Digestive System

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Digestive system Lips oral cavity tongue salivary glands pharynx esophagus peritoneum stomach m6-7 small intestine: cm25 DEODENUM: 2/5JEJUNUM: 3/5ILIUM: large intestine liver gall bladder pancreas :Duodenum Sup. Part Descending part Horizontal part Ascending part Major duodenal papilla Minor duodenal papilla : JEJUNUM / ILIUM From duodenojejunal curvature To Iliocecal Different jejunum & ilium 3Tenia coli: sigmoid 2 / rectum 0 Houstra / saccule Appendices epiploicae : No in Appendix / cecum / rectum Many in sigmoid DIFFERENT BETWEEN SMALL AND LARGE INTESTINE large intestine 1.5m Cecum appendix ascending colon transverse colon descending colon sigmoid colon rectum anal canal McBurneys point ascending colon transverse colon descending colon sigmoid colon :Rectum cm 12 Sacral flexure Puborectalis muscle Perineal flexure Rectum Ampulla : Anal canal cm 4 sup. = anal column / anal valve / anal sinus / pectinate line 2/3 Hiltons white line .inf 1/3 :Anal sphincter Internal sphincter External sphincter: deep / superficial / subcutaneous Liver: 1.5 kgr Located in Rt. & lf. Hypochondriac & epigastric region Surfaces: Sup. Anterior Surface: falciform ligament Inf. Surface: H shape fissure / porta hepatis / quadrate lobe / qudate lobe Post. Surface: bare area Rt. Surface: ribs 7-11 / Rt. lung Liver viewed from posterior Liver viewed from inferior Liver viewed from inferior Liver viewed from posterior :Liver vasculature 20%Hepatic artery 80%Portal vein Supra hepatic vein IVC :Nerve Sympathetic Parasympathetic From Vagus+ Phernic + celiac :Gall bladder Located in inf. Surface of liver cm7-10 Length: cm3-4 Wide: :Structure Fundus Body Infundibulum Neck Systic duct :Pancreas 2–L1 L cm15-20 Length: cm3Wide: cm2 Thickness: gram 90 :Structure Head :Uncinate process / sup. Mesenteric artery Neck: portal vein / sup. Mesenteric artery / aorta Body Tail Pancreatic duct ﻣﻧﺗﻅﺭ ﻟﺣﻅﻪ ﻣﻧﺎﺳﺏ ﻧﺑﺎﺵ ﻫﻣﻳﻥ ﻟﺣﻅﻪ ﺭﻭ ﺑﮕﻳﺭ ﻭ ﻣﻧﺎﺳﺏ ﺵ ﮐﻥ . ..

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The Anatomy of the Rectum and Anal Canal
BASIC SCIENCE identify the rectosigmoid junction with conﬁdence at operation. The anatomy of the rectum The rectosigmoid junction usually lies approximately 6 cm below the level of the sacral promontory. Approached from the distal and anal canal end, however, as when performing a rigid or ﬂexible sigmoid- oscopy, the rectosigmoid junction is seen to be 14e18 cm from Vishy Mahadevan the anal verge, and 18 cm is usually taken as the measurement for audit purposes. The rectum in the adult measures 10e14 cm in length. Abstract Diseases of the rectum and anal canal, both benign and malignant, Relationship of the peritoneum to the rectum account for a very large part of colorectal surgical practice in the UK. Unlike the transverse colon and sigmoid colon, the rectum lacks This article emphasizes the surgically-relevant aspects of the anatomy a mesentery (Figure 1). The posterior aspect of the rectum is thus of the rectum and anal canal. entirely free of a peritoneal covering. In this respect the rectum resembles the ascending and descending segments of the colon, Keywords Anal cushions; inferior hypogastric plexus; internal and and all of these segments may be therefore be spoken of as external anal sphincters; lymphatic drainage of rectum and anal canal; retroperitoneal. The precise relationship of the peritoneum to the mesorectum; perineum; rectal blood supply rectum is as follows: the upper third of the rectum is covered by peritoneum on its anterior and lateral surfaces; the middle third of the rectum is covered by peritoneum only on its anterior 1 The rectum is the direct continuation of the sigmoid colon and surface while the lower third of the rectum is below the level of commences in front of the body of the third sacral vertebra.
