12.05.2019 1 Imaging techniques Preparation for the dissection II Description of the X-ray picture Oesophagography Gastrography 1 2 3 4 5 6 12.05.2019 2 Cholecystography ERCP (endoskopic retrograde cholangiopancreaticography) Irigography intravenous urography Retrograde pyelography Hysterosalpingography 7 8 9 10 11 12 12.05.2019 3 Coronarography a. coronaria cordis sin. Coronarography a. coronaria cordis dx. A. carotis interna - angiogram a. carotis int. a. vertebralis flebography 13 14 15 16 17 18 12.05.2019 4 A. hepatica comm. Truncus coeliacus A. renalis https://is.muni.cz/auth/do/med/el/anatomie_samo studium/pages/18-RTG.html Regional anatomy of the head 19 20 21 22 23 24 12.05.2019 5 Regio parotideomasseterica • Tragus, zygomatic arch,angulus mandibulae, masseter • Nervus auriculotemporalis • Parotid gland • A. et v. temporalis supf. • Nervus facialis !!! Fossa infratemporalis • Ramus mandibulae, tuber maxillae, styloid septum, pharynx • N. mandibularis • A. et v. maxillaris Regiones faciei 25 26 27 28 29 30 12.05.2019 6 Fossa cranii interna REGIONAL ANATOMY OF THE NECK 31 32 33 34 35 36 12.05.2019 7 37 38 39 40 41 42 12.05.2019 8 Trigonum scalenovertebrale REGIONAL ANATOMY OF THE CHEST 43 44 45 46 47 48 12.05.2019 9 Mediastinum and its division Superior mediastinum Superior mediastinum Superior mediastinum Anterior Mediastinum Middle Mediastinum 49 50 51 52 53 54 12.05.2019 10 Posterior mediastinum - I Posterior mediastinum - II Posterior mediastinum III Right lateral view Left lateral view REGIONAL ANATOMY OF THE ABDOMEN 55 56 57 58 59 60 12.05.2019 11 BOARDERS OF THE ABDOMEN SKIN CAMPER SCARPA ABDOMINAL WALL Above the linea semilunaris (upper 2/3) Under the linea semilunaris (lower 1/3) Morphology of the abdominal wall VV. SUBCUTANEAE ABD. V. THORACOEPIGASTRICA V. EPIGASTRICA SPF. V. CIRCUMFLEXA ILIUM SPF. VV. PARAUMBILICALES A. EPIGASTRICA SPF. A. CIRCUMFLEXA ILIUM SPF. AA. INTERCOSTALES A. SUBCOSTALIS AA. LUMBALES 61 62 63 64 65 66 12.05.2019 12 A. EPIGASTRICA SUP. A. EPIGASTRICA INF. A. CIRCUMFLEXA ILIUM PROF. AA. INTERCOSTALES A. SUBCOSTALIS AA. LUMBALES NN. INTERCOSTALES N. SUBCOSTALIS N. ILIOHYPOGASTRICUS N. ILIOINGUINALIS NODI LYMPHATICI AXILLARES NODI LYMPHATICI INGUINALES SPF. Canalis inguinalis Anterior wall: aponeurosis of the m. obliquusexternus Superior wall: margine of the musculus obliquus int. abdominisand m. transversus abdominis Inferior wall: lig. inguinale CANALIS INGUINALIS Posterior wall: Fascia transversalis: Anulus inguinalis prof. Lig. interfoveolare Trigonum inguinale (Hesselbachi) Falx inguinalis (conjoint tendon) Tractus iliopubicus Anulus femoralis CANALIS INGUINALIS 67 68 69 70 71 72 12.05.2019 13 Plica umbilicalis mediana - lig. umbilicale medianum (chorda urachi) Fossa supravesicalis Plica umbilicalis medialis - lig. umbilicale mediale (laterale) (pars occlusa a. umbilicalis s. chorda umbilicalis) Fossa inguinalis medialis - direct inguinal hernia Plica umbilicalis lateralis - vasa epigastrica inf. Fossa inguinalis lateralis - indirect inguinal hernia Projection of the organs 1 medioclavicular line 2 Right umbilikoaxillary line 3 Liver 4 Triangle of Labeé 5 Transpyloric line 6 Murphy´s point 7 Désjardins pancreatic point 8 Umbilicus 9 Monroe´s line 10 MacBurney´s point 11 Lanz point 13 Bispinal line ascites CAVITAS ABDOMINALIS P – cavitas peritonealis A – spatium preperitoneale R – spatium retroperitoneale S – spatium subperitoneale (infraperitoneale) S Intraperitoneal organs: Abdominal part of the oesophagus, stomach, superior part of the duodenum, jejunum, ileum, appendix vermiformis, colon transversum, colon sigmoideum, liver, spleen Secondarily retroperitoneal organs: Most of duodenum, pancreas, caecum, colon ascendens, colon descendens Primarily retroperitoneal organs: Kidneys, suprarenal glands, aorta, vena cava inf. Cavitas peritonealis - pars supramesocolica, inframesocolica Pars supramesocolica Truncus coeliacus 73 74 75 76 77 78 12.05.2019 14 Right infra(meso)colic compartment A. mesenterica superior Left infra(meso)colic compartment A. mesenterica inferior Omentum minus - lig. hepatogastricum - lig. hepatoduodenale - a. hepatica propria - v. portae - ductus hepaticus comm. (d.choledochus) LIGAMENTUM HEPATODUODENALE Omentum majus - lig. gastrocolicum Bursa omentalis - vestibulum - recessus sup. b.o. - recessus sinister b.o. - recessus inf. b.o. 79 80 81 82 83 84 12.05.2019 15 Bursa omentalis Recessus inferior bursae omentalis (2) RECESSUS PERITONEALES Recessus intersigmoideus 85 86 87 88 89 90 12.05.2019 16 1. diaphragma 4. m. transversus abdominis 2. 11th rib 5. m. quadratus lumborum 3. 12th rib 6. m. psoas major 1. fascia renalis 5. corpus adiposum pararenale 2. lamina praerenalis 6. peritoneum 3. lamina retrorenalis 7. fascia transversalis 4. capsula adiposa Th XII Median section through the male pelvis 1. excavatio rectovesicalis Median section through the female pelvis 1. excavatio rectouterina (Douglas) 2. excavatio vesicouterina 91 92 93 94 95 96 12.05.2019 17 CAVITAS PELVIS PERITONEALIS EXCAVATIO RECTOVESICALIS LIGAMENTUM LATUM UTERI LIGAMENTUM OVARII PROPRIUM LIGAMENTUM SUSPENSORIUM OVARII LIGAMENTUM TERES UTERI A. UTERINA X URETER 97 98 99 100