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THE DIGESTIVE SYSTEM
BY,
K.SOUNDARARAJAN
K. Soundararajan, SRIHER 1
ORGANS OF THE DIGESTIVE
SYSTEM
K. Soundararajan, SRIHER 2
ORGANS
K. Soundararajan, SRIHER 3
Digestive System
• The digestive system, also known as the
gastrointestinal system, is responsible for the
physical and chemical breakdown of food
• Breakdown is necessary so food can be taken into
bloodstream and used by body cells and tissues
• System consists of alimentary canal and accessory
organs
K. Soundararajan, SRIHER 4
Food Breakdown
• Ingestion
– Taking of food into the body
• Peristalsis
– Physical movement along the tract
• Digestion
– Mechanical and chemical breakdown of food
• Absorption
– Passage of food from digestive tract into body
• Defecation
– Elimination of indigestible substances from body
K. Soundararajan, SRIHER 5
K. Soundararajan, SRIHER 6
Alimentary Canal
• A long, muscular tube that begins at the
mouth and includes the mouth (oral cavity),
pharynx, Oesophagus, stomach, small
intestine, large intestine, and anus
Accessory Organs
• Accessory organs are the salivary glands,
tongue, teeth, liver, gallbladder, and pancreas
K. Soundararajan, SRIHER 7
Basic structure of alimentary
canal
 Four layer of tissue
 Adventitia or
secosa
(peritoneum)
 Muscle layer
 Sub mucosa
 Mucosa lining
K. Soundararajan, SRIHER 8
K. Soundararajan, SRIHER 9
Basic structure of alimentary
canal
 Peritoneum
abdominal wall –parital
organ- visceral
 Muscle layer
circular muscle layer
longitudinal muscle
layer
contraction ,relaxation
movement of bolus by
peristalsis
K. Soundararajan, SRIHER 10
Basic structure of alimentary
canal
 Sub mucosa
collagen, elastic
fibers
 Mucosa
3 layers of tissue
Mucous membrane
protect , secret,
absorb
Lamina propria
protect
muscularis mucosa
Villi, gastric gland K. Soundararajan, SRIHER 11
BASIC STRUCTURE OF
ALIMENTARY CANAL
K. Soundararajan, SRIHER 12
QUADRANTS
K. Soundararajan, SRIHER 13
REGION OF ABDOMINAL
CAVITY
hypochondria
c
lumbar
Iliac fossa
epigastric
umbilical
hypo gastric
K. Soundararajan, SRIHER 14
Time for recap
K. Soundararajan, SRIHER 15
MOUTH
MOUTH
K. Soundararajan, SRIHER 16
MOUTH OR ORAL CAVITY
Boundaries
 Anterior - lips
 Posterior - oropharynx
 Laterally - muscle of cheek
 Superiorly - bony hard palate,
muscular soft palate.
 Inferiorly - muscular tongue ,
soft tissue of floor of
mouth K. Soundararajan, SRIHER 17
Parts of the Alimentary Canal
• The mouth, also called the buccal cavity,
receives food as it enters body
• While food is in mouth, it is
– Tasted
– Broken down physically by teeth
– Lubricated and partially digested by saliva
– And swallowed
K. Soundararajan, SRIHER 18
 Mouth = oral cavity
 Lips- orbicularis
oris muscle
 Cheeks –
buccinators muscle
19
The Mouth
K. Soundararajan, SRIHER
 VESTIBULE
part between cheek &
gum
 PALATE
anterior hard palate
posterior soft palate
 UVULA
curved fold of muscle
hanging from middle
border of soft palate
20
OPEN MOUTH
K. Soundararajan, SRIHER
 ARCHES
anterior fold-
palatoglossal arch
posterior fold-
palatopharyngeal arch
 PALATINE TONSIL
each side of arches
collection of lymphoid
tissue
21
OPEN MOUTH
K. Soundararajan, SRIHER
Parts of the Alimentary Canal
• The hard palate is the bony structure that forms the
roof of the mouth and separates the mouth from the
nasal cavities
• Behind the hard palate is the soft palate, which
separates the mouth from the nasopharynx
• The uvula, a cone-shaped muscular structure, hangs
from the middle of the soft palate and prevents food
from entering the nasopharynx during swallowing
K. Soundararajan, SRIHER 22
Tongue
 Mostly muscles
 Grip and reposition food
 Forms “bolus” of food (lump)
 Help in swallowing
 Speech – help form some consonants
 Taste buds contained by circumvallate and fungiform papillae
 Lingual tonsil – back of tongue
23K. Soundararajan, SRIHER
Tongue
 Voluntary muscular
structure
 Base – hyoid bone
 Floor – frenulum
 Superior surface-
papillae for sense
of taste
K. Soundararajan, SRIHER 24
Tongue
 Blood supply
Artery-
lingual artery (B)- external carotid
artery
Vein-
lingual vein (J)- internal jugular vein
K. Soundararajan, SRIHER 25
Tongue
 Nerve supply
hypoglossal nerve
lingual (B) of mandibular nerve
fasical & glossopharyngeal nerve
 Lymphatic's
drain in to upper deep cervical
retropharyngeal lymph node
K. Soundararajan, SRIHER 26
Teeth
 Called “dentition” (like dentist)
 Teeth live in sockets (alveoli) in the
gum-covered margins of the mandible
and maxilla
 Chewing: raising and lowering the
mandible and moving it from side to
side while tongue positions food
between teeth
27K. Soundararajan, SRIHER
Teeth
Two sets
 Primary or deciduous
 “Baby” teeth
 Start at 6 months
 20 are out by about 2 years
 Fall out between 2-6 years
 Permanent: 32 total
these 32 teeth complete by
21st year
28K. Soundararajan, SRIHER
Teeth
 Incisors
 Canine
 Premolar
 Molar
Cutting
Grinding or chewing
K. Soundararajan, SRIHER 29
Teeth are classified according to
shape and function
 Incisors: chisel-shaped for
chopping off pieces
 Canines: cone shaped to
tear and pierce
 Premolars (bicuspids) and
 Molars - broad crowns
with 4-5 rounded cusps for
grinding
30
incisor
canine
premolar
molar
K. Soundararajan, SRIHER
Tooth structure
 Two main regions
A. Crown (exposed)
B. Root (in socket)
C. Meet at neck
 Enamel
 99% calcium crystals
 Hardest substance in
body
 Dentin – bulk of the
tooth (bone-like but
harder than bone, with
collagen and mineral)
 Pulp cavity with vessels
and nerves
 Root canal: the part of
the pulp in the root 31
A
B
C
K. Soundararajan, SRIHER
Tooth structure
 Cementum – bone
layer of tooth root
 Attaches tooth to
periodontal ligament
 Periodontal ligament
 Anchors tooth in boney
socket of the jaw
 Continuous with gingiva
(gums)
32
A
B
C
K. Soundararajan, SRIHER
Tooth
 Blood supply
Artery-
maxillary artery
Vein-
internal jugular vein
 Nerve supply
upper- maxillary nerve
lower-mandibular nerve
Trigeminal
nerve
K. Soundararajan, SRIHER 33
SALIVARY GLANDS
K. Soundararajan, SRIHER 34
Parts of the Alimentary Canal
• Three pairs of salivary glands
– Parotid (cheek/jaw)
– Sublingual (beneath tongue)
– Submandibular (chin/neck)
• They produce a liquid called saliva
• Saliva lubricates mouth during speech and chewing and
moistens food so it can be swallowed easily
• Also contains enzyme called salivary amylase
• Salivary amylase begins chemical breakdown of
complex carbohydrates, or starches, into sugars that
can be taken into the body
K. Soundararajan, SRIHER 35
K. Soundararajan, SRIHER 36
The Salivary Glands
 Produce saliva
 Compound tubuloalveolar glands
 Parotid glands
 Parotid duct – parallel to zygomatic arch
 Contains only serous cells
 Submandibular glands
 Lies along medial surface of mandible
 Sublingual glands
 Lies in floor of oral cavity
 Contains primarily mucous cells
K. Soundararajan, SRIHER 37
Salivary glands
(tuboalveolar glands)
 Intrinsic salivary glands
 Secrete saliva all the time
to keep mouth moist
 Extrinsic salivary glands
 Paired (2 each)
 Parotid
 Submandibular
 Sublingual
 External to mouth
 Ducts to mouth
 Secrete saliva only right
before or during eating
38
Saliva: mixture of water, ions, mucus, enzymes
keep mouth moist
dissolves food so can be tasted
moistens food
starts enzymatic digestion
buffers acid
antibacterial and antiviral K. Soundararajan, SRIHER
Extrinsic salivary glands
 Parotids* - largest (think
mumps)
each side of face just
below external acoustic
meatus ends 2 upper
molar tooth
 Submandibular # - medial
surface mandible
Each side of face under
angle of jaw
 Sublingual + - under
tongue; floor of mouth
Floor of mouth end infront
of sub mandibular gland 39
*
#
K. Soundararajan, SRIHER
Salivary gland
 Blood supply
Artery-
external carotid artery
Vein-
external jugular vein
 Lymphatic's
submental node
submandibular node
deep cervical node
K. Soundararajan, SRIHER 40
Parts of the Alimentary Canal
• The teeth are special structures in mouth that
physically break down food by chewing and
grinding
• Process is called mastication
• The tongue is a muscular organ that contains
special receptors, called taste buds
• Taste buds allow a person to taste sweet, salt,
sour, and bitter sensations
• The tongue also aids in chewing and swallowing
foods
K. Soundararajan, SRIHER 41
Brother!