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Rectum & Anal Canal
Rectum & Anal canal Dr Brijendra Singh Prof & Head Anatomy AIIMS Rishikesh 27/04/2019 EMBRYOLOGICAL basis – Nerve Supply of GUT •Origin: Foregut (endoderm) •Nerve supply: (Autonomic): Sympathetic Greater Splanchnic T5-T9 + Vagus – Coeliac trunk T12 •Origin: Midgut (endoderm) •Nerve supply: (Autonomic): Sympathetic Lesser Splanchnic T10 T11 + Vagus – Sup Mesenteric artery L1 •Origin: Hindgut (endoderm) •Nerve supply: (Autonomic): Sympathetic Least Splanchnic T12 L1 + Hypogastric S2S3S4 – Inferior Mesenteric Artery L3 •Origin :lower 1/3 of anal canal – ectoderm •Nerve Supply: Somatic (inferior rectal Nerves) Rectum •Straight – quadrupeds •Curved anteriorly – puborectalis levator ani •Part of large intestine – continuation of sigmoid colon , but lacks Mesentery , taeniae coli , sacculations & haustrations & appendices epiploicae. •Starts – S3 anorectal junction – ant to tip of coccyx – apex of prostate •12 cms – 5 inches - transverse slit •Ampulla – lower part Development •Mucosa above Houstons 3rd valve endoderm pre allantoic part of hind gut. •Mucosa below Houstons 3rd valve upto anal valves – endoderm from dorsal part of endodermal cloaca. •Musculature of rectum is derived from splanchnic mesoderm surrounding cloaca. •Proctodeum the surface ectoderm – muco- cutaneous junction. •Anal membrane disappears – and rectum communicates outside through anal canal. Location & peritoneal relations of Rectum S3 1 inch infront of coccyx Rectum • Beginning: continuation of sigmoid colon at S3. • Termination: continues as anal canal, • one inch below
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Anatomy of Major Duodenal Papilla Influences ERCP Outcomes
Journal of Clinical Medicine Article Anatomy of Major Duodenal Papilla Inﬂuences ERCP Outcomes and Complication Rates: A Single Center Prospective Study Gheorghe G. Balan 1 , Mukul Arya 2, Adrian Catinean 3, Vasile Sandru 4,*, Mihaela Moscalu 1 , Gabriel Constantinescu 5, Anca Trifan 1 , Gabriela Stefanescu 1,* and Catalin Victor Sfarti 1 1 Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; [email protected] (G.G.B.); [email protected] (M.M.); [email protected] (A.T.); [email protected] (C.V.S.) 2 New York Presbitarian Brooklyn Methodist Hospital, New York, NY 11215, USA; [email protected] 3 Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; [email protected] 4 Department of Gastroenterology, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania 5 Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; [email protected] * Correspondence: [email protected] (V.S.); [email protected] (G.S.) Received: 27 March 2020; Accepted: 25 May 2020; Published: 28 May 2020 Abstract: Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been one of the most intensely studied endoscopic procedures due to its overall high complication rates when compared to other digestive endoscopy procedures. The safety and outcome of such procedures have been linked to multiple procedure- or patient-related risk factors. The aim of our study is to evaluate whether the morphology of the major duodenal papilla inﬂuences the ERCP outcomes and complication rates. Methods: A total of 322 patients with a native papilla have been included in the study over an eight month period.
