The document discusses the duodenum and its blood supply. It is divided into 4 parts, with the first part located superiorly and the fourth part ascending. Each part has specific relations to surrounding structures. The second part of the duodenum contains openings for the bile duct and pancreatic ducts. The duodenum receives its blood supply from the celiac trunk and superior mesenteric artery and drains into the portal vein and superior mesenteric vein.

1. Duodenum
and Celiac
Trunk

2. Posterior
abdominal wall
Anterior
abdominal wall
What is
MESENTERY?
Loop of
intestine

3. 1 2
FIXED (Retro
peritoneal) PART
(NO MESENTERY)
DUODENUM
FREE (MOVABLE)
PART
(WITH MESENTERY)
JEJUNUM & ILEUM

4. DUODENUM

SHAPE: C-shaped loop

LENGTH: 10 inches

BEGINNING: at
pyloro-duodenal
junction

TERMINATION: at
duodeno-jejunal flexure

PERITONEAL
COVERING:
retroperitoneal

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14. Parts
1st part
2nd part
3rd part
4th part

15. Length
3 inch

16. Direction

17. PART LENGTH LEVEL
FIRST
PART
(Superior)
2 INCHES L1
(Transpylor
ic
Plane)
SECOND
PART
(Descendin
g
3 INCHES DESCENDS
FROM L1
TO L3
THIRD
PART
(Horizontal
)
4 INCHES L3
(SUBCOTAL
PLANE)
FOURTH
PART
(Ascending
)
1 INCHES ASCENDS
FROM L3
TO L2

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Duodenum

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20. PARTS
•
The duodenum is
divided into (4) parts:
•
1st : Superior.
•
2nd : Descending
(vertical).
•
3rd : Inferior
(Horizontal)
•
4th : Ascending

22. Structures Related
psoas
pancreas

23. Relations

24. Superior(first) part:
Relations
2. The second inch of the
duodenum:
• Anteriorly:
a. The quadrate lobe of the liver,
b. The neck of the gall bladder
• Posteriorly:
a. The bile duct.
b. The gastroduodenal artery.
c. The portal vein.
d. The inferior vena csva.
• Superiorly: the opening into the
lesser sac.
• Inferiorly: pancreas.

25. Superior(first) part:
Relations
2. The second inch of the
duodenum:
• Anteriorly:
a. The quadrate lobe of the liver,
b. The neck of the gall bladder
• Posteriorly:
a. The bile duct.
b. The gastroduodenal artery.
c. The portal vein.
d. The inferior vena cava.
• Superiorly: the opening into the
lesser sac.
• Inferiorly: pancreas.

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27. RELATIONS OF FIRST PART
X
Anterior
Liver
1)
2)
3)
X
Posterior
1)Bile duct
2) Gastroduodenal art
3)Portal vein

28. Secondpart:
Length: three inches long.
Extent: from the neck of gall
bladder to L3
Direction: descends vertically.
Peritoneal covering:
covered by the peritoneum
only on the anterior surface
except the middle part
where is crossed by
transverse colon.

29. Secondpart:
Relations of the second part:
• Anteriorly:
1. Upper part: right lobe of the liver.
2. The middle part: transverse
colon.
3. Lower part: loops of the jejunum.
• Laterally:
The right colic flexure.
The fat in front of the right kidney.
• Medially:
The head of pancreas
The bile duct
• Posteriorly:
The hilum of right kidney.
The right renal vessels.
The right psoas major muscle.
.

30. Secondpart:
Relations of the second part:
• Anteriorly:
1. Upper part: right lobe of the liver.
2. The middle part: transverse
colon.
3. Lower part: loops of the jejunum.
• Laterally:
The right colic flexure.
The fat in front of the right kidney.
•Medially:
The head of pancreas
The bile duct
• Posteriorly:
The hilum of right kidney.
The right renal vessels.
The right psoas major muscle.
.

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34. RELATIONS OF SECOND PART
X
Anterior
)Liver
)Transverse Colon
)Small intestine
Posterior
Right
kidney
Lateral
R Colic
Flexur
e
Medial
Pancre
as

35. Third part:
Length: four inches
Extent: at the level of the
3rd lumbar vertebra
Direction: horizontal.
Peritoneal covering: is
only covered by
peritoneum anteriorly
and inferiorly except
the site of attachment
of mesentry.

36. Third part:
Length: four inches
Extent: at the level of the
3rd lumbar vertebra.
Direction: lies in a
horizontal plane,
Peritoneal covering: is
only covered by
peritoneum anteriorly
and inferiorly except
the site of attachment
of mesentry.