Answer me,
Please !!
K. Soundararajan, SRIHER 42
SECTION OF HEAD & NECK
K. Soundararajan, SRIHER 43
MUSCLE ATTACHMENTS
K. Soundararajan, SRIHER 44
PHARYNX
PHARYNX
K. Soundararajan, SRIHER 45
Pharynx
 Length - 12cm
Width - 3.5 cm
It is wide muscular
tube situated behind
nose, mouth, larynx.
3 layer of tissue
 Mucosa
(lining membrane )
 Middle layer
 Outer layer
( involuntary muscle)
K. Soundararajan, SRIHER 46
Pharynx
Three parts
• Nasopharynx
air ( nasal part )
• Oropharynx
air & food
( oral part )
• Laryngopharynx
food ( laryngeal
part )
K. Soundararajan, SRIHER 47
Pharynx
Boundaries
 Anterior - nasal, oral cavity, larynx,
anterior wall incomplete
 Posterior - pharynx glides freely on
pre vertebral fascia
 Superiorly - base of skull, occipital
bone,
pharyngeal tubercle
 Inferiorly - lower border of critoid
cartilage
K. Soundararajan, SRIHER 48
K. Soundararajan, SRIHER 49
Pharynx
 Blood supply
Artery-
several branches of fascial
arteries
Vein-
facial vein,
internal jugular vein.
• Nerve supply
Para- glossopharyngeal ,
vagus nerve
sym- cervical ganglia,
lesser palatine nerve
• Lymphatic's
jugulodigastric node
50
___oropharynx
___laryngophary
nx
*
*
*
K. Soundararajan, SRIHER
OSEOPHAGUS
OESOPHAGUS
K. Soundararajan, SRIHER 51
Oesophagus
Narrow muscular tube
It is collapsible tube
Length – 25cm
Width – 2 cm
Extend :
 Lies median plane in thorax in
front of vertebral column
behind trachea, heart
 Below diaphragm join
stomach
Greater part – thorax
Lesser part - abdomen
52K. Soundararajan, SRIHER
Oesophagus
 Sphincters
1. Pharyngeal (or)
upper
oesophageal
sphincter -
prevent air
passage
2. Cardiac (or) lower
oesophageal
sphincter -
prevent reflux of K. Soundararajan, SRIHER 53
Contains all 4
layers (see right)
 Epithelium: non keratinized stratified squamous epithelium
 Mucus glands in wall
 Muscle (muscularis externa) changes as it goes down
 Superior 1/3 of esophagus: skeletal muscle (like pharynx)
 Middle 1/3 mixture of skeletal and smooth muscle
 Inferior 1/3 smooth muscle (as in stomach and intestines)
 When empty, mucosa and submucosa lie in longitudinal folds
54
Microscopic anatomy of Oesophagus
K. Soundararajan, SRIHER
55
Oesophagus histology
K. Soundararajan, SRIHER
Oesophagus
 Blood supply
Artery
Thoracic - oesophageal artery (B) of
thoracic artery
Abdominal – inferior phrenic artery,
left gastric artery (B) of
coeliac artery
K. Soundararajan, SRIHER 56
Oesophagus
 Blood supply
Vein
Thoracic – azygos, hemiazygos vein
Abdominal – left gastric vein
• Nerve supply
anterior & posterior gastric nerve
• Lymphatic's
arteries into left gastric node
K. Soundararajan, SRIHER 57
K. Soundararajan, SRIHER 58
Abdomen part
K. Soundararajan, SRIHER 59
STOMACH
STOMACH
K. Soundararajan, SRIHER 60
Stomach
K. Soundararajan, SRIHER 61
Stomach
 It is a J- shaped dilated portion of
alimentary tract
 Location:
epigastric , umbilical,
left hypochondriac
 Size – 25 cm long
 Capacity
birth – 30 ml
puberty – 1 liter
adult – 1.5 to 2 liter
K. Soundararajan, SRIHER 62
Relations of Stomach
K. Soundararajan, SRIHER 63
Stomach Relations
 Anterior - left lobe of liver, anterior
abdominal wall, coastal cartilage
 Posterior - abdominal aorta, pancreas,
left kidney, adrenal gland,
spleen
 Superior - diaphragm, oesophagus,
left lobe of kidney
 Inferior – tranverse colon,
small intestine
 Left side - diaphragm, spleen
 Right side - liver , duodenum
K. Soundararajan, SRIHER 64
Stomach Regions
Parts
 Cardiac
fundus
body
 Pyloric
pyloric antrum (7.5
cm)
pyloric canal (2.5 cm)
65
dome
K. Soundararajan, SRIHER
Stomach Region
 Surface
1. anterior or
anterio-superior
(forward, upward)
2. Posterior or
posterio-inferior
(backward,
downward )
K. Soundararajan, SRIHER 66
Stomach Region
Sphincter
 Cardiac sphincter
(oesophagus)
 Pyloric sphincter
(duodenum)
curvature shape omentum border notch
Lesser Concave Lesser Right
( below)
Angular
Greater Convex Greater Left
(above)
cardiac
K. Soundararajan, SRIHER 67
Shape of stomach
 Shape – pyriform
 Obese person-
horizontal
 Radio graphic
examination of
stomach after
barium meal gives
shape clearly
K. Soundararajan, SRIHER 68
Interior of stomach
 It has longitudinal
folds and
irregular in shape
 Gastric canal
near lesser
curvature
swallow liquid
 Stomach bed is
separate from
stomach by
lesser sac
K. Soundararajan, SRIHER 69
 Rugae: longitudinal folds on internal surface
(helps distensibility)
 Muscularis: additional innermost oblique layer
(along with circular and longitudinal layers)
70K. Soundararajan, SRIHER
Layers of stomach
Muscle coat
1. Longitudinal
(outer layer)
2. Inner circular
(middle layer)
3. Deep oblique
(inner layer)
K. Soundararajan, SRIHER 71
Histology of
stomach
72
 Simple columnar
epithelium:
 secrete
bicarbonate-
buffered mucus
 Gastric pits
opening into
gastric glands
K. Soundararajan, SRIHER
Blood supply - artery
 Lesser curvature
left gastric artery (B) –
coeliac trunk
right gastric artery (B)-
proper hepatic artery
 Greater curvature
right gastro epiploic
artery(B)- gastroduodenal
artery
left gastro epiploic artery(B)-
spleenic artery
 Fundus
5 to 7 short gastric arteries
K. Soundararajan, SRIHER 73
Blood supply - vein
 Portal vein
 Right & left gastric
vein
 Right & left gastro
epiploic vein
 Superior & inferior
mescentric vein
 Short gastric vein
 Splenic vein
K. Soundararajan, SRIHER 74
Lymphatic's
 Right & left gastric
node
 Right & left gastro
epiploic node
 Short gastric node
 Coeliac node
 Hepatic node
 Pyloric node
 Pancreatic splenic
node
K. Soundararajan, SRIHER 75
Nerve supply
 Sympathetic-
T6 to10
via greater
splanchnic nerve,
coeliac & hepatic
plexus , vasomotor
 Parasympathetic-
vagus esophageal
plexus
K. Soundararajan, SRIHER 76
Histology of stomach K. Soundararajan, SRIHER 77
K. Soundararajan, SRIHER 78
SMALL INTESTINE
SMALL
INTESTINE
K. Soundararajan, SRIHER 79
Small intestine
 It continuous with
the stomach at
pyloric sphincter
 It is longest of
alimentary canal
 Greater part of
digestion &
absorption take
place here.
