Digestive System - 2020 December PDF

Prof. D-r Marija Papazova Digestive system The digestive system is comprised of the digestive tract extending from the mouth to the anus and of glands appended to the canal. Almost the entire digestive canal is built of four layers: mucosa, submucosa, a muscular layer and an outer layer that is e...

Prof. D-r Marija Papazova Digestive system The digestive system is comprised of the digestive tract extending from the mouth to the anus and of glands appended to the canal. Almost the entire digestive canal is built of four layers: mucosa, submucosa, a muscular layer and an outer layer that is either serosa or adventitia. Oral cavity (CAVUM ORIS)  Oral vestibule (vestibulum oris)  True oral cavity (cavum oris proprium)  Oral cavity The oral cavity is bounded ventrally by the lips and laterally by the cheeks. The floor of the oral cavity is formed by the oral diaphragm and the roof by the palate. Dorsally, it is continuous through the isthmus of fauces with the pharynx. Teeth (DENTES) Teeth (DENTES)  Parts  crown of tooth  Neck of tooth  root of tooth  Deciduous teeth – 20  permanent teeth - 32 True oral cavity Tongue (LINGUA)  Parts of the tongue  Body of the tongue (corpus linguae)  Root of the tongue (radix linguae)  Tip of tongue (apex linguae) Tongue (LINGUA)  Structure of the tongue  Organisation of the  (tunica mucosa linguae) tongue  (papillae linguales),  Fibrose skelet of the  (tonsila lingualis) tongue  Lingual aponeurosis (aponeurosis linguae)  Hyoglossal mebrane  lingual septum (septum linguae) Tongue (LINGUA) Muscles of the tongue  Extrinsic muscles  genioglossal muscle (m. genioglossus)  hyoglossal muscle (m. hyoglossus)  Chondroglossal muscle (m. chondroglossus)  Styloglossal muscle (m. styloglossus) Muscles of the tongue  Intrinsic  m. longitudinalis superior (unpair)  m. longitudinalis inferior  m. transversus linguae  m. verticalis linguae Isthmuss faucium Salivary glands (GLANDULAE ORIS) Pharynx (PHARIYNX) Pharynx (PHARIYNX)  (tunica mucosa)  Pharyngeal constrictors  (tela submucosa)  m. constrictor pharyngis  Muscle of the pharynx superior (tunica muscularis  m. constrictor pharyngis medius pharyngis)  m. constrictor pharyngis inferior  (tunica adventitia)  Pharyngeal levators  Palatopharyngeaus (m. palatopharyngeus)  stylopharyngeus (m. stylopharyngeus) Oesophagus (ESOPHAGUS) Oesophagus (ESOPHAGUS)  Topographical part  pars cervicalis  pars thoracica-posterior mediastinal  Pars abdominalis  Constrictions  Pharyngo-oesophageal constriction of Killian  Thoracic constriction  Diaphragmatic constriction The oesophagus is an approximately 25 cm long muscular tube that connects the pharynx to the stomach. Several curvatures and constrictions are located along its course through the neck and thorax to the abdominal cavity. Abdomen Abdomen-walls Abdomen-walls Abdomenal cavity Abdomenal cavity  Retroperitenoal space (spatium retroperitoneale) Abdomenal cavity  Peritoneal  Retroperitoneal cavity(cavum space (spatium peritonei) retroperitoneale)  Supramesocolic part (situs abdominis superior)  Inframesocolic part (situs abdominis inferior) Abdomenal cavity  Intraperitoneal organs  primary retroperitoneal organs  secundary retroperitoneal organs Stomach (GASTER) The stomach is the widest part of the digestive tract. It is located in the supramesocolic part of the peritoneal cavity under the left vault of the diaphragm. It extends on the right to the epigastric region. The shape of the stomach varies according to its content and the activity of its muscular wall.  Stomach (GASTER)  Vertical part or digestive part (pars digestoria)  fundus (fundus ventriculi)  body of stomach (corpus ventriculi)  Stomach (GASTER)  horisontal or undigestive part (pars еgestoria)  Pyloric antrum (antrum pyloricum)  pyloric channel (canalis pyloricus)  Stomach (GASTER)  intraperitoneal organ  omentum minus  lig. gastrophrenicum  lig. gastrolienale  lig. gastrocolicum  Small intestine (INTESTINUM TENUE)  DUODENUM  JEJUNUM  ILEUM The small intestine is the longest part of the digestive system. It is approximately 3-5 m long and its width is 2-4 cm. It is composed of intestinal loops that fill the majority of the abdominal cavity. The loops face the peritoneum of the anterior abdominal wall and are in contact with parts of the large intestine and other abdominal organs. DUODENUM The duodenum originates at the pyloric orifice of the stomach and continues into the jejunum at the duodenojejunal flexure. It is located at the level of L1-L3 and its length is about 25-30 cm. The duodenum has four main parts, the majority of which are secondarily retroperitoneal. The bile duct and both pancreatic ducts open into the duodenum. The duodenal arterial supply is provided by two large trunks from the abdominal aorta: the coeliac trunk and the superior mesenteric artery. Components of the mucosa  plicae circulares  villi intestinales  plica