes the
anterior and posterior vagal trunk
(LA-RP)
- Blood Supply
o 1st part: inferior thyroid artery
o 2nd part: branches from the thoracic
aorta
o 3rd part: branches of the left gastric
artery
- Venous Drainage
o 1st: inferior thyroid brachiocephalic
vein SVC
o 2nd: drain to hemiazygous or azygous
vein
o 3rd: drain to portal vein
- Distal esophagus/ Abdominal part of
the esophagus
o Related to the caudate lobe of the liver
o Terminates at the level of TV 11
Stomach
- Cardiac notch
- Fundus
o Segment above the horizontal line made
across the cardiac notch
- Body of the stomach
o Borders
Horizontal line from the cardiac
notch
Line from the cardiac notch to the
incisura angularis
- Pyloro-antral region
o Funnel shaped part of the stomach after
the incisura angularis
o Becomes muscular on the distal part in
the pyloric canal
Thickened due to the pyloric
sphincter
Made up of circular muscles
- Rugae- folds
- 3 layers of muscle
o Longitudinal -outer
o Circular - middle
o Oblique - innermost
- 2 curvatures:
o Greater Curvature
Greater omentum is attached to it
4 layered peritoneal fold
Connect the greater curvature
to the transverse colon
Contains the gastroepiploic
vessels
o Lesser Curvature
Attached to the inferior surface of
the liver by the lesser omentum
2 parts:
o Hepatogastric
ligament
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Gross Anatomy- 3rd Shift
AY 2016-2017

Houses the branches

of the left and right
gastric vessels to the
stomach
o Hepatoduodenal
ligament
Contains the portal
triad: common bile
duct, hepatic artery
proper, portal vein
- Other peritoneal folds
o Gastrosplenic ligament
Contains the short gastric vessels
that supply/drain the fundic part of
the stomach
- 2 openings
o Cardiac opening
From the esophagus
o Pyloric canal
Opens to the duodenum
- 2 surfaces
o Anterior
o Posterior
Found in the lesser sac (within the
folds of the greater omentum)
Lies on the stomach bed
Body and tail of the pancreas
Spleen
Left suprarenal gland
Upper part of the left kidney
Distal part of the transverse
colon
- Blood Supply of the stomach:
o Fundic Part
Short gastric arteries
o Greater Curvature- gastroepiploic
Left Gastroepiploic artery
Origin: Splenic artery
Right Gastroepiploic artery
Origin: Gastroduodenal artery
o Lesser Curvature
Left Gastric artery
Direct branch of the celiac
artery
Right Gastric artery
Branch of the hepatic artery
Duodenum
- C of the duodenum
o Encased on its concavity is the head of
the pancreas
- Pars superioris- 1st part
o 1st inch is intraperitoneal
o Covered by the hepatoduodenal
ligament
o Related to the gastroduodenal artery
posteriorly
- Pars descendens- 2nd part
o Openings of the pancreatic and common
bile duct
Ampulla of Vater opening to the
major duodenal papilla at the
posteromedial surface of the
duodenum
Minor duodenal papilla
Receives the opening of the
minor pancreatic duct
- Pars horizontalis- 3rd part
o Blood vessels crossing in front of the 3rd
part:
More to the right- Superior
Mesenteric Vein
To the left- Superior Mesenteric
Artery
- Pars ascendens- 4th part
o Marked by the duodenojejunal
flexure
o Attachment
Duodenojejunal ligament
Abmesenteric part
Start of the mesentery proper
Mesenteric part
Ligament of Treitz
Posteriorly
Attaches the flexure to the
posterior abdominal wall
- Blood Supply
o Superior pancreaticoduodenal artery
From the gastroduodenal artery
o Inferior pancreaticoduodenal artery
Lower half
Branch of the superior mesenteric
artery
Jejunum & Ileum
- Starts at the duodenojejunal flexure
- You cannot tell where the jejunum ends and
the ileum starts
o During the pracs:
Jejunum- tagged near the
duodenojejunal flexure or the upper
portion of the root of the mesentery
Ileum- tagged near the appendix,
cecum, or ileocecal junction
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Gross Anatomy- 3rd Shift
AY 2016-2017