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Vocabulario De Morfoloxía, Anatomía E Citoloxía Veterinaria
Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) Servizo de Normalización Lingüística Universidade de Santiago de Compostela COLECCIÓN VOCABULARIOS TEMÁTICOS N.º 4 SERVIZO DE NORMALIZACIÓN LINGÜÍSTICA Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) 2008 UNIVERSIDADE DE SANTIAGO DE COMPOSTELA VOCABULARIO de morfoloxía, anatomía e citoloxía veterinaria : (galego-español- inglés) / coordinador Xusto A. Rodríguez Río, Servizo de Normalización Lingüística ; autores Matilde Lombardero Fernández ... [et al.]. – Santiago de Compostela : Universidade de Santiago de Compostela, Servizo de Publicacións e Intercambio Científico, 2008. – 369 p. ; 21 cm. – (Vocabularios temáticos ; 4). - D.L. C 2458-2008. – ISBN 978-84-9887-018-3 1.Medicina ��veterinaria-Diccionarios��. 2.Galego (Lingua)-Glosarios, vocabularios, etc. políglotas. I.Lombardero Fernández, Matilde. II.Rodríguez Rio, Xusto A. coord. III. Universidade de Santiago de Compostela. Servizo de Normalización Lingüística, coord. IV.Universidade de Santiago de Compostela. Servizo de Publicacións e Intercambio Científico, ed. V.Serie. 591.4(038)=699=60=20 Coordinador Xusto A. Rodríguez Río (Área de Terminoloxía. Servizo de Normalización Lingüística. Universidade de Santiago de Compostela) Autoras/res Matilde Lombardero Fernández (doutora en Veterinaria e profesora do Departamento de Anatomía e Produción Animal.
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48 Anal Canal
Anal Canal The rectum is a relatively straight continuation of the colon about 12 cm in length. Three internal transverse rectal valves (of Houston) occur in the distal rectum. Infoldings of the submucosa and the inner circular layer of the muscularis externa form these permanent sickle- shaped structures. The valves function in the separation of flatus from the developing fecal mass. The mucosa of the first part of the rectum is similar to that of the colon except that the intestinal glands are slightly longer and the lining epithelium is composed primarily of goblet cells. The distal 2 to 3 cm of the rectum forms the anal canal, which ends at the anus. Immediately proximal to the pectinate line, the intestinal glands become shorter and then disappear. At the pectinate line, the simple columnar intestinal epithelium makes an abrupt transition to noncornified stratified squamous epithelium. After a short transition, the noncornified stratified squamous epithelium becomes continuous with the keratinized stratified squamous epithelium of the skin at the level of the external anal sphincter. Beneath the epithelium of this region are simple tubular apocrine sweat glands, the circumanal glands. Proximal to the pectinate line, the mucosa of the anal canal forms large longitudinal folds called rectal columns (of Morgagni). The distal ends of the rectal columns are united by transverse mucosal folds, the anal valves. The recess above each valve forms a small anal sinus. It is at the level of the anal valves that the muscularis mucosae becomes discontinuous and then disappears. The submucosa of the anal canal contains numerous veins that form a large hemorrhoidal plexus.
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The Digestive System Overview of the Digestive System • Organs Are Divided Into Two Groups the Alimentary Canal and Accessory
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Anatomy of Small Intestine Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
Color Code Important Anatomy of Small Intestine Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives: At the end of the lecture, students should: List the different parts of small intestine. Describe the anatomy of duodenum, jejunum & ileum regarding: the shape, length, site of beginning & termination, peritoneal covering, arterial supply & lymphatic drainage. Differentiate between each part of duodenum regarding the length, level & relations. Differentiate between the jejunum & ileum regarding the characteristic anatomical features of each of them. Abdomen What is Mesentery? It is a double layer attach the intestine to abdominal wall. If it has mesentery it is freely moveable. L= liver, S=Spleen, SI=Small Intestine, AC=Ascending Colon, TC=Transverse