longitudinalis duodeni - papilla duodeni major  papilla duodeni minor  Small intestine (INTESTINUM TENUE)  Free-mesenterial part of the small intestine  borders  flexura duodenojejunalis  ostium ileocecale  Small intestine (INTESTINUM TENUE)  two sides  Jejunum – superior and inferior side  Ileum – left and right side  two borders  Anterior and posterior border  Small intestine (INTESTINUM TENUE)  Intraperitoneal organ  mesenterium Vascularisation of the small intestine  Large intestine (INTESTINUM CRASSUM) The large intestine is the last part of the digestive tract. Its main functions are absorption of water and creation of faeces.The large intestine is about 1.5 m long and 6- 8 cm wide. Along its course, it is either located secondarily retroperitoneally on the posterior abdominal wall or is suspended in the abdominal cavity by the mesocolon. The large intestine forms a perimeter around the small intestine.  Large intestine (INTESTINUM CRASSUM)  CECUM  COLON  colon ascendens  colon transversum  colon descendens  colon sigmoideum  RECTUM  Large intestine (INTESTINUM CRASSUM)  External morphology  teniae coli  Haustra of colon- haustra coli  appendices epiploicae  Semilunar folds of colon (plicae semilunares coli)  Peritoneal of the large intestine  They are changing intraperitoneal and secundarly retroperitoneal parts of the large intestine  Intraperitoneal parts  cecum, colon transversum и colon sigmoideum  secundarly retroperitoneal parts  colon ascendens  colon descendens Large intestine (INTESTINUM CRASSUM)  a. mesenterica superior  a. mesenterica inferior  a. iliaca interna Large intestine (INTESTINUM CRASSUM) CECUM  Intraperitoneal organ  fossa iliaca dextra  ostium ileocecale  ostium appendicis vermiformis  appendix vermiformis COLON  Ascendent colon (COLON ASCENDENS)  Extending ascendently to flexura coli dextra  Secundarly retroperitoneal organ  (FLEXURA COLI DEXTRA)  Angle which forms colon ascendens extending to colon transfersum  Right hipohondric region  (COLON TRANSVERSUM)  between flexura coli dextra and flexura coli sinistra  intraperitoneal organ  mesocolon transversum  (FLEXURA COLI SINISTRA)  Flexura coli sinistra is located between colon transversum and colon descendens  (COLON DESCENDENS)  From flexura coli sinistra continue caudally throug sinister lumbal region  secundarly retroperitoneal organ  (COLON SIGMOIDEUM)  situated between colon descendens and rectum  From left illiac fossa to the level of the third sacral vertebrae  length: 45 cm – 1m  intraperitoneal organ  (RECTUM)  localisation  Infraperitoneal part of the pelvic cavity  subcutaneal part of the pelvic cavity  fascial region of the rectum- paraproctium  Topographical part of the (RECTUM)  Superior – pelvic parts  inferior or perineal part of the rectum Liver (HEPAR)  Peritoneal cavity(cavum peritonei)  Supramesocolic part(situs abdominis superior)  regio hypochondriaca dextra, epigastrica et sinistra The liver is the largest gland in the human body. It has both the exocrine and endocrine functions. The liver produces bile, which travels through the biliary tree and is stored in the gallbladder before being excreted by the bile duct into the duodenum. Other important functions of the liver are detoxification and haematopoesis during foetal development. The liver is situated in the supramesocolic part of the peritoneal cavity in the right hypochondrium. A minor part of the liver extends to the left hypochondrium.  Liver (HEPAR)  Intraperitoneal organ  (lig. falciforme hepatis)  (lig. coronarium hepatis)  (omentum minus)  ВНАТРЕШЕН ИЗГЛЕД НА РЕКТУМ  надолжни лигавични дипли  анални столбови (columnae anales - Morggani)  напречни лигавични дипли (plicae transversales)  plica transversalis - Kohlarauschi Bile ducts  Intrahepatic bile  Extrahepatic bile ducts ducts  They are located  out of the liver inside the liver  they are divided main and secondary  Gallblader The gallbladder is an about 10 cm long blind sac with a volume of about 15 ml. It is located in the fossa for the gallbladder on the visceral (inferior) surface of the liver. Bile is collected and concentrated in the gallbladder. The bile duct leads bile to the duodenum and to the gallbladder. Two types of the bile ducts exist:Intrahepatic(inside the liver)and extrahepatic (outside the liver) bile ducts.  Pancreas (PANCREAS)  Gland with exocrene and endocrene secretion  supramesocolic part of the peritoneal cavity in regio epigastrica et regio hypochondriaca sinistra  secundarly retroperitoneal organ The exocrine part produces pancreatic juice that contains a variety of enzymes. Pancreatic juice flows into the duodenum. The endocrine part releases hormones into the blood. One of the important hormones it releases is insulin.  Pancreas (PANCREAS)  excretoric channel:  main channel (ductus pancreaticus - Wirsung)  accessory channel(ductus pancreaticus accessorius - Santorini) Thank you for the attention!