K. Soundararajan, SRIHER 80
Small intestine
 It is divided in to
three region
i. Duodenum
ii. Jejunum
iii. Ileum
K. Soundararajan, SRIHER 81
Duodenum
 It is shortest , widest & most fixed part
 Extend
From - pylorus
To – duodenojejunal flexure
 Length- 25cm
It is ‘c’ shaped , receives opening of
bile & pancreatic duct
 Location
epigastric , umbilical
K. Soundararajan, SRIHER 82
Parts of duodenum
 It is divided into four
parts
1. First or superior
2. Second or
descending
3. Third or horizontal
4. Fourth or ascending
K. Soundararajan, SRIHER 83
First or superior part of
duodenum
 Begin – pylorus
 End – superior duodenal flexure
Relation
Anterior – quadrate lobe of liver, gall
bladder
Posterior – gastro duodenal artery, bile
duct,
portal vein
Superior – epiploic foramen
Inferior – head and neck of pancrease
K. Soundararajan, SRIHER 84
Second or descending part
 Begin – superior duodenal flexure
 End – inferior duodenal flexure
Relation
Anterior – right lobe of liver, transverse of
colon,
root of mesocolon, small intestine
Posterior – anterior surface of right
kidney(medial
border), right renal vessel, right
edge
of inferior venacava, right psoas
K. Soundararajan, SRIHER 85
Third or horizontal part
 Begin – inferior duodenal flexure
 End – front of abdominal aorta, lower margin
of head of pancreas
Relation
Anterior – superior mesenteric vessel,
root of mesentry
Posterior –right ureter, right psoas major, right
testicular or ovarian vessel, inferior
venacava, abdominal aorta
Superior – head of pancreas
Inferior – coil of jejunum
K. Soundararajan, SRIHER 86
Fourth or ascending part
 Begin – upper border of 2 lumbar
vertebra
 End – duodenojejunal flexure at jejunum
Relation
Anterior – transverse colon, transverse
mesocolon, lesser sac, stomach.
Posterior –left renal artery, left gonadal
artery,
inferior mesentric vein, left
sympathetic vein
Superior – body of pancrease
K. Soundararajan, SRIHER 87
Blood supply
 Artery
Upper half
Superior pancreaticoduodeal artery (B)
gastroduodenal artery
Lower half
Inferior pancreaticoduodenal artery (B)
superior mesenteric artery
 Vein
Superior pancreaticoduodeal vein drains
into
portal vein , inferior vein, joins mesenteric
vein
K. Soundararajan, SRIHER 88
Artery supply for duodenum
K. Soundararajan, SRIHER 89
Duodenum
 Lymphatic's
pancreaticoduodenal nodes to gastro
duodenal nodes
celiac nodes
superior mesenteric nodes
 Nerve supply
sympathetic & parasympathetic vagus
nerve from celiac & superior
mesenteric plexus
K. Soundararajan, SRIHER 90
Jejunum and Ileum
 The coil are freely mobile & attached
to posterior abdominal wall by fan-
shaped peritoneum
Begin – duodenojejunal flexure
End – ileoceral junction
K. Soundararajan, SRIHER 91
Jejunum and Ileum
K. Soundararajan, SRIHER 92
Jejunum and Ileum
Feature Jejunum Ileum
Location Occupies upper left
Part of intestinal area
Occupies lower right
Part of intestinal area
Wall Thicker more vascular Thinner less vascular
villi Large , thick ( leaf –
like)
More abundant
Large , thick ( leaf –
like)
More abundant
K. Soundararajan, SRIHER 93
Difference between
Jejunum
• Larger diameter
• Thickening wall
• Prominent fold
• 1-2 vascular
archade
• Long vasa recta
• Fat free
mesentery
Ileum
• Smaller
diameter
• Thinner wall
• Flat and few
• 4-5 vascular
archades
• Short vasa recta
• Abundant
mesenteric fat
K. Soundararajan, SRIHER 94
Blood supply
 Arteries
branch of superior
mesenteric artery ,
lower part of ileum
by ileocolic artery
 Vein
superior
mesenteric node
jejunum
ileumK. Soundararajan, SRIHER 95
Jejunum and ileum
 Lymphatic’s
intermediate mesenteric node,
superior mesenteric node
 Nerve
vagus nerve from superior mesenteric
plexus
sympathetic – T9 – T11 segment
parasympathetic- vagus
K. Soundararajan, SRIHER 96
LARGE INTESTINE
LARGE
INTESTINE
K. Soundararajan, SRIHER 97
LARGE INTESTINE
K. Soundararajan, SRIHER 98
Large intestine
 It is about 1.5 m in
long
 Extend
begin – caecum
end – anal canal
K. Soundararajan, SRIHER 99
Large intestine
 It divides into many
parts
 Caecum,
 Ascending colon,
 Transverse colon,
 Descending colon,
 Sigmoid colon,
 Rectum ,
 Anal canal
K. Soundararajan, SRIHER 100
Caecum
 It is large blind sac
forming large
intestine
 Long – 6 cm
 Relation
anterior :
coil of intestine,
anterior wall of
abdominal wall
posterior :
right psoas, iliacus
medially:
appendix
caecum
K. Soundararajan, SRIHER 101
Caecum
 Blood supply
 Artery
branch of ileocolic artery
 Vein
superior mesenteric vein
 Lymphatic’s
several mescentric
nodes
 Nerve
vagus nerve - superior
mesenteric plexus
K. Soundararajan, SRIHER 102
Appendix
K. Soundararajan, SRIHER 103
Vermiform Appendix
 It is a vestibular
organ
 It is narrow ,
muscular contain
large amount of
lymphoid tissue
 It base attached to
posterio medial
surface of caecum
below ileoceal
junction
appendix
K. Soundararajan, SRIHER 104
Vermiform Appendix
 Blood supply
Artery
appendicular artery (B) posterior cecal artery
Vein
appendicular vein drain in to posterior cecal vein
 Lymphatic’s
superior mesenteric node
 Nerve
vagus nerve - superior mesenteric plexus
K. Soundararajan, SRIHER 105
Large intestine – ascending
colon
 Length – 13cm
 Location – right lower
quadrant
 From
caecum
 To
inferior surface of right
lobe of liver , right colic
flexure
Sigmoid
colon
K. Soundararajan, SRIHER 106
Relation of ascending colon
 Anterior
coil of intestine,
greater omentum,
anterior abdominal wall.
 Posterior
iliacus, iliac crest,
quadratus lumbrum,
lower pole of kidney
K. Soundararajan, SRIHER 107
Ascending colon
 Blood supply
Artery
ileocolic & right colic (B) of superior
mesenteric artery
Vein
superior mesenteric vein
 Lymphatic’s
superior mesenteric node
 Nerve
superior mesenteric plexus ( vagus )
K. Soundararajan, SRIHER 108
Large intestine – transverse
colon
 Length – 38cm
 Location – right &
left upper quadrant
 From
right colic flexure
 To
left colic flexure
Sigmoid
colon
K. Soundararajan, SRIHER 109
Relation of transverse colon
 Anterior
greater omentum,
anterior abdominal wall.
