 You can see the largest impression on the spleen is of the stomach, this is the gastric impression. This structure here, the blood vessel which you can see is the abdominal aorta dividing into the right and the left common iliac artery. Hello everyone, welcome to the second part of this particular session. In the first part, we had covered up till the large intestine and in the second part I will be covering the remaining topics. So let's begin with the liver and the extra hepatic biliria apparatus. So here we can see the liver view from the anterior aspect. So whenever the specimen of liver is given to you, you should know how to hold it in anatomical position. To hold it in anatomical position, you can use the plain forcep and put it in the inferior vena keva. On the posterior aspect of the liver, there will be inferior vena keva in this region. So you can just put the forcep, plain forcep inside it and hold it straight in the right hand. So the liver is more towards the right side, so it has to be held in right hand. So that's how it has to be held in anatomical position. Then the various parts of the liver is the right low of the liver, left low of the liver. This is the anatomical right and left low. There are eight surgical of the fungal segments of the liver as well, coinards, liver segments and here we can see this is the palsy form ligament and there is an anatomical structure in the lower aspect of the palsy form ligament. It is referred to as the ligamentum theris hepatis, it's a remnant of left umbilical vein and will be asked about the various other folds of the peritoneum. One is the palsy form ligament which goes on the left side as the left triangular ligament and on the right side there is coronary ligament. There is an superior layer of coronary ligament and an inferior layer of coronary ligament. Let's see a different image for it. So here we can see here is the superior layer of coronary ligament, here is the inferior layer of coronary ligament and the two layers of coronary ligament continue downwards as the right triangular ligament, okay. This is the visceral surface of the liver. So in general we can say the liver has got a diaphragmatic surface and a visceral surface, okay. This is the diaphragmatic surface and this one is the visceral surface where various organs are related. So if you see the relations here, the esophagus is related, esophagus continues as the stomach, right. So stomach will be related here and there is a part of stomach called as the pylorus which is related here and here we can see there is the gallbladder itself which is seen. Then there is first part of the duodenum related in this region. Then the colon, there is a flexure of the colon that is called as the hepatic flexure of the colon is in this region, okay. And in this region there is right kidney and right kidney also has got a supraenial gland above it so that also is related on the visceral surface, okay. So various relations on the visceral surface you can remember in anti-clockwise manner that will be easy to recollect in exams, okay. And this is the falciform ligament and also there is a ligament here that is called as the ligamentum venosum, okay, remnant of ductus venosis and this is the cordate lobe of the liver and this quadrangular area here this is the cordate lobe of the liver, okay. You should know the difference here and in liver segments if you study the cordate lobe is the segment one of the liver, okay. So in liver basic folds of the peritoneum then relations of these visceral surface all these are important as far as practical exams are concerned, okay. Now let's look at the extra hepatic biliary apparatus. So you should know at least the components of the extra hepatic biliary apparatus. So from the liver, hepatic ducts, the bides they unite to form the hepatic ducts, right and the left hepatic ducts which continue as the common hepatic duct, okay. And then common hepatic ducts is joined by this cystic ducts, okay. Cystic ducts it comes from this region. There's the gallbladder. Here we can see the parts of the gallbladder, fundus, body and the neck. The neck of the gallbladder continues as the cystic duct, okay. The cystic duct and common hepatic duct they unite to form the bile duct also referred to as the common bile duct, okay. And common bile duct unites with the main pancreatic duct. So here we can see the hepato-pancreatic ampula which opens into the second part of the duodenum, okay. And this also marks the junction of the foregut and the midgut. Here we can also see the accessory pancreatic duct opening into the minor duodenal papilla, okay. And these ducts are surrounded by sphincters. There is sphincter coladocus which surrounds the bile duct. Sphincter pancreaticus which surrounds the main pancreatic duct. And this hepato-pancreatic ampula it is surrounded by a sphincter called a sphincter of Audi, okay. So these at least basic parts of the extra hepatic biliri apparatus we should be knowing. Now let's cover the kidneys. So whenever the kidney is given you will be asked to identify the side of the kidney and hold it in anatomical position, okay. So how to identify the side? Just like we identify side of the bones by justifying in three dimensions. Similar points we will have to say for the kidney. So here suppose this is the kidney of the left side and you will have to hold it in the left hand, okay. In such a way that the structures of the hyalum of the kidney from anterior to posterior it should be vein, artery and pelvis, okay. That's the renal pelvis. So anterior most structure should be the renal vein, then the renal artery and the posterior most structure is the renal pelvis which continues as the urator down, okay. So this is for the anterior-posterior relation. For medial lateral we can say hyalum is on the medial