Colon Abdomen The small intestines consist of two parts: 1- fixed part (no mesentery) (retroperitoneal) : duodenum 2- free (movable) part (with mesentery) :jejunum & ileum Only on the boys’ slides RELATION BETWEEN EMBRYOLOGICAL ORIGIN & ARTERIAL SUPPLY مهم :Extra Arterial supply depends on the embryological origin : Foregut Coeliac trunk Midgut superior mesenteric Hindgut Inferior mesenteric Duodenum: • Origin: foregut & midgut • Arterial supply: 1. Coeliac trunk (artery of foregut) 2. Superior mesenteric: (artery of midgut) The duodenum has 2 arterial supply because of the double origin The junction of foregut and midgut is at the second part of the duodenum Jejunum & ileum: • Origin: midgut • Arterial
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Part Innervation Blood Supply Venous Drainage
sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE Roof: greater palatine & nasopalatine Mouth nerves (maxillary N.) Floor: lingual nerve (mandibular N.) Taste {ant 1/3}: chorda tympani nerve (facial nerve) Cheeks: buccal nerve (mandibular N.) Buccinator muscle: Buccal Nerve 1 (facial Nerve) Orbicularis oris muscle: facial nerve Tip: Submental LNs Tongue lingual artery (ECA) sides of ant 2/3: Ant 1/3: Lingual nerve (sensory) & tonsillar branch of facial artery lingual veins correspond to submandibular & chorda tympani (Taste) (ECA) the arteries and drain into IJV deep cervical LNs Post 2/3: glossopharyngeal N. (both) ascending pharyngeal artery post 1/3: Deep (ECA) cervical LNs greater palatine vein greater palatine artrey Palate Hard Palate: greater palatine and (→maxillary V.) (maxillary A.) nasopalatine nerves ascending palatine vein Deep cervical lymph ascending palatine artrey Soft Palate: lesser palatine and (→facial V.) nodes (facial A.) glossopharyngeal nerves ascending pharyngeal ascending pharyngeal artery vein PANS (secreto-motor) & Sensory: 2 Parotid gland Auriculotemporal nerve {Inferior salivary Nucleus → tympanic branch of glossopharyngeal N.→ Lesser petrosal nerve parasympathetic preganglionic fibres → otic ganglia → auriculotemporal nerve parasympathetic postganglionic fibres} sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE PANS (secreto-motor): facial nerve Submandibular Sensory: lingual nerve gland {Superior salivary Nucleus → Chorda tympani branch from facial
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Normal Gross and Histologic Features of the Gastrointestinal Tract
NORMAL GROSS AND HISTOLOGIC 1 FEATURES OF THE GASTROINTESTINAL TRACT THE NORMAL ESOPHAGUS left gastric, left phrenic, and left hepatic accessory arteries. Veins in the proximal and mid esopha- Anatomy gus drain into the systemic circulation, whereas Gross Anatomy. The adult esophagus is a the short gastric and left gastric veins of the muscular tube measuring approximately 25 cm portal system drain the distal esophagus. Linear and extending from the lower border of the cri- arrays of large caliber veins are unique to the distal coid cartilage to the gastroesophageal junction. esophagus and can be a helpful clue to the site of It lies posterior to the trachea and left atrium a biopsy when extensive cardiac-type mucosa is in the mediastinum but deviates slightly to the present near the gastroesophageal junction (4). left before descending to the diaphragm, where Lymphatic vessels are present in all layers of the it traverses the hiatus and enters the abdomen. esophagus. They drain to paratracheal and deep The subdiaphragmatic esophagus lies against cervical lymph nodes in the cervical esophagus, the posterior surface of the left hepatic lobe (1). bronchial and posterior mediastinal lymph nodes The International Classification of Diseases in the thoracic esophagus, and left gastric lymph and the American Joint Commission on Cancer nodes in the abdominal esophagus. divide the esophagus into upper, middle, and lower thirds, whereas endoscopists measure distance to points in the esophagus relative to the incisors (2). The esophagus begins 15 cm from the incisors and extends 40 cm from the incisors in the average adult (3). The upper and lower esophageal sphincters represent areas of increased resting tone but lack anatomic landmarks; they are located 15 to 18 cm from the incisors and slightly proximal to the gastroesophageal junction, respectively.