 Posterior
second part of duodenum,
head of pancrease,
coil of jejunum ,
coil of ileum.
K. Soundararajan, SRIHER 110
Transverse colon
 Blood supply
Artery
Proximal two third:
middle colic artery (B) superior mesenteric arter
Distal third:
left colic artery (B) inferior mesenteric artery
Vein
the vein correspond to arteries drains in to
superior & inferior mesenteric vein
K. Soundararajan, SRIHER 111
Transverse colon
 Lymphatic’s
colic node, superior & inferior
mesenteric node
 Nerve
Proximal two third:
Vagus nerve -superior mesenteric
plexus
Distal third:
Pelvic splanchnic nerve-inferior
mesenteric plexus
K. Soundararajan, SRIHER 112
Large intestine- descending
colon
 Length – 25cm
 Location – left upper
& lower quadrant
 From
left colic flexure
 To
sigmoid colon
Sigmoid
colon
K. Soundararajan, SRIHER 113
Relation of descending colon
 Anterior
coil of small intestine
greater omentum,
anterior abdominal wall.
 Posterior
left kidney (lateral border), transversus
abdominus, quadratus lumborum, iliac
crest, left psoas, iliacus, iliohypogastric
nerve, ilioinguninal nerve, femoral
nerve.
K. Soundararajan, SRIHER 114
Descending colon
 Blood supply
Artery
left colic sigmoid (B) of inferior
mesenteric artery
Vein
inferior mesenteric vein
 Lymphatic’s
inferior mesenteric node
 Nerve
inferior mesenteric nerve , pelvic
splanchnic nerve
K. Soundararajan, SRIHER 115
Large intestine – sigmoid
colon
 Length – 25 to 38cm
 Location – left lower
quadrant
 From
in front pelvic brim
 To
rectum
Sigmoid
colon
K. Soundararajan, SRIHER 116
Relation of sigmoid colon
 Anterior
Male – urinary bladder
Female – posterior surface of uterus,
upper part of vagina
 Posterior
rectum & sacrum
lower coil of terminal part of ileum
K. Soundararajan, SRIHER 117
Sigmoid colon
 Blood supply
Artery
inferior mesenteric artery
Vein
inferior mesenteric vein joins portal
venous system
 Lymphatic’s
inferior mesenteric node
 Nerve
inferior hypo gastric plexuses.
K. Soundararajan, SRIHER 118
LARGE INTESTINE
K. Soundararajan, SRIHER 119
Rectum
 Length – 13 cm
 Location
posterior part of lesser
pelvic, in front of
sacrum coccyx (lower
3 pieces)
 Extend
 From
continuation of
sigmoid colon
 To
anal canal at
anorectal junction
K. Soundararajan, SRIHER 120
Curvatures of rectum
K. Soundararajan, SRIHER 121
Relation of rectum
 Posterior
sacrum, coccyx, coccyges, piriformis, levatores
ani, sacral plexus.
 Anterior
 Male
upper two-third – rectovesical pouch with coil of
intestine, sigmoid colon.
lower one-third – urinary bladder base, ureter
terminal, seminal vesicles, deferent ducts,
prostate
 Female
upper two-third – rectovesical pouch with coil of
intestine, sigmoid colon separates from ureter ,
upper part of vagina K. Soundararajan, SRIHER 122
Mucosal folds
K. Soundararajan, SRIHER 123
Rectum
 Blood supply
 Arteries
superior, middle, inferior rectal artery
 Vein
superior, middle, inferior rectal vein
 Nerve
inferior hypogastric plexuses
 Lymphatic’s
pararectal nodes , inferior mesenteric
node,
internal iliac nodes K. Soundararajan, SRIHER 124
Anal canal
 Length – 3.8 cm
 Location-
below the level of
pelvic diaphragm
 Extend
 From
rectal ampulla
 To
anus
K. Soundararajan, SRIHER 125
Relations
 Anterior
Male - membranous urethra, bulb of
penis
Female - lower end of vagina
Both sexes- perineal body
 Posterior
anococcygeal ligament, tip of coccyx
 Laterally
ischioanal fossae
K. Soundararajan, SRIHER 126
Anal canal
 Blood supply
 Arteries
superior & inferior rectal artery
 Vein
superior & inferior rectal vein, internal pudendal
vein
 Lymphatic’s
superior & inferior rectal node, superficial
inguinal nodes
 Nerve
inferior hypogastric plexuses, inferior rectal nerve,
pudendal nerve, perinal branch of 4 th sacral nerve
K. Soundararajan, SRIHER 127
Rectum & Anal canal
K. Soundararajan, SRIHER 128
Lymph drainage of rectum & anal
canal
K. Soundararajan, SRIHER 129
K. Soundararajan, SRIHER 130
K. Soundararajan, SRIHER 131
Accessory organs
K. Soundararajan, SRIHER 132
LIVER
LIVER
K. Soundararajan, SRIHER 133
LIVER
K. Soundararajan, SRIHER 134
Liver
 It is largest gland
 Weight- 1 & 2.3 kg
 Location-
right & left hypogastric ,
epigastric region
K. Soundararajan, SRIHER 135
ANTERIOR
K. Soundararajan, SRIHER 136
Liver
–liver is the largest solid organ in
the body, located in the upper right
abdominal cavity.
–An accessory organ of digestion
that contributes to, but is not
physically involved in, the process
of digestion.
–Liver cells (hepatocytes)
continuously produce bile, aK. Soundararajan, SRIHER 137
POSTERIOR
K. Soundararajan, SRIHER 138
Liver
–Bile produced by the liver flows
through the hepatic ducts, through
the common hepatic duct, and then
into either the cystic duct to the
gallbladder or the common bile
duct.
–All of the ducts that carry bile are
collectively known as the biliary
tree.
K. Soundararajan, SRIHER 139
POSTERIOR SURFACE
K. Soundararajan, SRIHER 140
Relations
 Anterior & superior
diaphragm , anterior wall of abdominal wall
 Inferior ,
stomach, bile duct, duodenum, hepatic
flexure of colon , right kidney , adernal
gland
 Posterior
oesophagus, inferior vena cava, aorta, gall
bladder, diaphragm, vertebral column.
 Laterally
lower ribs, diaphargm
K. Soundararajan, SRIHER 141
Liver
 Blood supply
Artery
hepatic artery
Vein
portal vein, inferior venacava
 Lymphatic’s
hepatic, paracardial, coeliac node
 Nerve
vagal nerve
K. Soundararajan, SRIHER 142
GALL BLADDER
GALL BLADDER
K. Soundararajan, SRIHER 143
Gallbladder
– An accessory organ of digestion posterior to
the liver.
– Concentrates and stores bile from the liver.
– The presence of fatty chyme in the duodenum
causes the gallbladder to contract, sending bile
into the common bile duct and duodenum to
digest fats.
– It is pear shaped sac
– It is divided into fundus , body , neck
– It is covered by peritoneum
K. Soundararajan, SRIHER 144
Gallbladder
 Relations
 Anterior
anterior abdominal
wall, inferior
surface of liver
 Posterior
transverse colon,
first , second part
of duodenum
K. Soundararajan, SRIHER 145
Gallbladder
 Blood supply
cystic artery,
cystic vein
 Lymphatic’s
cystic lymph
node
 Nerve
celiac plexus
(vagus)
K. Soundararajan, SRIHER 146
PANCREAS
PANCREAS
K. Soundararajan, SRIHER 147
PANCREAS
It is pale green gland
Weight – 60 grams
Length – 12 to 15 cm
Location –
epigastric , left hypo gastric
region.
K. Soundararajan, SRIHER 148
PANCREASE
K. Soundararajan, SRIHER 149
Pancreas
–An accessory organ of digestion
posterior to the stomach.