aspect, okay. Then what we can say for superior and inferior. For superior and inferior also this urator is important. It should be directed downwards in a smooth manner, okay. It should not kink. If we like hold it upside down the urator, direction of urator will be somewhat like this, okay. This up turning of the urator is separate towards the kinking of urator. This kinking shouldn't happen. The urator should smoothly come down, okay. So for superior and inferior we can say the urator is directed downwards and it is not kinking, okay. So this was about side determination of the kidney. And in kidney also we will be asked about the various relations of the kidney. So the relations, anterior relations of the left kidney apc in this region there is the left supra-renal gland. Then there is splenic impression. Then there is the gastric impression here. And there is a large area for pancreatic impression. Then on the medial aspect there is zezunal impression and on the lateral aspect there is the splenic flexure of the colon, okay. So here is the colon is related here, okay. From here it turns down, okay. So we have the various relations on the anterior aspect of the left kidney. Relations on the anterior aspect of the right kidney if we see here there will be right supra-renal gland. And there is a C-shaped second part of the duodenum, okay. Second part of the duodenum and the large area is covered by liver, liver is related. Then on the medial aspect again zezunum and colon, okay. Zezunum and colon are on both sides, left side as well as right side. But make sure zezunum, we label it on the medial aspect and colon on the lateral aspect on both the sides, okay. So this was anterior relations. We should note the posterior relations as well. So here in this image we can see the posterior relations of both kidneys. The left kidney is related with 11th rib as well as 12th rib. Whereas the right kidney is related only with the 12th rib, okay. Right kidney is slightly at a lower level, that's why. And apart from that diaphragm is related along with its ligaments, the medial-arquate ligament, the lateral-arquate ligament and these three nerves, subcostal nerve, iliohypogastric nerve and ilioenguinal nerve from above downwards. And subcostal nerve is along with the vessels, okay. So along with the subcostal vessels and three muscles from medial to lateral. It is common for both the sides. Sauce major, quadratus, lumborum and transversus abdominis, okay. These are the posterior relations. And in this image we can see the interior of the kidneys. The kidney is cut open along the outer surface. And here we can see on the inner aspect there is. This is the cortex of the kidney and this is the medulla of the kidney, okay. So it should be able to differentiate which part is cortex, which part is medulla and some the medulla, the minor calyx, major calyx they arise which will continue as the renal pelvis, okay. Now let's start with the posterior abdominal wall. So in the posterior abdominal wall, the three muscles which we saw in the posterior relations, sauce major, quadratus, lumborum and transversus abdominis, those three muscles will be seen. And various nerves of the lumbar plexus, those are seen. So we should be able to identify these nerves in a particular relation like from above downwards. So just below the diaphragm there is subcostal nerves and vessels. And there is iliohypogastric nerve, then ilioenguinal nerve. And there is a nerve which goes towards this anterior superior iliac spine. This nerve is the lateral cutaneous nerve of the thigh. Okay, then there will be femoral nerve. And a nerve just anterior to the sauce major that is genitofemoral nerve which will split into the two components, genital as well as femoral. And medial to it the nerve will be obturator nerve, okay. So there will be obturator nerve and as well as lumbosacral trunk will be seen more on the medial aspect, okay. So here is the dissected specimen which we can see. Just in front of the sauce major you can appreciate this is the genitofemoral nerve, okay. And various other nerves it is not seen very clearly in the image, but at least a basic idea you should know that how the structures are related from about onwards, okay. So in posterior abdominal wall muscles as well as nerves, at least these things you should be knowing, okay. Now let's start with the urinary bladder. So here we can see the urinary bladder viewed from the posterior aspect is the posterior viewed is the superior surface of the urinary bladder. And this image shows how to hold the urinary bladder in anatomical position, okay. So we can see it is being held with both the hands, okay. Midline structures always hold with both the hands. If it is a structure of one particular side, hold it on that side, okay. So here we can see held with both the sides. The four fingers are along the inter lateral surface of the urinary bladder. The thumb is on the superior surface, okay. That's how it has to be held in anatomical position. And here we can see these are the seminal vesicles as well as the ductus difference. This should be on the posterior aspect, okay. And you may be asked whether it is a male urinary bladder or a female urinary bladder, okay. For that you will have to look for these structures. Ductus difference and seminal vesicles present only in male. So that's how you can differentiate. Also you can look the prostate gland if it is present. That means it is a male urinary bladder, okay. That's how you can differentiate male urinary bladder from female urinary bladder, okay. And in these structures you should know which structure is medial which is lateral. The ductus difference is on the medial aspect. The seminal vesicle is on the lateral aspect, okay. On the superior surface the urinary bladder is covered by peritonium in an