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5- ANATOMY OF SMALL INTESTINE.pdf

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This document provides information about the anatomy of the small intestine. It discusses the three parts of the small intestine - the duodenum, jejunum, and ileum. For each part, it describes the shape, length, location of beginning and termination, blood supply, lymphatic drainage, and other distinguishing anatomical features. The duodenum is fixed and retroperitoneal, while the jejunum and ileum have mesenteries and are more movable. The document also details the four sections of the duodenum and their relations to surrounding structures.

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Dr. Jamila El-Medany
OBJECTIVES At the end of the lecture, students should: List the different parts of small intestine. Describe the anatomy of duodenum, jejunum & ileum regarding: the shape, length, site of beginning & termination, peritoneal covering, arterial supply & lymphatic drainage. Differentiate between each part of duodenum regarding the length, level & relations. Differentiate between the jejunum & ileum regarding the characteristic anatomical features of each of them.
Posterior abdominal wall Anterior abdominal wall What is MESENTERY? Loop of intestine
1 2 FIXED (Retro peritoneal) PART (NO MESENTERY) DUODENUM FREE (MOVABLE) PART (WITH MESENTERY) JEJUNUM & ILEUM
DUODENUM SHAPE: C-shaped loop LENGTH: 10 inches BEGINNING: at pyloro-duodenal junction TERMINATION: at duodeno-jejunal flexure PERITONEAL COVERING: retroperitoneal
PARTS The duodenum is divided into (4) parts: 1st : Superior. 2nd : Descending (vertical). 3rd : Inferior (Horizontal) 4th : Ascending
LENGTH SURFACE ANATOMY PART LENGTH LEVEL FIRST PART (Superior) 2 INCHES L1 (Transpyloric Plane) SECOND PART (Descending 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
Structures Related psoas pancreas
RELATIONS OF FIRST PART X Anterior Liver 1) 2) 3) X Posterior 1)Bile duct 2) Gastroduodenal artery 3)Portal vein
RELATIONS OF SECOND PART X Anterior )Liver )Transverse Colon )Small intestine Posterior Right kidney Lateral R Colic Flexure Medial Pancreas
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.
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
RELATIONS OF FOURTH PART Anterior: Small intestine Posterior: Left psoas major psoas
5- ANATOMY OF SMALL INTESTINE.pdf
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.
JEJUNUM & ILEUM SHAPE: Coiled tube LENGTH: 6 meters (20 feet) BEGINNING: at Duodeno- jejunal flexure TERMINATION: at Ilieo- caecal junction EMBRYOLOGICAL ORIGIN: Midgut Blood SUPPLY: Superior mesenteric A & V LYMPHATIC DRAINAGE: Superior mesenteric lymph nodes
JEJUNUM ILEUM LENGTH Shorter (proximal 2/5) of SI Longer (distal 3/5) of SI DIAMETER Wider Narrower WALL Thicker (more plicae circulares) Thinner (less plicae circulares) APPEARANCE Dark red (more vascular) Light red (less vascular) VESSELS High & Less arcades (long terminal branches) Low & More arcades (short terminal branches MESENTERIC FAT Small amount & away from intestinal border Large amount & close to intestinal border LYMPHOID TISSUE Few aggregations Numerous aggregations (Peyers patches)
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5- ANATOMY OF SMALL INTESTINE.pdf

  • 2. OBJECTIVES At the end of the lecture, students should: List the different parts of small intestine. Describe the anatomy of duodenum, jejunum & ileum regarding: the shape, length, site of beginning & termination, peritoneal covering, arterial supply & lymphatic drainage. Differentiate between each part of duodenum regarding the length, level & relations. Differentiate between the jejunum & ileum regarding the characteristic anatomical features of each of them.
  • 4. 1 2 FIXED (Retro peritoneal) PART (NO MESENTERY) DUODENUM FREE (MOVABLE) PART (WITH MESENTERY) JEJUNUM & ILEUM
  • 5. DUODENUM SHAPE: C-shaped loop LENGTH: 10 inches BEGINNING: at pyloro-duodenal junction TERMINATION: at duodeno-jejunal flexure PERITONEAL COVERING: retroperitoneal
  • 6. PARTS The duodenum is divided into (4) parts: 1st : Superior. 2nd : Descending (vertical). 3rd : Inferior (Horizontal) 4th : Ascending
  • 7. LENGTH SURFACE ANATOMY PART LENGTH LEVEL FIRST PART (Superior) 2 INCHES L1 (Transpyloric Plane) SECOND PART (Descending 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
  • 9. RELATIONS OF FIRST PART X Anterior Liver 1) 2) 3) X Posterior 1)Bile duct 2) Gastroduodenal artery 3)Portal vein
  • 10. RELATIONS OF SECOND PART X Anterior )Liver )Transverse Colon )Small intestine Posterior Right kidney Lateral R Colic Flexure Medial Pancreas
  • 11. 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.
  • 12. 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
  • 13. RELATIONS OF FOURTH PART Anterior: Small intestine Posterior: Left psoas major psoas
  • 15. 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.
  • 16. JEJUNUM & ILEUM SHAPE: Coiled tube LENGTH: 6 meters (20 feet) BEGINNING: at Duodeno- jejunal flexure TERMINATION: at Ilieo- caecal junction EMBRYOLOGICAL ORIGIN: Midgut Blood SUPPLY: Superior mesenteric A & V LYMPHATIC DRAINAGE: Superior mesenteric lymph nodes
  • 17. JEJUNUM ILEUM LENGTH Shorter (proximal 2/5) of SI Longer (distal 3/5) of SI DIAMETER Wider Narrower WALL Thicker (more plicae circulares) Thinner (less plicae circulares) APPEARANCE Dark red (more vascular) Light red (less vascular) VESSELS High & Less arcades (long terminal branches) Low & More arcades (short terminal branches MESENTERIC FAT Small amount & away from intestinal border Large amount & close to intestinal border LYMPHOID TISSUE Few aggregations Numerous aggregations (Peyers patches)