–Presence of food in the duodenum
causes the pancreas to secrete
digestive enzymes into the
pancreatic duct to the duodenum.
–Also functions as an organ of the
endocrine system.
K. Soundararajan, SRIHER 150
PANCREASE
K. Soundararajan, SRIHER 151
Relations
 Anterior
right to left
transverse of colon , lesser sac, stomach
 Posterior
right to left
left kidney, hilum of spleen, left
suprarenal gland, left psoas , superior
mesenteric artery, aorta, inferior
venacava, portal & splenic vein, bile duct
K. Soundararajan, SRIHER 152
Blood supply
 Artery
splenic artery
superior pancreatico
duodenal artery
inferior pancreatico
duodenal artery
K. Soundararajan, SRIHER 153
Blood supply
 Vein
splenic vein
superior pancreatico
duodenal vein
inferior pancreatico
duodenal vein
portal vein
K. Soundararajan, SRIHER 154
pancreas
 Lymphatic’s
celiac node
superior mesenteric node
 Nerve
vagal nerve
K. Soundararajan, SRIHER 155
Spleen
K. Soundararajan, SRIHER 156
Spleen
 It is reddish &
largest single mass
of lymphoid tissue
 It act as filter of
blood
 It is wedged in
fundus of stomach,
diaphragm
 Location
left hypogastric ,
epigastric
K. Soundararajan, SRIHER 157
Relations
 Anterior
stomach, tail of pancreas, left colic
flexure
left kidney along medial border
 Posterior
diaphragm, left pleura, left lungs , 9th to
11th ribs
K. Soundararajan, SRIHER 158
Spleen
 Blood supply
 Artery
splenic artery, celiac artery
 Vein
splenic vein, superior mesenteric vein,
portal vein
 Lymphatic’s
celiac nodes
 Nerve
celiac plexus
K. Soundararajan, SRIHER 159
K. Soundararajan, SRIHER 160

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Digestive system seminar

  • 2. ORGANS OF THE DIGESTIVE SYSTEM K. Soundararajan, SRIHER 2
  • 4. Digestive System • The digestive system, also known as the gastrointestinal system, is responsible for the physical and chemical breakdown of food • Breakdown is necessary so food can be taken into bloodstream and used by body cells and tissues • System consists of alimentary canal and accessory organs K. Soundararajan, SRIHER 4
  • 5. Food Breakdown • Ingestion – Taking of food into the body • Peristalsis – Physical movement along the tract • Digestion – Mechanical and chemical breakdown of food • Absorption – Passage of food from digestive tract into body • Defecation – Elimination of indigestible substances from body K. Soundararajan, SRIHER 5
  • 7. Alimentary Canal • A long, muscular tube that begins at the mouth and includes the mouth (oral cavity), pharynx, Oesophagus, stomach, small intestine, large intestine, and anus Accessory Organs • Accessory organs are the salivary glands, tongue, teeth, liver, gallbladder, and pancreas K. Soundararajan, SRIHER 7
  • 8. Basic structure of alimentary canal  Four layer of tissue  Adventitia or secosa (peritoneum)  Muscle layer  Sub mucosa  Mucosa lining K. Soundararajan, SRIHER 8
  • 10. Basic structure of alimentary canal  Peritoneum abdominal wall –parital organ- visceral  Muscle layer circular muscle layer longitudinal muscle layer contraction ,relaxation movement of bolus by peristalsis K. Soundararajan, SRIHER 10
  • 11. Basic structure of alimentary canal  Sub mucosa collagen, elastic fibers  Mucosa 3 layers of tissue Mucous membrane protect , secret, absorb Lamina propria protect muscularis mucosa Villi, gastric gland K. Soundararajan, SRIHER 11
  • 12. BASIC STRUCTURE OF ALIMENTARY CANAL K. Soundararajan, SRIHER 12
  • 14. REGION OF ABDOMINAL CAVITY hypochondria c lumbar Iliac fossa epigastric umbilical hypo gastric K. Soundararajan, SRIHER 14
  • 15. Time for recap K. Soundararajan, SRIHER 15
  • 17. MOUTH OR ORAL CAVITY Boundaries  Anterior - lips  Posterior - oropharynx  Laterally - muscle of cheek  Superiorly - bony hard palate, muscular soft palate.  Inferiorly - muscular tongue , soft tissue of floor of mouth K. Soundararajan, SRIHER 17
  • 18. Parts of the Alimentary Canal • The mouth, also called the buccal cavity, receives food as it enters body • While food is in mouth, it is – Tasted – Broken down physically by teeth – Lubricated and partially digested by saliva – And swallowed K. Soundararajan, SRIHER 18
  • 19.  Mouth = oral cavity  Lips- orbicularis oris muscle  Cheeks – buccinators muscle 19 The Mouth K. Soundararajan, SRIHER
  • 20.  VESTIBULE part between cheek & gum  PALATE anterior hard palate posterior soft palate  UVULA curved fold of muscle hanging from middle border of soft palate 20 OPEN MOUTH K. Soundararajan, SRIHER
  • 21.  ARCHES anterior fold- palatoglossal arch posterior fold- palatopharyngeal arch  PALATINE TONSIL each side of arches collection of lymphoid tissue 21 OPEN MOUTH K. Soundararajan, SRIHER
  • 22. Parts of the Alimentary Canal • The hard palate is the bony structure that forms the roof of the mouth and separates the mouth from the nasal cavities • Behind the hard palate is the soft palate, which separates the mouth from the nasopharynx • The uvula, a cone-shaped muscular structure, hangs from the middle of the soft palate and prevents food from entering the nasopharynx during swallowing K. Soundararajan, SRIHER 22
  • 23. Tongue  Mostly muscles  Grip and reposition food  Forms “bolus” of food (lump)  Help in swallowing  Speech – help form some consonants  Taste buds contained by circumvallate and fungiform papillae  Lingual tonsil – back of tongue 23K. Soundararajan, SRIHER
  • 24. Tongue  Voluntary muscular structure  Base – hyoid bone  Floor – frenulum  Superior surface- papillae for sense of taste K. Soundararajan, SRIHER 24
  • 25. Tongue  Blood supply Artery- lingual artery (B)- external carotid artery Vein- lingual vein (J)- internal jugular vein K. Soundararajan, SRIHER 25
  • 26. Tongue  Nerve supply hypoglossal nerve lingual (B) of mandibular nerve fasical & glossopharyngeal nerve  Lymphatic's drain in to upper deep cervical retropharyngeal lymph node K. Soundararajan, SRIHER 26
  • 27. Teeth  Called “dentition” (like dentist)  Teeth live in sockets (alveoli) in the gum-covered margins of the mandible and maxilla  Chewing: raising and lowering the mandible and moving it from side to side while tongue positions food between teeth 27K. Soundararajan, SRIHER
  • 28. Teeth Two sets  Primary or deciduous  “Baby” teeth  Start at 6 months  20 are out by about 2 years  Fall out between 2-6 years  Permanent: 32 total these 32 teeth complete by 21st year 28K. Soundararajan, SRIHER
  • 29. Teeth  Incisors  Canine  Premolar  Molar Cutting Grinding or chewing K. Soundararajan, SRIHER 29
  • 30. Teeth are classified according to shape and function  Incisors: chisel-shaped for chopping off pieces  Canines: cone shaped to tear and pierce  Premolars (bicuspids) and  Molars - broad crowns with 4-5 rounded cusps for grinding 30 incisor canine premolar molar K. Soundararajan, SRIHER
  • 31. Tooth structure  Two main regions A. Crown (exposed) B. Root (in socket) C. Meet at neck  Enamel  99% calcium crystals  Hardest substance in body  Dentin – bulk of the tooth (bone-like but harder than bone, with collagen and mineral)  Pulp cavity with vessels and nerves  Root canal: the part of the pulp in the root 31 A B C K. Soundararajan, SRIHER
  • 32. Tooth structure  Cementum – bone layer of tooth root  Attaches tooth to periodontal ligament  Periodontal ligament  Anchors tooth in boney socket of the jaw  Continuous with gingiva (gums) 32 A B C K. Soundararajan, SRIHER