empty urinary bladder. But when the urinary bladder gets spilled the peritonium is reflected on the superior surface of the urinary bladder. So that this superior surface comes to lie in contact with the anterior abdominal ball, okay. If there is urinary retention, so urine can be drained to a procedure called as suprapubic systotomy, okay. Now let's look at the interior of the urinary bladder. So here we can see the interior of urinary bladder. So what all things are seen. There will be one smooth area that is referred to as the trigon of the urinary bladder and the remaining part. And in the remaining part we can see the mucosal folds of the urinary bladder, okay. So this smooth part is due to the absorbed mesonetric ducts, okay. And various parts we should be knowing there is interuretric ridge called as bars, bar of mercy earth. Then uretric orifice. Here we can see small small uretric orifice, okay. Then uretro uretral ridge. And there is a projection of the prostate here that is referred to as the uvula vasike. The median loop of the prostate projects into the urinary bladder that is uvula vasike. Then in the lower part we may see the prostate gland, okay. So this is how the interior looks like. Now let's cover the uterus along with the associated structures that is the adnexa. So the palovian tube, ovaries, the vagina, all associated structures along with the uterus, those are referred to as adnexa, okay. So in the uterus, upper part is the body of the uterus and the lower part is the cervix of the uterus, okay. And to hold the uterus in anatomical position it has to be held in both the hand in such a way that ovaries are lying on the posterior aspect, okay. So ovaries should be on the posterior aspect. And at times uterus may be seen along with the urinary bladder. So in that case, urinary bladder should be on the anterior aspect. And the fold of peritonium here that is referred to as the broad ligament. The various parts of the broad ligament are important. The part of the broad ligament in relation with the uterus is referred to as mesometrium. The part of the broad ligament in relation with the palovian tube is called as mesofalpings. And the part in relation with the ovary that is referred to as meso ovarian, okay. So various parts of the broad ligament as well as contents of the broad ligament are important. The content of the broad ligament, if the uterine tube is there, then there are two vessels, the uterine artery, the ovarian artery, there are two ligaments, round ligament of uterus, then ligament of the ovary, okay. The eminence of the mesonetric duct, the ecuforon, paruforon, all these are there, okay. And in uterus, one of the most frequently asked question is the supports of the uterus. Even in practical as well as in theory exams it is asked. So it should be knowing about the various supports of the uterus. So we can just divide it into primary supports and secondary supports. Secondary supports are nothing but they are folds of the peritonium. It supports the uterus, whereas this primary supports are very important. So for the subdivided into three parts, muscular, visceral and fibromuscular, okay. In muscular support there is pelvic diaphragm, perineal body, and urogenital diaphragm. Visceral support includes the organs which are adjacent to the uterus, the unary bladder, vagina and the axis, uterine axis. And fibromuscular support are the strongest of all the supports. The transverse cervical ligament, tuboservical uterus acral and the round ligament of the uterus, okay. Amongst all the supports, this is the most important support, okay. Transverse cervical ligament of mechan dot, it is also referred to as cardinal ligament, okay. Now let's cover the testis. So specimen of testis along with the spermatic cord, okay. So we will have to hold the spermatic cord. So that's how one can hold the testis and in such a way that there is a space here just below the epididymis. This epididymis should be facing on the lateral aspect, okay. That's how the testis has to be held in anatomical position. And to determine the side, bottle side determination points we can say for superior and inferior we can say spermatic cord on the superior aspect, or else we can say the epididymis is on the superior aspect. For anterior and posterior we can say the epididymis is on the posterior aspect, okay. And for medial and lateral this space is important. That is the finus of the epididymis that faces laterally, okay. And the coverings of the testis are important. The outermost covering is of the peritoneum, the tunica vaginalis, and there is tunica albuginia, and the innermost covering is tunica basculosa, okay. And here the various coverings and the arterial supplies by the testicular artery, venous drainage is by the empeniform plexus of veins, and its lymphatic drainage is important because it looks as if it will go towards the aortic lymph nodes, but no, it goes towards the aortic lymph nodes because the arterial supply comes from that region, so that's why lymphatic drainage also goes in that region, okay. So pre- and pari-aortic lymph nodes are important for lymphatic drainage because whenever there is cancer it spreads through the lymphatic drainage, right. And baricocele is a condition in which the venous drainage of the testis is affected, so the empeniform plexus of veins they get dilated, so that is called as baricocele, and it's most frequent on the left side. Now let's look at the mid-serial section of male pelvis as well as female pelvis. So whenever the mid-serial section is kept, the first thing that will be asked to you is the whether is it a male pelvis or a female pelvis, okay. So what all key thing we can look for? So in a male pelvis the external genitals may be seen, but if it is not seen then you will have to look for the organs which