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Board Review for Anatomy
Board Review for Anatomy John A. McNulty, Ph.D. Spring, 2005 . LOYOLA UNIVERSITY CHICAGO Stritch School of Medicine Key Skeletal landmarks • Head - mastoid process, angle of mandible, occipital protuberance • Neck – thyroid cartilage, cricoid cartilage • Thorax - jugular notch, sternal angle, xiphoid process, coracoid process, costal arch • Back - vertebra prominence, scapular spine (acromion), iliac crest • UE – epicondyles, styloid processes, carpal bones. • Pelvis – ant. sup. iliac spine, pubic tubercle • LE – head of fibula, malleoli, tarsal bones Key vertebral levels • C2 - angle of mandible • C4 - thyroid notch • C6 - cricoid cartilage - esophagus, trachea begin • C7 - vertebra prominence • T2 - jugular notch; scapular spine • T4/5 - sternal angle - rib 2 articulates, trachea divides • T9 - xiphisternum • L1/L2 - pancreas; spinal cord ends. • L4 - iliac crest; umbilicus; aorta divides • S1 - sacral promontory Upper limb nerve lesions Recall that any muscle that crosses a joint, acts on that joint. Also recall that muscles innervated by individual nerves within compartments tend to have similar actions. • Long thoracic n. - “winged” scapula. • Upper trunk (C5,C6) - Erb Duchenne - shoulder rotators, musculocutaneous • Lower trunk (C8, T1) - Klumpke’s - ulnar nerve (interossei muscle) • Radial nerve – (Saturday night palsy) - wrist drop • Median nerve (recurrent median) – thenar compartment - thumb • Ulnar nerve - interossei muscles. Lower limb nerve lesions Review actions of the various compartments. • Lumbosacral lesions - usually
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Small & Large Intestine
Small & Large Intestine Gastrointestinal block-Anatomy-Lecture 6,7 Editing file Objectives Color guide : Only in boys slides in Green Only in girls slides in Purple important in Red At the end of the lecture, students should be able to: Notes in Grey ● List the different parts of small intestine. ● Describe the anatomy of duodenum, jejunum & ileum regarding: (the shape, length, site of beginning & termination, peritoneal covering, arterial supply & lymphatic drainage) ● Differentiate between each part of duodenum regarding the length, level & relations. ● Differentiate between the jejunum & ileum regarding the characteristic anatomical features of each of them. ● List the different parts of large intestine. ● List the characteristic features of colon. ● Describe the anatomy of different parts of large intestine regarding: (the surface anatomy, peritoneal covering, relations, arterial & nerve supply) Small intestine The small intestine divided into : Fixed Part (No Mesentery): Free (Movable) Part (With Parts Duodenum* Mesentery): Jejunum & Ileum Shape C-shaped loop coiled tube Length 10 inches 6 meters (20 feet) Transverse Colon separates the Beginning At pyloro-duodenal junction at duodeno-jejunal flexure stomach/liver from the jejunum/ileum Termination At duodeno-jejunal flexure at ileo-ceacal flexure Peritoneal Covering Retroperitoneal mesentery of small intestine Divisions 4 parts --------- Foregut (above bile duct opening in 2nd part )& Midgut Embryological origin Midgut (below bile duct opening in 2nd part) So 2nd part has double
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Digestive System
Naziha Sultan Ahmed, BVMS, MSc Scientific degree (Assis. Prof.), Department of Anatomy College of Veterinary Medicine, University of Mosul, Mosul, Iraq https://orcid.org/0000-0002-2856-8277 https://www.researchgate.net/profile/Naziha_Ahmed Anatomy | Part 18| 2nd year 2019 Digestive System Fixation of the liver (Ligaments of the liver): 1-Lesser omentum: consist of two parts: a/Hepatogastric ligament: connect between hepatic porta and lesser curvature of the stomach . b/Hepatoduodenal ligament: connect between hepatic porta and the cranial part of the duodenum. 2-Coronary ligament: connect between the parietal (diaphragmatic ) surface of liver, with the diaphragm and the caudal vena cava. 3-Falciform ligament: connect between the notch of round ligament in the liver and the sternal part of the diaphragm. 4-Round ligament: the residue (remnants) of the umbilical vein of the fetus. 5-Hepatorenal ligament: connect between the right lobe of liver and the right kidney. 6-Right & left triangular ligaments: connect between the dorsal border of right and left lobes of the liver and the diaphragm . Both ligaments continue medially with the coronary ligament. CouAnatomy | Digestive system | Assis. Prof. Naziha Sultan Ahmed Page | 1 The pancreas: Pancreas has V-shape. It consists of base and two limbs (right & left limbs). *In horse: large pancreas body perforated by portal vein and long left limb, with short right limb (because of large size of cecum in horse ). The horse pancreas has two ducts: 1-Chief pancreatic duct: opens with bile duct at the major duodenal papilla. 2-Accessory pancreatic duct: opens at the minor duodenal papilla. *In dog: pancreas notched by the portal vein.
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