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.
The Duodenum
The duodenum is divided into four parts.
The superior Part
The descending part
The horizontal part
the inferior part
The ascending part
The descending part
the hepatopancreatic ampulla
the duodenal major papilla ( the bile papilla) : It is
at the posteromedial wall of the descending part of t
he duodenum. The common bile duct and the pancr
eatic duct unite to open at here.
The suspensory muscle of duodenum ( ligament of
Treitz) : The terminal part of the duodenum and th
e duodenojejunal flexure are usually suspended an
d fixed in position by it. It is a sign to definite the b
eginning of the jejunum and to distinguish the upp
er and lower alimentary canal.
The Jejunum and Ileum
The jejunum The ileum
Position The upper 2/5 of the smal The lower 3/5 of the small int
l intestine estine
Lies in the left epigastric Lies in the right hypogastric
The wall and Thicker and bigger Thinner and smaller
diameter
Color Redder Pale red
Circular fold Large and thick Small and thin
Villi Dense (thick) Sparse (thin)
The aggregated Absent (only find few Larger and more (whose
lymphatic solitary lymphatic long axis is paralleling with
follicles follicles) the long axis of the ileum)
 Jejunum and ileum are attached to the
posterior wall by mesentery and this allows them
very free movement.
 Section 6 The Large Intestine

The large intestine extends from the ileum to the

anus and about 1.5m long. The large intestine is more
fixed in position and has a great diameter than the
small intestine.
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, adipos
e projections, scattered over the free surface of the colo
n.
The large intestine is divided into the following parts.
The Cecum
ileocecal orifice
the orifice of the vermiform appendix.
 The Vermiform Appendix

It is a narrow, worm shaped tube. It has a triangul

ar mesentery, called mesoappendix.
The commonly body surface projection for the append
icular base is the junction of the lateral and middle thi
rds of the line joining the right anterior superior iliac
spine to the umbilicus, this position is called McBurne
y’s point.
The Colon

It may be divided into four parts:

The ascending colon
The transverse colon
The descending colon
The sigmoid colon
 The Rectum
It is continuous with the sigmoid colon, its lower pa
rt is dilated to form the ampulla of rectum.
There are two curves in sagittal plane in rectum: t
he sacral flexure of the rectum; the perineal flexure o
f the rectum.
 The rectum has incompletely peritoneum
covers. There are three permanent transverse
folds of the rectum to hold the stool.
The Anal Canal

It begins where the lower end of the ampulla of re

ctum suddenly narrows. It ends at the anus.
In the lower part of the canal the mucous membra
ne present 6~10 the anal columns.
 The lower ends of these columns are joined to
gether by the anal valves, above each of which li
es a small anal sinus.
The dentate line : The line along which the an
al valves and the lower end of the anal column a
re situated is termed the dentate line .
the anal pecten
 Below the anal pecten is the white line, it lies at th
e interval between the sphincter ani internus and th
e sphincter ani externus.
 Section 7 The Liver
The liver (Hepar) is the largest gland in the body. I
t has many important functions except digestion, suc
h as resolve the poisons, alcohol and drug, compose a
nd transform the sugar, protein, vitamin and so on. T
he liver is a reddish-brown organ.
 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 of
the midline for about 3cm.
 The liver presents two surfaces:
the superior or diaphragmatic surface
the inferior or visceral surface
the falciform ligament
The
diaphragmatic the right and left triangular ligament
surface d the anterior and posterior
coronary ligament
 The liver can be divided into a small left lobe and
a big right lobe by the falciform ligament.
the bare area of liver
 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 po
rta hepatis, which may be regarded as the hilum of the live
r. The structures through the porta hepatis contain the hep
atic portal vein, the proper hepatic artery, the right and lef
t hepatic ducts and so on.
 the hepatic pedicle: The structure through th
e porta hepatis is called the hepatic pedicle, it c
ontains the hepatic portal vein, the proper hepa
tic artery and the hepatic nerve plexus enter the
liver, and the right and left hepatic ducts and so
me lymph vessels emerge.
 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 v
ein in embryo, the posterior part is ligamentum veno
sum which is the trace of the venous duct in embryo.
 The right vertical line is composed of two foss
ae. The anterior part is the fossa to hold the gall
bladder and the posterior part is the fossa to pas
s through the inferior vena cava.
 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
 The liver can keep permanent position relying
on many structures.