  • 33. Tooth  Blood supply Artery- maxillary artery Vein- internal jugular vein  Nerve supply upper- maxillary nerve lower-mandibular nerve Trigeminal nerve K. Soundararajan, SRIHER 33
  • 35. Parts of the Alimentary Canal • Three pairs of salivary glands – Parotid (cheek/jaw) – Sublingual (beneath tongue) – Submandibular (chin/neck) • They produce a liquid called saliva • Saliva lubricates mouth during speech and chewing and moistens food so it can be swallowed easily • Also contains enzyme called salivary amylase • Salivary amylase begins chemical breakdown of complex carbohydrates, or starches, into sugars that can be taken into the body K. Soundararajan, SRIHER 35
  • 37. The Salivary Glands  Produce saliva  Compound tubuloalveolar glands  Parotid glands  Parotid duct – parallel to zygomatic arch  Contains only serous cells  Submandibular glands  Lies along medial surface of mandible  Sublingual glands  Lies in floor of oral cavity  Contains primarily mucous cells K. Soundararajan, SRIHER 37
  • 38. Salivary glands (tuboalveolar glands)  Intrinsic salivary glands  Secrete saliva all the time to keep mouth moist  Extrinsic salivary glands  Paired (2 each)  Parotid  Submandibular  Sublingual  External to mouth  Ducts to mouth  Secrete saliva only right before or during eating 38 Saliva: mixture of water, ions, mucus, enzymes keep mouth moist dissolves food so can be tasted moistens food starts enzymatic digestion buffers acid antibacterial and antiviral K. Soundararajan, SRIHER
  • 39. Extrinsic salivary glands  Parotids* - largest (think mumps) each side of face just below external acoustic meatus ends 2 upper molar tooth  Submandibular # - medial surface mandible Each side of face under angle of jaw  Sublingual + - under tongue; floor of mouth Floor of mouth end infront of sub mandibular gland 39 * # K. Soundararajan, SRIHER
  • 40. Salivary gland  Blood supply Artery- external carotid artery Vein- external jugular vein  Lymphatic's submental node submandibular node deep cervical node K. Soundararajan, SRIHER 40
  • 41. Parts of the Alimentary Canal • The teeth are special structures in mouth that physically break down food by chewing and grinding • Process is called mastication • The tongue is a muscular organ that contains special receptors, called taste buds • Taste buds allow a person to taste sweet, salt, sour, and bitter sensations • The tongue also aids in chewing and swallowing foods K. Soundararajan, SRIHER 41
  • 42. Brother! Answer me, Please !! K. Soundararajan, SRIHER 42
  • 43. SECTION OF HEAD & NECK K. Soundararajan, SRIHER 43
  • 46. Pharynx  Length - 12cm Width - 3.5 cm It is wide muscular tube situated behind nose, mouth, larynx. 3 layer of tissue  Mucosa (lining membrane )  Middle layer  Outer layer ( involuntary muscle) K. Soundararajan, SRIHER 46
  • 47. Pharynx Three parts • Nasopharynx air ( nasal part ) • Oropharynx air & food ( oral part ) • Laryngopharynx food ( laryngeal part ) K. Soundararajan, SRIHER 47
  • 48. Pharynx Boundaries  Anterior - nasal, oral cavity, larynx, anterior wall incomplete  Posterior - pharynx glides freely on pre vertebral fascia  Superiorly - base of skull, occipital bone, pharyngeal tubercle  Inferiorly - lower border of critoid cartilage K. Soundararajan, SRIHER 48
  • 50. Pharynx  Blood supply Artery- several branches of fascial arteries Vein- facial vein, internal jugular vein. • Nerve supply Para- glossopharyngeal , vagus nerve sym- cervical ganglia, lesser palatine nerve • Lymphatic's jugulodigastric node 50 ___oropharynx ___laryngophary nx * * * K. Soundararajan, SRIHER
  • 52. Oesophagus Narrow muscular tube It is collapsible tube Length – 25cm Width – 2 cm Extend :  Lies median plane in thorax in front of vertebral column behind trachea, heart  Below diaphragm join stomach Greater part – thorax Lesser part - abdomen 52K. Soundararajan, SRIHER
  • 53. Oesophagus  Sphincters 1. Pharyngeal (or) upper oesophageal sphincter - prevent air passage 2. Cardiac (or) lower oesophageal sphincter - prevent reflux of K. Soundararajan, SRIHER 53
  • 54. Contains all 4 layers (see right)  Epithelium: non keratinized stratified squamous epithelium  Mucus glands in wall  Muscle (muscularis externa) changes as it goes down  Superior 1/3 of esophagus: skeletal muscle (like pharynx)  Middle 1/3 mixture of skeletal and smooth muscle  Inferior 1/3 smooth muscle (as in stomach and intestines)  When empty, mucosa and submucosa lie in longitudinal folds 54 Microscopic anatomy of Oesophagus K. Soundararajan, SRIHER
  • 56. Oesophagus  Blood supply Artery Thoracic - oesophageal artery (B) of thoracic artery Abdominal – inferior phrenic artery, left gastric artery (B) of coeliac artery K. Soundararajan, SRIHER 56
  • 57. Oesophagus  Blood supply Vein Thoracic – azygos, hemiazygos vein Abdominal – left gastric vein • Nerve supply anterior & posterior gastric nerve • Lymphatic's arteries into left gastric node K. Soundararajan, SRIHER 57
  • 62. Stomach  It is a J- shaped dilated portion of alimentary tract  Location: epigastric , umbilical, left hypochondriac  Size – 25 cm long  Capacity birth – 30 ml puberty – 1 liter adult – 1.5 to 2 liter K. Soundararajan, SRIHER 62
  • 63. Relations of Stomach K. Soundararajan, SRIHER 63
  • 64. Stomach Relations  Anterior - left lobe of liver, anterior abdominal wall, coastal cartilage  Posterior - abdominal aorta, pancreas, left kidney, adrenal gland, spleen  Superior - diaphragm, oesophagus, left lobe of kidney  Inferior – tranverse colon, small intestine  Left side - diaphragm, spleen  Right side - liver , duodenum K. Soundararajan, SRIHER 64
  • 65. Stomach Regions Parts  Cardiac fundus body  Pyloric pyloric antrum (7.5 cm) pyloric canal (2.5 cm) 65 dome K. Soundararajan, SRIHER
  • 66. Stomach Region  Surface 1. anterior or anterio-superior (forward, upward) 2. Posterior or posterio-inferior (backward, downward ) K. Soundararajan, SRIHER 66
  • 67. Stomach Region Sphincter  Cardiac sphincter (oesophagus)  Pyloric sphincter (duodenum) curvature shape omentum border notch Lesser Concave Lesser Right ( below) Angular Greater Convex Greater Left (above) cardiac K. Soundararajan, SRIHER 67
  • 68. Shape of stomach  Shape – pyriform  Obese person- horizontal  Radio graphic examination of stomach after barium meal gives shape clearly K. Soundararajan, SRIHER 68
  • 69. Interior of stomach  It has longitudinal folds and irregular in shape  Gastric canal near lesser curvature swallow liquid  Stomach bed is separate from stomach by lesser sac K. Soundararajan, SRIHER 69
  • 70.  Rugae: longitudinal folds on internal surface (helps distensibility)  Muscularis: additional innermost oblique layer (along with circular and longitudinal layers) 70K. Soundararajan, SRIHER
  • 71. Layers of stomach Muscle coat 1. Longitudinal (outer layer) 2. Inner circular (middle layer) 3. Deep oblique (inner layer) K. Soundararajan, SRIHER 71
  • 72. Histology of stomach 72  Simple columnar epithelium:  secrete bicarbonate- buffered mucus  Gastric pits opening into gastric glands K. Soundararajan, SRIHER
  • 73. Blood supply - artery  Lesser curvature left gastric artery (B) – coeliac trunk right gastric artery (B)- proper hepatic artery  Greater curvature right gastro epiploic artery(B)- gastroduodenal artery left gastro epiploic artery(B)- spleenic artery  Fundus 5 to 7 short gastric arteries K. Soundararajan, SRIHER 73