are there, so here you can see this is the urinary bladder and this is the rectum, okay. In between them we are not able to see the uterus, okay. That's why this is the mid-serial section of a male pelvis, okay. And you should be able to identify various structures from anterior to posterior, so here is the penis, then this is the pubic symphysis which is seen, okay. And just this space here is referred to as the retro-pubic space behind the pubic, right. Then there's the urinary bladder and here is the recto-acycl fold of the peritoneum, then this is the rectum and this is the pterum, okay. So all these structures which should be able to identify it. Now let's see the female pelvis as well. So here we can see the female pelvis, so again try to identify structures from anterior to posterior, this is the pubic symphysis, again the retro-pubic space here, then urinary bladder, then here you can see this is the uterus, okay. So this is the key identification feature for a female pelvis, okay. So uterus is seen, we continue downward cervix and the vagina is seen, okay. And this is the rectum and behind this there is sacrum, okay. So all these things we should be able to identify and there are folds of peritoneum, there is a characteristic fold here that is called as the recto-uterine pouch, also called as pouch of Douglas, okay. So fluid collection most frequently occurs in this region, so clinically very important, okay. So in male pelvis as well as female pelvis various structures from anterior to posterior you should be able to identify. Now let's look at some 3D models of pubdomen and pelvis. So here we can see the specimen of liver along with duodenum, pancreas and this spleen, okay. Everything together. So let's zoom in and see what all structures are seen. So various parts of the duodenum you can appreciate, first part, second part, third part and the terminal part is the fourth part which will continue as the jejunum, okay. And in pancreas there is the head of the pancreas, insinate process, body of the pancreas and tail of the pancreas, okay. Pancreatic duct system is also seen if I zoom in more. So are you able to see this? This is the duct system of the pancreas. There is a main pancreatic duct which opens into the major duodenal papilla and there is an accessory pancreatic duct which opens into the minor duodenal papilla, okay. Then in this spleen you can see a characteristic impression. You can see the largest impression on the spleen is of the stomach, okay. This is the gastric impression and pancreas is directly shown, the tail of the pancreas and here the colon is related, colic flexure and here is the left kidney which is related, okay. This is the visceral surface of the spleen. This is the diaphragmatic surface of the spleen. Let's look at the liver as well. Liver it is rotated in such a way that we are viewing the inferior surface of the visceral surface of the liver. So here is the caudate lobe. This is the caudate lobe. This is the ligament and teresipatitis. Here is the region of ligament and venosum and this is the inferior vena keva and for holding an anatomical position we have to put the force inside this inferior vena keva and hold it straight, okay. And various relations we learned here on the visceral surface, okay. Let's look at the diaphragmatic surface as well. Here this is the diaphragmatic surface of the liver. This is the falciform ligament, right. This is the right lobe and this is the left lobe. So it's a very good specimen of liver along with duodenum, pancreas and the spleen. Here there is one more specimen of the abdomen where we are looking at the posterior abdominal wall and the various other structures related here. So you can see the kidneys, the left kidney, the right kidney. Then this structure here, the blood vessel which you can see is the abdominal aorta dividing into the right and the left common iliac artery, common iliac further dividing into the external iliac artery and the internal iliac artery. External iliac artery will further continue as the femoral artery, okay. And internal iliac artery if it is more further it will divide into an anterior division and a posterior division and there will be further multiple branches. So on the posterior abdominal wall also the branches of these blood vessels aorta as well as the tributaries of inferior vena these may be asked. So you should be knowing about it. Anterior branches if we see there is celiac trunk superior miscentric artery and inferior miscentric artery, okay. And lateral branches from above downwards it will be inferior phrenic artery, middle supra renal artery, renal artery and gonadal artery, okay. And on the posterior aspect there is four pairs of lumbar artery and there is one median sacral artery. So all these branches of abdominal aorta should be aware of and here we can see the sauce major muscle. The nerve running in front of the sauce major is genitofemoral nerve, right. And there will be various other nerves in the posterior abdominal wall from above downwards that I had discussed previously. So this was about the models of abdominal. So let's summarize what you have covered in this particular session. In the first part I had covered up to the large intestine, okay. And the second part I covered liver extrapatibular apparatus, kidney posterior abdominal wall, urinal bladder, adnexarcthex testis as well as the metrolateral section of male and female pelvis. And lastly we saw the 3D model, okay. So I just tried to quickly revise all the organ which will be useful for you all to watch it just before the practical or the bi-bi-examination. Details about theory part you all should read, okay. And for PDF handout of this particular session you all can WhatsApp me at this number and please do watch other sessions of this YouTube channel, okay. Thank you.