Transcript Alimentary system2

The Alimentary SystemⅡ
张
正
洪
副教授
Yunyang Medical College
Composition
Digestive tube 消化管
• oral
Mouth
cavity
Major salivary glands
• Pharynx
• Esophagus
Duodenum
• Stomach
Liver
• Small intestine Jejunum
Ileum Duodenum
• Large intestine
Digestive glands 消化腺
• Major salivary glands唾液腺
• Liver 肝
Ileum
• Pancreas 胰
Pharynx
Esophagus
Stomach
Pancreas
Large intes
Jejunum
The Stomach 胃
The stomach is a mascular
capsule ,and it is the most
dilated portion of the
alimentary canal,and is
situated between the end
of the esophagus and the
beginning of the small
intestine.
The Stomach 胃
Shape

Two surfaces: anterior and
posterior

Two curvatures两个弯曲
Lesser curvature 胃小弯 :
angular incisure 角切迹
Greater curvature 胃大弯

Two openings
Cardia 贲门
Pylorus 幽门
Fundus of
stomach 胃底
Parts of stomach
Cardiac part 贲门部
Cardiac part
贲门部
Fundus of stomach 胃底
Body of stomach 胃体
Body
of stomach
胃体
Pyloric part 幽门部

Pyloric antrum 幽门
Pyloric canal 幽门管
Pyloric antrum 幽门窦
窦

Pyloric canal 幽门管
Pyloric part 幽门部
Position
－Main
parts is situated
in the left
hypochondriac region,
small in the epigastric
region; the cardia is
situated in the left of T11,
the pylorus lies in the
right of L1
The Small Intestine小肠


It extends from the
pylorus to the ileocecal
orifice,and it is About 57m long.
Duodenum
Be divided into

Duodenum
十二指肠

Jejunum 空肠

Ileum回肠
Ileum
Jejunum
Duodenum十二指肠
It is the shortest,widest
and most fixed part of
the small intestine,and is
about 20-25cm long.
Position and shape
It lies on the posterior
abdominal wall (L1L3) ,and likes a C-shape
which enclose the head of
the pancreas
Four parts

Superior part
Duodenal bulb 十二指肠球

Descending part Longitudinal
fold of duodenum
Major duodenal papilla
十二指肠大乳头


Horizontal part
Ascending part
duodenojejunal flexure
十二指
肠空肠曲
Suspensory muscle of duodenum十
二指肠悬肌 (ligament of Treitz)
Jejunum and ileum 空肠和回肠
The upper 2/5 of
this part of small
intestine is called
jejunum and the
lower 3/5,ileum.
The features of the
jejunum and ileum
Meckel憩室
Large Intestine大肠

It is about 1.5m long, and
it extends from ileum to
anus.

Five parts:





Caecum 盲肠
Vermiform appendix 阑
尾
Colon 结肠
Rectum 直肠
Anal canal 肛管
Three Features on apparence



Colic bands 结肠带
Haustra of colon 结肠袋
Epiploic appendices 肠脂垂
Caecum 盲肠
It is a Blind pouch and the first
part of large intestine.
 Lies in right iliac fossa
 The ileum enters the cecum
obliquely, and partially
invaginates into it, forming the
ileocecal valve－consists of two
folds, probably delays flow of
ileal contents into large
intestine
A opening of appendix

Vermiform appendix 阑尾




Blind worm-like tube
It springs from the
posteromedial wall of the
cecum.
It is about 5-7cm long.
The base of the appendix
lies at the point of
convergence of three colic
bands (used as a guide to
find the appendix during
operation)
Position:
It lies usually in the right
iliac fossa
Surface projection of the
base is at the so-called
McBurney’s point which
is at junction of lateral
and middle thirds of line
joining right anterior
superior iliac spine and
umbilicus
variable in position
Colon 结肠
three characteristics on surface
Four parts
 Ascending colon
right colic flexure
 Transverse colon
left colic flexure
 Descending colon
 Sigmoid colon(Sa3)
Rectum 直肠(10-14cm )
Curvatures
 Sagittal plane
Sacral flexure
Perineal flexure
Coronal plane
 Lower part of rectum
dilated to form ampulla
of rectum 直肠壶腹
 Three transverse folds of
rectum 直肠横襞 (7cm)

Anal canal 肛管(3-4cm)







Anal columns 肛柱
Anal valves 肛瓣
Anal sinuses 肛窦
Dentate line齿状线
Anal pecten 肛梳
White line 白线(Hilton’s line)
Anus 肛门
Anal sphincters 肛门括约肌
Sphincter ani internus肛门内括约肌
Sphincter ani externus 肛门外括约肌
A question for discussion
Mouth

How does the
remainder of food
pass the degestive
canal ?
Pharynx
Esophagus
Stomach
Liver
Pancre
Duodenum
Large in
Ileum
Jejunum
The Liver 肝
The liver is the largest gland
in the body and is
essential to life.
Shape
 Two surfaces
Diaphragmatic surface
膈面
falciform ligament
And coronary lig.镰状韧
带和冠状韧带,bare area
Visceral surface脏面
－has a H-shaped groove
 Left limb of H
Anteriorly: fissure for
ligamentum teres hepatis肝
圆韧带裂
Posteriorly: fissure for
ligamentum venosum 静脉
韧带裂
 Right limb of H
Anteriorly: fossa for
gallbladder 胆囊窝
Posteriorly: sulcus for vena
cava 下腔静脉沟
Cross-bar of H is the porta
hepatic 肝门: traversed by
right and left hepatic ducts,
left and right branches of
proper hepatic artery and
hepatic portal vein, nerves
and lymphatic vessels.
hepatic pedicle 肝蒂
 Four lobes: left, right,
quadrate and caudate lobes
Position:
Most of liver lies in the right hypochondriac
region and epigastric region, less part extends
into the left hypochondriac region
Border and adjacency
Extrahepatic Biliary ducts system
It consists of:


Gall bladder 胆囊
Left and right
hepatic ducts 肝左、
右管


Common hepatic
duct肝总管
Common bile
duct 胆总管
Gallbladder 胆囊
Position :
Four parts:
 Fundus of gallbladder 胆囊底
Surface projection: at the
junction of right
midclavicular line and right
costal arch
 Body of gallbladder 胆囊体
 Neck of gallbladder 胆囊颈
 Cystic duct 胆囊管
Triangle of Calot

Boundaries: the
common hepatic duct
on the left, the cystic
duct on the right, the
visceral surface of
liver, superiorly

Content: cystic artery
Biliary duct system and Drainage of the bile

Right and left hepatic ducts unite
outside of liver to form the
common hepatic duct

Cystic duct joins common hepatic
duct to form common bile duct

Common bile duct and pancreatic
duct usually unite to form the
hepatopancreatic ampulla
The Pancreas 胰
Shape and Position
 Lies behind the peritoneum
on the posterior abdominal
wall, roughly at the level of
of L1~L2
three parts
 Head
Uncinate process
 Body
 Tail－runs in base of
lienorenal ligament to reach
hilum of spleen
Pancreatic duct
 Main Pancreatic duct
Begins at tail and
throughout gland.
Joins common bile duct
before entering
descending part of
duodenum at major
duodenal papilla(Vater
ampulla)
 Accessory pancreatic duct
Opens 2cm above main duct
at lesser duodenal papilla
SUMMARY