Median arcuate ligament

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Median arcuate ligament
Gray391.png
The diaphragm. Under surface.
Details
Identifiers
Latin ligamentum arcuatum medianum
TA98 A04.4.02.005
TA2 2343
FMA 58281
Anatomical terminology

The median arcuate ligament is a ligament under the diaphragm that connects the right and left crura of diaphragm.

Contents

Structure

The median arcuate ligament is formed by the right and left crura of the diaphragm. [1] The crura connect to form an arch, behind which is the aortic hiatus, through which pass the aorta, the azygos vein, and the thoracic duct.

Variation

In between 10% and 24% of people, the median arcuate ligament occurs very low. [2]

Clinical significance

Compression of celiac artery and celiac ganglia by the median arcuate ligament can lead to the median arcuate ligament syndrome, which is characterized by abdominal pain, weight loss, and an epigastric bruit. [3]

See also

Related Research Articles

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Hiatal hernia Type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest

A hiatal hernia is a type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn. Other symptoms may include trouble swallowing and chest pains. Complications may include iron deficiency anemia, volvulus, or bowel obstruction.

Thoracic diaphragm Sheet of internal skeletal muscle

The thoracic diaphragm, or simply the diaphragm, is a sheet of internal skeletal muscle in humans and other mammals that extends across the bottom of the thoracic cavity. The diaphragm separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity and performs an important function in respiration: as the diaphragm contracts, the volume of the thoracic cavity increases, creating a negative pressure there, which draws air into the lungs.

Pubic symphysis Cartilaginous joint that sits between and joins the left and right superior rami of the pubic bones

The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is located in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubic symphysis. In females, the pubic symphysis is close to the clitoris. In normal adults it can be moved roughly 2 mm and with 1 degree rotation. This increases for women at the time of childbirth.

Inguinal canal Human abdominal anatomy

The inguinal canals are the two passages in the anterior abdominal wall of humans and animals which in males convey the spermatic cords and in females the round ligament of the uterus. The inguinal canals are larger and more prominent in males. There is one inguinal canal on each side of the midline.

Celiac plexus Complex network of nerves located in the upper abdomen

The celiac plexus, also known as the solar plexus because of its radiating nerve fibers, is a complex network of nerves located in the abdomen, near where the celiac trunk, superior mesenteric artery, and renal arteries branch from the abdominal aorta. It is behind the stomach and the omental bursa, and in front of the crura of the diaphragm, on the level of the first lumbar vertebra.

Abdominal aorta

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.

A side stitch is an intense stabbing abdominal pain under the lower edge of the ribcage that occurs during exercise. It is also called a side ache, side cramp, muscle stitch, or simply stitch, and the medical term is exercise-related transient abdominal pain (ETAP). It sometimes extends to shoulder tip pain, and commonly occurs during running, swimming, and horseback riding. Approximately two-thirds of runners will experience at least one episode of a stitch each year. The precise cause is unclear, although it most likely involves irritation of the abdominal lining, and the condition is more likely after consuming a meal or a sugary beverage. If the pain is present only when exercising and is completely absent at rest, in an otherwise healthy person, it does not require investigation. Typical treatment strategies involve deep breathing and/or manual pressure on the affected area.

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The suspensory muscle of duodenum is a thin muscle connecting the junction between the duodenum, jejunum, and duodenojejunal flexure to connective tissue surrounding the superior mesenteric artery and coeliac artery. It is also known as the ligament of Treitz. The suspensory muscle most often connects to both the third and fourth parts of the duodenum, as well as the duodenojejunal flexure, although the attachment is quite variable.

Periaortic lymph nodes

The periaortic lymph nodes are a group of lymph nodes that lie in front of the lumbar vertebrae near the aorta. These lymph nodes receive drainage from the gastrointestinal tract and the abdominal organs.

Celiac artery First major branch of the abdominal aorta

The coeliacartery, also known as the coeliac 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.

Lesser omentum

The lesser omentum is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum. The lesser omentum is usually divided into these two connecting parts: the hepatogastric ligament, and the hepatoduodenal ligament.

Inferior phrenic arteries

The inferior phrenic arteries are two small vessels which supply the diaphragm. They present much variety in their origin.

Greater omentum The fat sheath under abdominal wall

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.

Celiac ganglia

The celiac ganglia or coeliac ganglia are two large irregularly shaped masses of nerve tissue in the upper abdomen. Part of the sympathetic subdivision of the autonomic nervous system (ANS), the two celiac ganglia are the largest ganglia in the ANS, and they innervate most of the digestive tract.

Lateral arcuate ligament

The lateral arcuate ligament is a ligament under the diaphragm that arches across the upper part of the quadratus lumborum muscle. It is traversed by the subcostal nerve, artery and vein.

Median umbilical ligament Structure in human anatomy

The median umbilical ligament is an unpaired ligamentous structure in human anatomy. It is covered by the median umbilical fold.

Crus of diaphragm

The crus of diaphragm, refers to one of two tendinous structures that extends below the diaphragm to the vertebral column. There is a right crus and a left crus, which together form a tether for muscular contraction. They take their name from their leg-shaped appearance – crus meaning leg in Latin.

Dorsal veins of the penis

In human anatomy, the dorsal veins of the penis comprise the superficial dorsal vein of the penis and the deep dorsal vein of the penis.

Median arcuate ligament syndrome

In medicine, the median arcuate ligament syndrome is a rare condition characterized by abdominal pain attributed to compression of the celiac artery and the celiac ganglia by the median arcuate ligament. The abdominal pain may be related to meals, may be accompanied by weight loss, and may be associated with an abdominal bruit heard by a clinician.

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

  1. Bayat I, Wang J, Ho P, Bird D (March 2020). "Intravascular ultrasound-guided laparoscopic division of the median arcuate ligament". Journal of Vascular Surgery Cases and Innovative Techniques. 6 (1): 147–151. doi:10.1016/j.jvscit.2020.01.011. PMC   7056607 . PMID   32154471.
  2. Surrusco, Matthew S.; Michelotti, Marcos J.; Garberoglio, Carlos A.; Mukherjee, Kaushik (2018-07-27). "A Novel Approach to Median Arcuate Ligament Release Using Robot-Assisted Surgical Techniques and Intraoperative Indocyanine Green Angiography". Videoscopy. 28 (5). doi:10.1089/vor.2018.0540.
  3. Duncan AA (April 2008). "Median arcuate ligament syndrome". Current Treatment Options in Cardiovascular Medicine. 10 (2): 112–6. doi:10.1007/s11936-008-0012-2. PMID   18325313. S2CID   1606510. Archived from the original on December 4, 2012.