Alimentary 2

8/8/2019 Alimentary 2

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Section 5 The small Intestine

The small intestine extends from the pylorus

to the place where it joins the large intestine. It is

about 6~7m long. It consists of duodenum,

jejunum and ileum.


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The superior Part

The descending part

The horizontal part

The ascending part the inferior part

The Duodenum

The duodenum is divided into four parts.


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the duodenal major papilla ( the bile papilla) : It is

at the posteromedial wall of the descending part of

the duodenum. The common bile duct and the

pancreatic duct unite to open at here.

the hepatopancreatic ampulla

The descending part


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The suspensory muscle of duodenum ( ligament of

Treitz) : The terminal part of the duodenum and

the duodenojejunal flexure are usually suspended

and fixed in position by it. It is a sign to definite the

beginning of the jejunum and to distinguish the

upper and lower alimentary canal.


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The jejunum The ileum

Position The upper 2/5 of the

small intestine

Lies in the left epigastric

The lower 3/5 of the small

intestine

Lies in the right hypogastric

The wall and

diameter

Thicker and bigger Thinner and smaller

Color Redder Pale redCircular fold Large and thick Small and thin

Villi Dense (thick) Sparse (thin)

The aggregated

lymphatic

follicles

Absent (only find few

solitary lymphatic

follicles)

Larger and more (whose long

axis is paralleling with the

long axis of the ileum)

The Jejunum and Ileum


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Jejunum and ileum are attached to the

posterior wall by mesentery and this allows them

very free movement.


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Section 6 The Large Intestine

The large intestine extends from the ileum to theanus and about 1.5m long. The large intestine is more

fixed in position and has a great diameter than the

small intestine.


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Three typical structures in colon and cecum

three colic bands : the longitudinal muscular fibers

haustras of colon : the colon is puckered and sacculated

epiploic appendices : small, peritoneum-covered,

adipose projections, scattered over the free surface of

the colon.


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The large intestine is divided into the following parts.

The Cecum

ileocecal orifice

the orifice of the vermiform appendix.


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The Vermiform Appendix

It is a narrow, worm shaped tube. It has a

triangular mesentery, called mesoappendix.


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The commonly body surface projection for the

appendicular base is the junction of the lateral and

middle thirds of the line joining the right anteriorsuperior iliac spine to the umbilicus, this position is

called McBurneys point.


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The Colon

It may be divided into four parts:

The ascending colon

The transverse colon

The descending colon

The sigmoid colon


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The Rectum

It is continuous with the sigmoid colon, its lower

part is dilated to form the ampulla of rectum.

There are two curves in sagittal plane in rectum:

the sacral flexure of the rectum; the perineal flexure

of the rectum.


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The rectum has incompletely peritoneum

covers. There are three permanent transverse

folds of the rectum to hold the stool.


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The Anal Canal

It begins where the lower end of the ampulla of

rectum suddenly narrows. It ends at the anus.

In the lower part of the canal the mucous

membrane present 6~10 the anal columns.


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The lower ends of these columns are joined

together by the anal valves, above each of which

lies a small anal sinus.

The dentate line : The line along which the

anal valves and the lower end of the anal

column are situated is termed the dentate line .the anal pecten


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Below the anal pecten is the white line, it lies at

the interval between the sphincter ani internus and

the sphincter ani externus.


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Section 7 The Liver

The liver (Hepar) is the largest gland in the body.

It has many important functions except digestion,

such as resolve the poisons, alcohol and drug,

compose and transform the sugar, protein, vitaminand so on. The liver is a reddish-brown organ.


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The liver lies mainly in the upper and right

parts of the abdominal cavity below the right

half of the diaphragm and extends to the left ofthe midline for about 3cm.


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The liver presents two surfaces:

the superior or diaphragmatic surface

the inferior or visceral surface

d

The

diaphragmatic

surface

the falciform ligament

the right and left triangular ligament

the anterior and posteriorcoronary ligament


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The liver can be divided into a small left lobe and

a big right lobe by the falciform ligament.the bare area of liver


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The inferior or visceral surface is marked off by

a H-shaped fissure and groove.

the porta hepatis: The cross--bar of the H is the

porta hepatis, which may be regarded as the hilum of the

liver. The structures through the porta hepatis contain the

hepatic portal vein, the proper hepatic artery, the right and

left hepatic ducts and so on.


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the hepatic pedicle: The structure through

the porta hepatis is called the hepatic pedicle, it

contains the hepatic portal vein, the proper

hepatic artery and the hepatic nerve plexus

enter the liver, and the right and left hepatic

ducts and some lymph vessels emerge.