37. Third part:
Relations of the 3rd part:
• Anteriorly:
1. The root of the mesentery.
2. The coils of jejunum.
• Posteriorly:
1. The right ureter.
2. The right psoas major muscle.
3. The right testicular (or ovarian)
vessels.
4. Inferior vena cava.
5. Abdominal aorta & origin of the
inferior mesenteric artery.
• Superiorly:
The pancrcas.
• Inferiorly:
Coils of the jejunum.

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39. RELATIONS OF THIRD PART

Anterior:
a)Small intestine
b) Superior
mesenteric vessels

Posterior:
1) Right psoas major
2) Inferior vena cava
3) Abdominal aorta
4) Inferior
mesenteric vessels.
1 2 3

40. Fourth part:
Length: one inch long.
Extent: from the level of the
3rd to the level of the 2nd
lumbar vertebrae.
Direction: ascends to end by
forming the duodenojejunal
flexure.
Peritoneal covering: is
covered by the peritoneum
anteriorly and to the left.

41. Fourth part:
Length: one inch long.
Extent: from the leve] of the
3rd to the level of the 2nd
lumbar vertebrae.
Direction: ascends to end by
forming the duodenojejunal
flexure.
Peritoneal covering: is
covered by the peritoneum
anteriorly and to the left.

42. Fourth part:
Length: one inch long.
Extent: from the leve] of the
3rd to the level of the 2nd
lumbar vertebrae.
Direction: ascends to end by
forming the duodenojejunal
flexure.
Peritoneal covering: is
covered by the peritoneum
anteriorly and to the left.

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44. RELATIONS OF FOURTH PART

Anterior:
Small intestine

Posterior:
Left psoas major
psoas

45. OPENINGS IN
SECOND PART OF DUODENUM
.1
Common
opening of bile
duct & main
pancreatic duct:
on summit of
major duodenal
papilla.
.2
Opening of
accessory
pancreatic duct
(one inch
higher): on
summit of minor
duodenal papilla.

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48. Structures opening in the 2nd part of the duodenum

49. Structures opening in the
2nd part of the duodenum
 The bile duct unites with the
pancreatic duct forming a
dilatation called the
hepatopancreatic ampulla
(ampulla of Vater).
 The ampulla opens on an
elevation called the major
duodenal papilla.
 The accessory pancreatic
duct opens one-inch above
the major duodenal papilla,
forming a smaller elevation
called the minor duodenal
papilla.

50. Structures opening in the
2nd part of the duodenum
 The bile duct unites with the
pancreatic duct forming a
dilatation called the
hepatopancreatic ampulla
(ampulla of Vater).
 The ampulla opens on an
elevation called the major
duodenal papilla.
 The accessory pancreatic
duct opens one-inch above
the major duodenal papilla,
forming a smaller elevation
called the minor duodenal
papilla.

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52. Structures opening in the
2nd part of the duodenum

54. Blood Supply & Lymph drainage

Because the duodenum is
derived from both: Foregut &
Midgut,

It has its Arterial Supply from
:

Celiac & Superior mesenteric
arteries.

Venous Drainage to :

Superior mesenteric& Portal
veins.

LYMPHATIC DRAINAGE:
Celiac & Superior mesenteric
lymph nodes.

55. • Blood supply of the duodenum
• The superior pancreaticoduodenal
artery arises from the
gastroduodenal artery
• inferior pacreaticoduodenal artery
originates as the first branch of the
superior mesenteric artery.
• These vessels both lie in the curve
between the duodenum and the head
of the pancreas,

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68. Coeliac Trunk

69. •The primitive gut tube can be
divided into foregut, midgut, and
hindgut regions.
•The foregut is supplied by the
celiac trunk.
•The midgut is supplied by the
superior mesenteric artery .
•The hindgut is supplied by the
inferior mesenteric artery .

70. •The three anterior branches
supply the gastrointestinal
viscera:
•the celiac trunk
•superior mesenteric artey
•inferior mesenteric artery

71. •The celiac
trunk Arises
from the
abdominal
aorta anterior
to the upper
part of vertebra
LI. It divides
into:
•Gastric
•Splenic
•Common
hepatic
arteries

72. • The common hepatic artery divides
into its two terminal branches,
• the hepatic artery proper and divides
into the i.right hepatic artery
ii.left hepatic artery
• gastroduodenal artery:
• right gastro-epiploic(omental
)artery
• superior pancreaticoduodenal artery

73. • The splenic artery takes a tortuous
course to the left along the superior
border of the pancreas .
• The splenic artery gives off
• short gastric arteries
• left gastro-epiploic artery

74. •The left gastric artery :
•The left gastric artery supplies the
lesser curvature of the stomach and
anastomoses with the right gastric
artery.
•eophageal branches (anastomose
with esophageal branches from the
thoracic aorta).

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