- Jejunum Sacculations
o Thicker, darker Taenia coli
o Bigger diameter Colon
o LUQ - Ascending colon
o Fewer, longer arcades in the mesenteric o Short
fat o Retroperitoneal, no mesentery
o No Peyers patches o Right Colic Flexure/ Hepatic Flexure
o Blood supply is to the left of the Flexure btw. ascending colon and
abdominal aorta transverse colon
- Ileum o Differentiate ascending from transverse
o Thinner, lighter during the pracs: look at the greater
o Smaller diameter omentum (with- Transverse; without-
o RLQ Ascending)
o Numerous, shorter arcades in the - Transverse colon
mesenteric fat o Attachments
o With Peyers patches Greater omentum- to the stomach
o Blood supply is to the right of the Transverse mesocolon
abdominal aorta Contains the middle colic
vessels
Superior Mesenteric Artery o Has 2 blood supply
- Crosses the 3rd part of the Duodenum Middle Colic Artery- from SMA
- Branches (those to the left of the SMA SI; Left Colic Artery- from IMA
those to the right of the SMA LI) The middle and left colic artery are
o Inferior Pancreaticoduodenal artery connected with each other by the
Branch of the SMA not found in the Marginal Artery of Drummond
mesentery proper - Descending colon
o Middle colic artery o Left colic flexure
Going up to the transverse colon Higher than the RCF because it is
o Right colic artery attached to the diaphragm via the
Supply the ascending colon phrenicocolic ligament
o Ileocolic artery o Transverse: with greater omentum;
To the ileum and cecum Descending: without greater omentum
o Branches to the appendix o Terminates at the pelvic brim
Contained in the mesoappendix - Sigmoid Colon
o Commencement: pelvic brim
o Termination: SV 3

Cecum
- Located in the right iliac fossa with the
appendix
- Appendix
o Position of tip of the appendix varies (in
pelvis, retrocecal, retroileal)
o Opening to the cecum would be the
same
Posteromedial surface of the cecum
where you have the convergence of
the teniae coli
- Differences btw the SI and LI
o External Differences found in the LI and
not in the SI
Appendices epiplociae
Inferior Mesenteric artery
- Origin of all blood supply of the LEFT SIDE
OF THE COLON (distal 1/3 of the t.colon to
prox. 1/3 of the rectum)
- Branch of the Abdominal aorta
o Gives off the IMA on its medial surface
before it divides into the right and left
common iliac arteries
- Branches going up to the descending colon
and distal 1/3 of the transverse colon,
sigmoid, and proximal 1/3 of rectum
- Terminal branch: superior rectal artery

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Gross Anatomy- 3rd Shift
AY 2016-2017

