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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?
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