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By Raftery, Delbridge, Douglas

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Additional resources for Basic Science for the MRCS. A revision guide for surgical trainees

Sample text

Posteriorly: separated from diaphragm, aorta, pancreas, spleen, left kidney and suprarenal gland, transverse mesocolon, and colon by lesser sac of peritoneum. Blood supply The blood supply (Fig. 17) is via: l The left gastric artery, which is derived from the coeliac axis and runs along the lesser curvature of the stomach where it anastomoses with the right gastric branch of the hepatic artery. l The right gastric artery from the hepatic artery. l The right gastroepiploic artery: arises from the gastrodudodenal branch of the hepatic artery and anastomoses along the greater curve with the left gastroepiploic artery.

Lesser sac (omental bursa) T12 Relations l l l l l Anteriorly: lesser omentum and stomach. Superiorly: superior recess whose anterior border is the caudate lobe of the liver. Inferiorly: projects downwards to transverse mesocolon. To the left: spleen, gastrosplenic and lienorenal ligaments. To the right: opens into the greater sac via the epiploic foramen. Epiploic foramen (Foramen of Winslow; Fig. 10) l l l l Anteriorly: free edge of lesser omentum containing bile duct to the right, hepatic artery to the left and portal vein behind.

L Assists in increasing intra-abdominal pressure during defecation, micturition and parturition. Coccygeus l Small triangular muscle behind and in the same plane as levator ani. Origin l Spine of ischium. Insertion l Side of coccyx and lowest part of sacrum. l Muscle has same attachments as sacrospinous ligament. Nerve supply l Perineal branch of S4. Action l Holds the coccyx in its natural forwards position. Pelvic fascia l Parietal pelvic fascia is a strong membrane covering the muscles of pelvic wall and is attached to bones at margins of muscles.

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Basic Science for the MRCS. A revision guide for surgical trainees by Raftery, Delbridge, Douglas

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