  • 74. Blood supply - vein  Portal vein  Right & left gastric vein  Right & left gastro epiploic vein  Superior & inferior mescentric vein  Short gastric vein  Splenic vein K. Soundararajan, SRIHER 74
  • 75. Lymphatic's  Right & left gastric node  Right & left gastro epiploic node  Short gastric node  Coeliac node  Hepatic node  Pyloric node  Pancreatic splenic node K. Soundararajan, SRIHER 75
  • 76. Nerve supply  Sympathetic- T6 to10 via greater splanchnic nerve, coeliac & hepatic plexus , vasomotor  Parasympathetic- vagus esophageal plexus K. Soundararajan, SRIHER 76
  • 77. Histology of stomach K. Soundararajan, SRIHER 77
  • 80. Small intestine  It continuous with the stomach at pyloric sphincter  It is longest of alimentary canal  Greater part of digestion & absorption take place here. K. Soundararajan, SRIHER 80
  • 81. Small intestine  It is divided in to three region i. Duodenum ii. Jejunum iii. Ileum K. Soundararajan, SRIHER 81
  • 82. Duodenum  It is shortest , widest & most fixed part  Extend From - pylorus To – duodenojejunal flexure  Length- 25cm It is ‘c’ shaped , receives opening of bile & pancreatic duct  Location epigastric , umbilical K. Soundararajan, SRIHER 82
  • 83. Parts of duodenum  It is divided into four parts 1. First or superior 2. Second or descending 3. Third or horizontal 4. Fourth or ascending K. Soundararajan, SRIHER 83
  • 84. First or superior part of duodenum  Begin – pylorus  End – superior duodenal flexure Relation Anterior – quadrate lobe of liver, gall bladder Posterior – gastro duodenal artery, bile duct, portal vein Superior – epiploic foramen Inferior – head and neck of pancrease K. Soundararajan, SRIHER 84
  • 85. Second or descending part  Begin – superior duodenal flexure  End – inferior duodenal flexure Relation Anterior – right lobe of liver, transverse of colon, root of mesocolon, small intestine Posterior – anterior surface of right kidney(medial border), right renal vessel, right edge of inferior venacava, right psoas K. Soundararajan, SRIHER 85
  • 86. Third or horizontal part  Begin – inferior duodenal flexure  End – front of abdominal aorta, lower margin of head of pancreas Relation Anterior – superior mesenteric vessel, root of mesentry Posterior –right ureter, right psoas major, right testicular or ovarian vessel, inferior venacava, abdominal aorta Superior – head of pancreas Inferior – coil of jejunum K. Soundararajan, SRIHER 86
  • 87. Fourth or ascending part  Begin – upper border of 2 lumbar vertebra  End – duodenojejunal flexure at jejunum Relation Anterior – transverse colon, transverse mesocolon, lesser sac, stomach. Posterior –left renal artery, left gonadal artery, inferior mesentric vein, left sympathetic vein Superior – body of pancrease K. Soundararajan, SRIHER 87
  • 88. Blood supply  Artery Upper half Superior pancreaticoduodeal artery (B) gastroduodenal artery Lower half Inferior pancreaticoduodenal artery (B) superior mesenteric artery  Vein Superior pancreaticoduodeal vein drains into portal vein , inferior vein, joins mesenteric vein K. Soundararajan, SRIHER 88
  • 89. Artery supply for duodenum K. Soundararajan, SRIHER 89
  • 90. Duodenum  Lymphatic's pancreaticoduodenal nodes to gastro duodenal nodes celiac nodes superior mesenteric nodes  Nerve supply sympathetic & parasympathetic vagus nerve from celiac & superior mesenteric plexus K. Soundararajan, SRIHER 90
  • 91. Jejunum and Ileum  The coil are freely mobile & attached to posterior abdominal wall by fan- shaped peritoneum Begin – duodenojejunal flexure End – ileoceral junction K. Soundararajan, SRIHER 91
  • 92. Jejunum and Ileum K. Soundararajan, SRIHER 92
  • 93. Jejunum and Ileum Feature Jejunum Ileum Location Occupies upper left Part of intestinal area Occupies lower right Part of intestinal area Wall Thicker more vascular Thinner less vascular villi Large , thick ( leaf – like) More abundant Large , thick ( leaf – like) More abundant K. Soundararajan, SRIHER 93
  • 94. Difference between Jejunum • Larger diameter • Thickening wall • Prominent fold • 1-2 vascular archade • Long vasa recta • Fat free mesentery Ileum • Smaller diameter • Thinner wall • Flat and few • 4-5 vascular archades • Short vasa recta • Abundant mesenteric fat K. Soundararajan, SRIHER 94
  • 95. Blood supply  Arteries branch of superior mesenteric artery , lower part of ileum by ileocolic artery  Vein superior mesenteric node jejunum ileumK. Soundararajan, SRIHER 95
  • 96. Jejunum and ileum  Lymphatic’s intermediate mesenteric node, superior mesenteric node  Nerve vagus nerve from superior mesenteric plexus sympathetic – T9 – T11 segment parasympathetic- vagus K. Soundararajan, SRIHER 96
  • 99. Large intestine  It is about 1.5 m in long  Extend begin – caecum end – anal canal K. Soundararajan, SRIHER 99
  • 100. Large intestine  It divides into many parts  Caecum,  Ascending colon,  Transverse colon,  Descending colon,  Sigmoid colon,  Rectum ,  Anal canal K. Soundararajan, SRIHER 100
  • 101. Caecum  It is large blind sac forming large intestine  Long – 6 cm  Relation anterior : coil of intestine, anterior wall of abdominal wall posterior : right psoas, iliacus medially: appendix caecum K. Soundararajan, SRIHER 101
  • 102. Caecum  Blood supply  Artery branch of ileocolic artery  Vein superior mesenteric vein  Lymphatic’s several mescentric nodes  Nerve vagus nerve - superior mesenteric plexus K. Soundararajan, SRIHER 102
  • 104. Vermiform Appendix  It is a vestibular organ  It is narrow , muscular contain large amount of lymphoid tissue  It base attached to posterio medial surface of caecum below ileoceal junction appendix K. Soundararajan, SRIHER 104
  • 105. Vermiform Appendix  Blood supply Artery appendicular artery (B) posterior cecal artery Vein appendicular vein drain in to posterior cecal vein  Lymphatic’s superior mesenteric node  Nerve vagus nerve - superior mesenteric plexus K. Soundararajan, SRIHER 105
  • 106. Large intestine – ascending colon  Length – 13cm  Location – right lower quadrant  From caecum  To inferior surface of right lobe of liver , right colic flexure Sigmoid colon K. Soundararajan, SRIHER 106
  • 107. Relation of ascending colon  Anterior coil of intestine, greater omentum, anterior abdominal wall.  Posterior iliacus, iliac crest, quadratus lumbrum, lower pole of kidney K. Soundararajan, SRIHER 107
  • 108. Ascending colon  Blood supply Artery ileocolic & right colic (B) of superior mesenteric artery Vein superior mesenteric vein  Lymphatic’s superior mesenteric node  Nerve superior mesenteric plexus ( vagus ) K. Soundararajan, SRIHER 108
  • 109. Large intestine – transverse colon  Length – 38cm  Location – right & left upper quadrant  From right colic flexure  To left colic flexure Sigmoid colon K. Soundararajan, SRIHER 109
  • 110. Relation of transverse colon  Anterior greater omentum, anterior abdominal wall.  Posterior second part of duodenum, head of pancrease, coil of jejunum , coil of ileum. K. Soundararajan, SRIHER 110
  • 111. Transverse colon  Blood supply Artery Proximal two third: middle colic artery (B) superior mesenteric arter Distal third: left colic artery (B) inferior mesenteric artery Vein the vein correspond to arteries drains in to superior & inferior mesenteric vein K. Soundararajan, SRIHER 111