o Goes to the pelvis o Common Hepatic Artery

o Supply the superior 1/3 of the rectum Branches:
Right Gastric Artery
Rectum Gastroduodenal Artery
- Differentiate from the sigmoid colon: o Related to the duodenum
sigmoid colon has teniae coli and o Supplies the pancreas and
appendices epiplociae the duodenum
- Divided into 3 parts o Branches: superior and
o Upper 1/3- anterior and lateral is inferior
covered with peritoneum pancreaticoduodenal
o Middle 1/3- only the anterior is covered artery
with peritoneum Hepatic Artery Proper
o Distal 1/3- extraperitoneal (no o Goes 90 degrees up the
peritoneal covering) hepatoduodenal ligament
- Blood Supply (5) o Anterior to the portal vein
o Upper 1/3- 1 superior rectal artery from
o Enters the porta hepatis
the IMA
and divides into the left
o Middle 1/3- 2 middle rectal arteries from
and right hepatic artery
the internal iliac artery
o Distal 1/3- 2 inferior rectal arteries from Common bile duct
the internal pudendal artery, branch of - Formed by the common hepatic duct (from
the iliac artery the liver) and the cystic duct (from the
o Communications between the portal and gallbladder)
the caval system (portocaval system) as
in the distal esophagus and umbilicus Porta hepatis
- Venous drainage - Hepatic artery proper enters
o Drain into the inferior mesenteric vein - Portal vein enters
then to the splenic vein to the portal - Hepatic duct exits
vein
Gall Bladder
Appendix - Storage and concentration of bile secreted
- Position of tip of the appendix varies (in from the kidney
pelvis, retrocecal, retroileal) - Parts:
- Opening to the cecum would be the same o Fundus
o Posteromedial surface of the cecum Related to the anterior abdominal
where you have the convergence of the wall
teniae coli Transpyloric line
o Body
Portal Vein
o Neck
- Formed by the splenic vein and the superior
Constricted portion opening into the
mesenteric vein behind the neck of the
cystic duct
pancreas
- Go to the hepatoduodenal ligament, enter
Pancreas
the porta hepatis and divides into the left
- Parenchyma is like that of the parotid and
and right branch to supply the liver
thyroid gland (lobulated)
- Anterior to the portal vein is the hepatic
- At the back is the splenic vein (darker,
artery, lateral is the common bile duct
thinner)
Celiac Trunk
- At its superoposterior part lies the splenic
- From the abdominal aorta
artery (thicker)
- Very short and branches out immediately
- Parts of the pancreas
- Branches
o Head- located at the C of the duodenum
o Left gastric artery
o Neck- part of the stomach bed
Goes up to the stomach and
o Tail- related to the spleen
o Splenic Artery
Goes to the superoposterior portion
Liver
of the pancreas
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Gross Anatomy- 3rd Shift
AY 2016-2017
- Found on the RUQ and LUQ (Right
hypochondriac, epigastric, Left
hypochondriac
- Attachments:
o Coronary ligament
Attaches the superior part of the
liver to the diaphragm
o Triangular ligaments (2)
Connects the sides of the liver to
the diaphragm
o Falciform ligament
Connects the anterior part of the
liver to the umbilicus
Contains 2 vessels:
Paraumbilical vein-
functional
Ligamentum teres hepatis-
fibrous cord; remnant of the
umbilical vein
- Bare area of the liver
o Found in the posterior surface of the
liver
o Without peritoneal covering
- Divided functionally by a line from the
gallbladder fossa to the IVC true division of
the liver
o Right and left halves following the blood
vessels and ducts
- Draw a line from the falciform ligament to
the fossa of the ligamentum venosum form
2 parallel lines
o In the middle, you can find the porta
hepatis
Forms the horizontal line of the H
o Caudate lobe- posterior to porta
hepatis (above the H)
Importance: branches from both the
left and right portal vein and
hepatic artery supplying it
o Quadrate lobe- anterior to porta
hepatis (below the H)
Follows the blood supply of the left
- Impressions will not be tagged in the pracs
- Portal triad may be tagged on the liver or on
the cadaver; know which one is the artery,
vein, or duct
SAGGITAL SECTION OF THE FACE (ORAL
CAVITY)
Vestibule
- Area between the gums, teeth/ cheeks
- Found in the vestibule
o Openings of the parotid duct (Stensens
duct)
On the mucosa of the vestibule
opposite the upper 2nd molar tooth
Lips
- Attached to the gums via the frenulum
labiorium
o One inferior and one superior
Tongue
- Frenulum lingua
o Attaches tongue to the floor of the
mouth
o At the sides of the frenulum lingua,
there are 2 openings for the
submandibular gland (Whartons duct)
- At the sides of the base of the tongue, you
have the multiple openings of the sublingual
gland (duct of Rivinus)
- Divided into 2 parts by the sulcus
terminalis (inverted V marked by the valate
papillae):
o Anterior 2/3
General sensation- Lingual nerve
(branch of the mandibular division
of trigeminal nerve)
Special taste sensation- Chorda
tympani of the 7th CN
o Posterior 2/3
General sensation and special taste
sensations is by the
glossopharyngeal nerve
Oral Cavity Proper
- Boundaries
o Superior: hard palate (horizontal plate of
the palatine bone and the palatine
process of the maxilla) and soft palate
(muscles)
o Floor: Geniohyoid (attached to the
genioid tubercle to the hyoid bone) and
Mylohyoid muscle
o Lateral: Cheeks and buccinator muscle
o Posterior: oropharyngeal isthmus
- Folds:
o Palatoglossal arch
Contains the palatoglossal muscle
In between the 2 palatoglossus is
the oropharyngeal isthmus
o Palatopharyngeal arch
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Gross Anatomy- 3rd Shift
AY 2016-2017
From pharynx to palate
- In between the 2 folds is a space that
contains the palatine tonsil
Uvula
- Protrusion of the soft palate in the midline
- Contains muscles
Muscles will not be tagged kasi too small most
likely tagged will be the big structures (soft
palate, frenulum, etc); side questions nalang
yung muscle
Pharynx
- 3 parts:
o Oropharynx- after the oropharyngeal
isthmus
Oropharyngeal isthmus to the
glottis opening
Innervation: glossopharyngeal
nerve
o Nasopharynx- above oropharynx
Communicates to the nasal cavity
via the posterior choanae
You will find an opening
Eustachian tube
(communicate with the middle
ear)
Protruberance on the
posterosuperior surface of the
Eustachian tube location of
the tubal tonsils
Inferior border of nasal cavity =
superior border of oral cavity
Innervation: maxillary nerve
o Laryngopharynx- below oropharynx
Innervation: internal laryngeal
nerve
Epiglottis
Inferiormost fiber of the muscle of
the pharynx cricopharyngeus
muscle
Ring of Waldeyer
- Lingual tonsil (1)
o Near the posterior 2/3 of the tongue
- Palatine tonsil (2)
- Tubal Tonsil (1)
- Pharyngeal Tonsil (1)
**Review nalang kung nasan sila =))