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The left vertical line of the H is composed of two

parts, the anterior part is ligamentum teres hepatis

(round ligament) which is the trace of the umbilical

vein in embryo, the posterior part is ligamentum

venosum which is the trace of the venous duct in

embryo.


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The right vertical line is composed of two

fossae. The anterior part is the fossa to hold the

gallbladder and the posterior part is the fossa to

pass through the inferior vena cava.


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The liver can be divided into four lobes by the H

groove in the visceral surface.

the left lobe ; the right lobe

the quadrate lobe ; the caudate lobe


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The liver can keep permanent position relying

on many structures.

spleenstomach

Lessor

omentum

liver

duodenum

greater omentum

diaphrag

m


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Section 8 The Gallbladder and Biliary Ducts

The Gallbladder

It stores and concentrates the bile. It lies in a fossa

on the visceral surface of the liver.


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The gallbladder consists of

four parts:

the fundus; the bodythe neck (the spiral folds)

the cystic duct

The body surface projection

of the fundus of the

gallbladder: lies behind the

point where the lateral edge of

the right rectus abdominiscrosses the costal arch.


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The stone in the

gallbladder is the

common disease

in clinic. The

stone can be

anywhere in the

biliary duct


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The Biliary Ducts

Bile is a kind of alimentary fluid to digest the fat.

Bile is produced by hepatocytes.

Within the liver :

The bile the tiny bile canaliculi thin-walled

bile ductules the segmental bile ducts the right

and left hepatic ducts through the porta hepatis

leave the liver the common hepatic duct


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The Common Bile Duct

It is formed near the

hepatic portal vein by the

junction of the cystic and

common hepatic ducts. It lies

in the right border of the

lesser omentum.


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The common bile duct

comes into contact with the

main pancreatic duct to form

the hepatopancreatic ampulla,

the distal constricted end of

this ampulla opens into thedescending part of the

duodenum on the summit of

the major duodenal papilla.


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The circular muscle

around the hepatopancreatic

ampulla is thickened called

the sphincter of

hepatopancreatic ampulla

(Oddis sphincter).


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The produce of bile and its flowing course:

Bile is produced by hepatocytes.

When eat, Bile from the gallbladder the cystic duct

the common bile duct the hepatopancreatic

ampulla open in the duodenal major papilla into

the duodenum (digest)

When dont eat, bile produced by hepatocytes theright and the left hepatic ducts the common hepatic

duct the common bile duct the cystic duct the

gallbladder (store and concentrate)


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Section 9 The Pancreas

The pancreas is a long, soft, finely lobulated

gland. It is located in the upper part of the

abdomen, hidden by many organs.

The pancreas can be divided into the broad head

; the neck; the body ; the narrow tail.


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The adjacent organs of the pancreas are many

more. They are mainly the hepatic portal vein,

the superior mesenteric vein, the left kidney, thecommon bile duct, the spleen and so on.

liver

stomach

gallbladder

greater

omentum

spleen

pancreas

transverse colon

liver

stomach

Greater omentum

left suprarenal

gland and the

left kidney


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The main pancreatic

duct joins the commonbile duct and open into the

duodenum through the

duodenal major papilla.

The pancreas produces

both exocrine and

endocrine secretions.


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The alimentary system

1.Concept:

the isthmus of fauces; tonsilar ring;

the duodenal major papilla; the dentate line;

the suspensory muscle of duodenum

the porta hepatis; the hepatic pedicle

2.What is the composition of the alimentary system?

3.What are the bulk of the tooth (or the tooth tissue)

and the periodontal structures?


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4.How many kinds papillae on the dorsum surface

of tongue? What are they? Which kinds papillae

have taste buds?

5.Please write down the function of the

genioglossus.

6.What are the names of three pairs of salivaryglands? Where do their ducts open?

7. Please write down the names of three parts of the

pharynx, the names of the communicating partswith the nasal cavity, the oral cavity and the

laryngeal cavity.


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8.What are the names and positions (include the

level with the vertebra and the distance from the

incisor teeth) of three constrictions of theesophagus?

9.Please write down the shape and parts of the

stomach.

10.Please write down the parts of the duodenum

and the characteristic of the descending part (the

second part).

11.What are the names of three typical structures

in colon and cecum?


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12.Where is the body surface projection of the

appendicular base?

13.Please write down the names of four parts ofthe colon.

14.What are two curves of the rectum?

15.Please write down the shape of the liver

(include visceral surface and the visceral surface).

16.Where does the bile produce? What is theflowing course of the bile when we eat or not eat?

17.Where is the body surface projection of the

fundus of the gallbladder?

Alimentary 2

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