diaphrag
liver m

Lessor
omentum
stomach
spleen
duodenum

greater omentum
 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.
 The gallbladder consists of f
our parts:
the fundus; the body
the neck (the spiral folds)
the cystic duct
The body surface projection
of the fundus of the gallbladde
r: lies behind the point where t
he lateral edge of the right rect
us abdominis crosses the costal
arch.
The stone in the
gallbladder is th
e common diseas
e in clinic. The st
one can be anyw
here in the biliar
y duct
 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-walle
d bile ductules ￫ the segmental bile ducts ￫ the
right and left hepatic ducts ￫ through the porta h
epatis ￫ leave the liver ￫ the common hepatic d
uct
 The Common Bile Duct
It is formed near the hepati
c portal vein by the junction o
f the cystic and common hepa
tic ducts. It lies in the right bo
rder of the lesser omentum.
 The common bile duct come
s into contact with the main pa
ncreatic duct to form the hepat
opancreatic ampulla, the distal
constricted end of this ampulla
opens into the descending part
of the duodenum on the summi
t of the major duodenal papilla
.
 The circular muscle aroun
d the hepatopancreatic amp
ulla is thickened called the s
phincter of hepatopancreatic
ampulla (Oddi’s sphincter).
 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 ampul
la → open in the duodenal major papilla → into the duo
denum (digest)

When don’t eat, bile produced by hepatocytes → the

right and the left hepatic ducts → the common hepatic
duct → the common bile duct → the cystic duct → the g
allbladder (store and concentrate)
 Section 9 The Pancreas
The pancreas is a long, soft, finely lobulated glan
d. It is located in the upper part of the abdomen, hi
dden by many organs.
The pancreas can be divided into the broad head
; the neck; the body ; the narrow tail.
 The adjacent organs of the pancreas are many
more. They are mainly the hepatic portal vein,
the superior mesenteric vein, the left kidney, the
common bile duct, the spleen and so on.
left suprarenal
gland and the
left kidney
stomach

gallbladder spleen
liver liver
pancreas
stomach

transverse colongreater om
entum

Greater omentum
 The main pancreatic
duct joins the common
bile duct and open into the
duodenum through the
duodenal major papilla.

The pancreas produces

both exocrine and
endocrine secretions.
 The alimentary system
[Link]:
the isthmus of fauces; tonsilar ring;
the duodenal major papilla; the dentate line;
the suspensory muscle of duodenum
the porta hepatis; the hepatic pedicle

[Link] is the composition of the alimentary system?

[Link] are the bulk of the tooth (or the tooth tissue)
and the periodontal structures?
[Link] many kinds papillae on the dorsum surface
of tongue? What are they? Which kinds papillae ha
ve taste buds?
[Link] write down the function of the genioglossu
s.
[Link] are the names of three pairs of salivary gla
nds? Where do their ducts open?
7. Please write down the names of three parts of the
pharynx, the names of the communicating parts wi
th the nasal cavity, the oral cavity and the laryngea
l cavity.
[Link] are the names and positions (include the l
evel with the vertebra and the distance from the i
ncisor teeth) of three constrictions of the esophag
us?

[Link] write down the shape and parts of the sto

mach.

[Link] write down the parts of the duodenum a

nd the characteristic of the descending part (the s
econd part).
[Link] are the names of three typical structures
in colon and cecum?
[Link] is the body surface projection of the ap
pendicular base?
[Link] write down the names of four parts of t
he colon.
[Link] are two curves of the rectum?

[Link] write down the shape of the liver (inclu

de visceral surface and the visceral surface).

[Link] does the bile produce? What is the flow

ing course of the bile when we eat or not eat?

[Link] is the body surface projection of the fu

ndus of the gallbladder?