  • 112. Transverse colon  Lymphatic’s colic node, superior & inferior mesenteric node  Nerve Proximal two third: Vagus nerve -superior mesenteric plexus Distal third: Pelvic splanchnic nerve-inferior mesenteric plexus K. Soundararajan, SRIHER 112
  • 113. Large intestine- descending colon  Length – 25cm  Location – left upper & lower quadrant  From left colic flexure  To sigmoid colon Sigmoid colon K. Soundararajan, SRIHER 113
  • 114. Relation of descending colon  Anterior coil of small intestine greater omentum, anterior abdominal wall.  Posterior left kidney (lateral border), transversus abdominus, quadratus lumborum, iliac crest, left psoas, iliacus, iliohypogastric nerve, ilioinguninal nerve, femoral nerve. K. Soundararajan, SRIHER 114
  • 115. Descending colon  Blood supply Artery left colic sigmoid (B) of inferior mesenteric artery Vein inferior mesenteric vein  Lymphatic’s inferior mesenteric node  Nerve inferior mesenteric nerve , pelvic splanchnic nerve K. Soundararajan, SRIHER 115
  • 116. Large intestine – sigmoid colon  Length – 25 to 38cm  Location – left lower quadrant  From in front pelvic brim  To rectum Sigmoid colon K. Soundararajan, SRIHER 116
  • 117. Relation of sigmoid colon  Anterior Male – urinary bladder Female – posterior surface of uterus, upper part of vagina  Posterior rectum & sacrum lower coil of terminal part of ileum K. Soundararajan, SRIHER 117
  • 118. Sigmoid colon  Blood supply Artery inferior mesenteric artery Vein inferior mesenteric vein joins portal venous system  Lymphatic’s inferior mesenteric node  Nerve inferior hypo gastric plexuses. K. Soundararajan, SRIHER 118
  • 120. Rectum  Length – 13 cm  Location posterior part of lesser pelvic, in front of sacrum coccyx (lower 3 pieces)  Extend  From continuation of sigmoid colon  To anal canal at anorectal junction K. Soundararajan, SRIHER 120
  • 121. Curvatures of rectum K. Soundararajan, SRIHER 121
  • 122. Relation of rectum  Posterior sacrum, coccyx, coccyges, piriformis, levatores ani, sacral plexus.  Anterior  Male upper two-third – rectovesical pouch with coil of intestine, sigmoid colon. lower one-third – urinary bladder base, ureter terminal, seminal vesicles, deferent ducts, prostate  Female upper two-third – rectovesical pouch with coil of intestine, sigmoid colon separates from ureter , upper part of vagina K. Soundararajan, SRIHER 122
  • 124. Rectum  Blood supply  Arteries superior, middle, inferior rectal artery  Vein superior, middle, inferior rectal vein  Nerve inferior hypogastric plexuses  Lymphatic’s pararectal nodes , inferior mesenteric node, internal iliac nodes K. Soundararajan, SRIHER 124
  • 125. Anal canal  Length – 3.8 cm  Location- below the level of pelvic diaphragm  Extend  From rectal ampulla  To anus K. Soundararajan, SRIHER 125
  • 126. Relations  Anterior Male - membranous urethra, bulb of penis Female - lower end of vagina Both sexes- perineal body  Posterior anococcygeal ligament, tip of coccyx  Laterally ischioanal fossae K. Soundararajan, SRIHER 126
  • 127. Anal canal  Blood supply  Arteries superior & inferior rectal artery  Vein superior & inferior rectal vein, internal pudendal vein  Lymphatic’s superior & inferior rectal node, superficial inguinal nodes  Nerve inferior hypogastric plexuses, inferior rectal nerve, pudendal nerve, perinal branch of 4 th sacral nerve K. Soundararajan, SRIHER 127
  • 128. Rectum & Anal canal K. Soundararajan, SRIHER 128
  • 129. Lymph drainage of rectum & anal canal K. Soundararajan, SRIHER 129
  • 135. Liver  It is largest gland  Weight- 1 & 2.3 kg  Location- right & left hypogastric , epigastric region K. Soundararajan, SRIHER 135
  • 137. Liver –liver is the largest solid organ in the body, located in the upper right abdominal cavity. –An accessory organ of digestion that contributes to, but is not physically involved in, the process of digestion. –Liver cells (hepatocytes) continuously produce bile, aK. Soundararajan, SRIHER 137
  • 139. Liver –Bile produced by the liver flows through the hepatic ducts, through the common hepatic duct, and then into either the cystic duct to the gallbladder or the common bile duct. –All of the ducts that carry bile are collectively known as the biliary tree. K. Soundararajan, SRIHER 139
  • 141. Relations  Anterior & superior diaphragm , anterior wall of abdominal wall  Inferior , stomach, bile duct, duodenum, hepatic flexure of colon , right kidney , adernal gland  Posterior oesophagus, inferior vena cava, aorta, gall bladder, diaphragm, vertebral column.  Laterally lower ribs, diaphargm K. Soundararajan, SRIHER 141
  • 142. Liver  Blood supply Artery hepatic artery Vein portal vein, inferior venacava  Lymphatic’s hepatic, paracardial, coeliac node  Nerve vagal nerve K. Soundararajan, SRIHER 142
  • 143. GALL BLADDER GALL BLADDER K. Soundararajan, SRIHER 143
  • 144. Gallbladder – An accessory organ of digestion posterior to the liver. – Concentrates and stores bile from the liver. – The presence of fatty chyme in the duodenum causes the gallbladder to contract, sending bile into the common bile duct and duodenum to digest fats. – It is pear shaped sac – It is divided into fundus , body , neck – It is covered by peritoneum K. Soundararajan, SRIHER 144
  • 145. Gallbladder  Relations  Anterior anterior abdominal wall, inferior surface of liver  Posterior transverse colon, first , second part of duodenum K. Soundararajan, SRIHER 145
  • 146. Gallbladder  Blood supply cystic artery, cystic vein  Lymphatic’s cystic lymph node  Nerve celiac plexus (vagus) K. Soundararajan, SRIHER 146
  • 148. PANCREAS It is pale green gland Weight – 60 grams Length – 12 to 15 cm Location – epigastric , left hypo gastric region. K. Soundararajan, SRIHER 148
  • 150. Pancreas –An accessory organ of digestion posterior to the stomach. –Presence of food in the duodenum causes the pancreas to secrete digestive enzymes into the pancreatic duct to the duodenum. –Also functions as an organ of the endocrine system. K. Soundararajan, SRIHER 150
  • 152. Relations  Anterior right to left transverse of colon , lesser sac, stomach  Posterior right to left left kidney, hilum of spleen, left suprarenal gland, left psoas , superior mesenteric artery, aorta, inferior venacava, portal & splenic vein, bile duct K. Soundararajan, SRIHER 152
  • 153. Blood supply  Artery splenic artery superior pancreatico duodenal artery inferior pancreatico duodenal artery K. Soundararajan, SRIHER 153
  • 154. Blood supply  Vein splenic vein superior pancreatico duodenal vein inferior pancreatico duodenal vein portal vein K. Soundararajan, SRIHER 154
  • 155. pancreas  Lymphatic’s celiac node superior mesenteric node  Nerve vagal nerve K. Soundararajan, SRIHER 155
  • 157. Spleen  It is reddish & largest single mass of lymphoid tissue  It act as filter of blood  It is wedged in fundus of stomach, diaphragm  Location left hypogastric , epigastric K. Soundararajan, SRIHER 157
  • 158. Relations  Anterior stomach, tail of pancreas, left colic flexure left kidney along medial border  Posterior diaphragm, left pleura, left lungs , 9th to 11th ribs K. Soundararajan, SRIHER 158
  • 159. Spleen  Blood supply  Artery splenic artery, celiac artery  Vein splenic vein, superior mesenteric vein, portal vein  Lymphatic’s celiac nodes  Nerve celiac plexus K. Soundararajan, SRIHER 159