| Epigastrium | |
|---|---|
 Surface lines of the front of the thorax and abdomen | |
| Details | |
| Part of | abdomen |
| Identifiers | |
| Latin | regio epigastrica |
| TA98 | A01.2.04.003 |
| TA2 | 257 |
| FMA | 20389 |
| Anatomical terminology | |
In anatomy, the epigastrium (or epigastric region) is the upper central region of the abdomen. It is located between the costal margins and the subcostal plane. Pain may be referred to the epigastrium from damage to structures derived from the foregut.
The epigastrium is one of the nine regions of the abdomen, along with the right and left hypochondria, right and left lateral regions (lumbar areas or flanks), right and left inguinal regions (or fossae), and the umbilical and pubic regions. It is located between the costal margins and the subcostal plane.
During breathing, the diaphragm contracts and flattens, displacing the viscera and producing an outward movement of the upper abdominal wall (epigastric region). It is a convergence of the diaphragm and the abdominals, so that "when both sets of muscles (diaphragm and abdominals) tense, the epigastrium pushes forward". [1] Therefore, the epigastric region is not a muscle nor is it an organ, but it is a zone of activity where the actions of the rectus abdominis and the diaphragm produce an outward bulging of the upper abdominal wall.
The epigastrium lies over a number of structures in the abdomen. Part of the liver lies in the right of the epigastrium. [2] It also lies over the duodenum, the edge of the spleen, [2] part of the stomach, [2] and part of the pancreas.
The epigastrium is the part of the abdomen where abdominal thrusts (the Heimlich manoeuvre) are able to produce a rapid and forceful exhalation of breath.[ citation needed ]
Palpation of the epigastrium can be used to feel the structures below it. [2] This includes the liver, and the stomach. [2] An aortic aneurysm may be felt as a mass in the epigastrium. [3]
Stomach sounds may be heard when auscultating (using a stethoscope) on the epigastrium. [2]
Pain can be referred to the epigastrium from damaged internal organs. [4] This is primarily from the foregut, with structures including the stomach, parts of the duodenum, and the biliary tract. [4] Pain may also be referred from the pancreas, such as in acute pancreatitis. [5]
The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e., it has both an endocrine and a digestive exocrine function. 99% of the pancreas is exocrine and 1% is endocrine. As an endocrine gland, it functions mostly to regulate blood sugar levels, secreting the hormones insulin, glucagon, somatostatin and pancreatic polypeptide. As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach; and digestive enzymes, which break down carbohydrates, proteins and fats in food entering the duodenum from the stomach.
The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal organs, and is composed of a layer of mesothelium supported by a thin layer of connective tissue. This peritoneal lining of the cavity supports many of the abdominal organs and serves as a conduit for their blood vessels, lymphatic vessels, and nerves.
Abdominal pain, also known as a stomach ache, Is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a differential diagnosis is extremely important.
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta.
The celiacartery, also known as the celiac trunk or truncus coeliacus, is the first major branch of the abdominal aorta. It is about 1.25 cm in length. Branching from the aorta at thoracic vertebra 12 (T12) in humans, it is one of three anterior/ midline branches of the abdominal aorta.
The abdomen is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior tagma of the body; it follows the thorax or cephalothorax.
Pancreatic divisum is a congenital anomaly in the anatomy of the ducts of the pancreas in which a single pancreatic duct is not formed, but rather remains as two distinct dorsal and ventral ducts. Most individuals with pancreas divisum remain without symptoms or complications. A minority of people with pancreatic divisum may develop episodes of abdominal pain, nausea or vomiting due to acute or chronic pancreatitis. The presence of pancreas divisum is usually identified with cross sectional diagnostic imaging, such as endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP). In some cases, it may be detected intraoperatively. If no symptoms or complications are present, then treatment is not necessary. However, if there is recurrent pancreatitis, then a sphincterotomy of the minor papilla may be indicated.
In human anatomy, the superior epigastric artery is a terminal branch of the internal thoracic artery that provides arterial supply to the abdominal wall, and upper rectus abdominis muscle. It enters the rectus sheath to descend upon the inner surface of the rectus abdominis muscle. It ends by anastomosing with the inferior epigastric artery.
The right colic artery is an artery of the abdomen, a branch of the superior mesenteric artery supplying the ascending colon. It divides into two terminal branches - an ascending branch and a descending branch - which form anastomoses with the middle colic artery, and ileocolic artery (respectively).
The lumbar arteries are arteries located in the lower back or lumbar region. The lumbar arteries are in parallel with the intercostals.
The foregut in humans is the anterior part of the alimentary canal, from the distal esophagus to the first half of the duodenum, at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, developing from the folding primitive gut, and is developmentally distinct from the midgut and hindgut. Although the term “foregut” is typically used in reference to the anterior section of the primitive gut, components of the adult gut can also be described with this designation. Pain in the epigastric region, just below the intersection of the ribs, typically refers to structures in the adult foregut.
In anatomy, the division of the abdomen into regions can employ a nine-region scheme. The hypochondrium refers to the two hypochondriac regions in the upper third of the abdomen; the left hypochondrium and right hypochondrium. They are located on the lateral sides of the abdominal wall respectively, inferior to (below) the thoracic cage, being separated by the epigastrium.
The greater omentum is a large apron-like fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and doubles back to ascend to the transverse colon before reaching to the posterior abdominal wall. The greater omentum is larger than the lesser omentum, which hangs down from the liver to the lesser curvature. The common anatomical term "epiploic" derives from "epiploon", from the Greek epipleein, meaning to float or sail on, since the greater omentum appears to float on the surface of the intestines. It is the first structure observed when the abdominal cavity is opened anteriorly.
The transpyloric plane, also known as Addison's plane, is an imaginary horizontal plane, located halfway between the suprasternal notch of the manubrium and the upper border of the symphysis pubis at the level of the first lumbar vertebrae, L1. It lies roughly a hand's breadth beneath the xiphisternum or midway between the xiphisternum and the umbilicus. The plane in most cases cuts through the pylorus of the stomach, the tips of the ninth costal cartilages and the lower border of the first lumbar vertebra.
The costal margin, also known as the costal arch, is the lower edge of the chest (thorax) formed by the bottom edge of the rib cage.
The umbilical region is one of the nine regions of the abdomen. It is the region that surrounds the area around the umbilicus and is placed approximately half way between the xiphoid process and the pubic symphysis. This region of the abdomen contains part of the stomach, the head of the pancreas, the duodenum, a section of the transverse colon and the lower aspects of the left and right kidney. The upper three regions, from left to right, are the left hypochondriac, epigastric, and right hypochondriac regions. The middle three regions, from left to right, are the left lumbar, umbilical, and right lumbar regions. The bottom three regions, from left to right, are the left inguinal, hypogastric, and right inguinal regions.
The abdominopelvic cavity is a body cavity that consists of the abdominal cavity and the pelvic cavity. The upper portion is the abdominal cavity, and it contains the stomach, liver, pancreas, spleen, gallbladder, kidneys, small intestine, and most of the large intestine. The lower portion is the pelvic cavity, and it contains the urinary bladder, the rest of the large intestine, and the internal reproductive organs.
The minor duodenal papilla is the opening of the accessory pancreatic duct into the descending second section of the duodenum.
The development of the digestive system in the human embryo concerns the epithelium of the digestive system and the parenchyma of its derivatives, which originate from the endoderm. Connective tissue, muscular components, and peritoneal components originate in the mesoderm. Different regions of the gut tube such as the esophagus, stomach, duodenum, etc. are specified by a retinoic acid gradient that causes transcription factors unique to each region to be expressed. Differentiation of the gut and its derivatives depends upon reciprocal interactions between the gut endoderm and its surrounding mesoderm. Hox genes in the mesoderm are induced by a Hedgehog signaling pathway secreted by gut endoderm and regulate the craniocaudal organization of the gut and its derivatives. The gut system extends from the oropharyngeal membrane to the cloacal membrane and is divided into the foregut, midgut, and hindgut.
The human abdomen is divided into quadrants and regions by anatomists and physicians for the purposes of study, diagnosis, and treatment. The division into four quadrants allows the localisation of pain and tenderness, scars, lumps, and other items of interest, narrowing in on which organs and tissues may be involved. The quadrants are referred to as the left lower quadrant, left upper quadrant, right upper quadrant and right lower quadrant. These terms are not used in comparative anatomy, since most other animals do not stand erect.
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