Anatomy of lower GIT& its blood supply

Dr. NEHAL MOHAMMED MD, Ph.D Assistant professor of Anatomy &Embryology KFMC-FOM

Contents:

Small intestine Large intestine:

Colon Rectum Anal canal Blood supply of the GIT

Fig. 24.22a

Small Intestine:3 regions a. Duodenum (10 in long): 3 accessory organs associated:

-Pancreas (Pancreatic duct) -Gall Bladder (Cystic D.) -liver (Hepatic D.)

b. Jejunum (middle portion)

between duodenum & ileum 8 ft. long larger lumen > ileum absorption of nutrients

c. Ileum
longest section of SI (12 ft.) posterior portion Terminates at the Ileocecal Valve (opens into the cecum) Contains Peyers Patches

Fig. 24.17a

Duodenum:-

Four parts of the duodenum:-

Superior (first) part:at the level of vertebra L1. it lies in the transverse plane. Descending (second) part : at the level of L2. The bile duct and the pancreatic duct drain in this part.

Horizontal (third) part : at the level of L3. It lies anterior to the inferior vena cava and the abdominal aorta. The horizontal part of the duodenum is crossed anteriorly by the superior mesenteric vessels.
Ascending (fourth) part : ascends to the level of L2. It turns anteriorly to join the jejunum at the duodenojejunal junction.
6

Jejunum:-

Fig. 24.22b

-It is wider bored, thicker walled than the ilium because the plica circularis are larger, and more numerous than the ileum. -Simple arterial arcades in its mesentery. -Less fat and more windows in its mesentery.

Ilium:Narrower lumen, thinner wall, smooth mucous membrane, more fat ,less windows and contains Peyer patches.

Jejunum versus Ilium:

10

Ileocecal region:-

Different positions of the appendix:Retrocecal (the commonest). Sub cecal. Anteileal. Retroileal. Pelvic.

11

LARGE INTESTINE:-

The large intestine frames the small intestines and extends from the ileocecal valve to the anus. Its diameter, is greater than that of the small intestine and it is 1.5m long.

12

Large intestine is formed of 4 regions:a. Cecum -1st region of LI -Sac-like portion beneath ileocecal valve -Appendix hangs from its postero medial surface. b. Colon c. Rectum d. Anal Canal

13

Fig. 24.27

14

Pelvic peritoneum: The anterior abdominal wall (1) Superior to the pubis (2) The superior surface of the urinary bladder (3) The vesicouterine pouch (4) The fundus and body of the uterus (5) The rectouterine pouch (6) Anterior surface and sides of the rectum (7) The sigmoid mesocolon (8) Laterally, a paravesical fossa is Apparent on each side of the urinary bladder. Further posteriorly, a pararectal fossa is apparent on each side of the rectum.

15

Rectum: The rectum begins at the level of the third sacral vertebra. It is curving forward with a loop to the left. It has a peritoneal covering on the front and sides of its proximal third; only on its front for the middle third; and no covering for the distal third. Blood supply; Superior, middle & inferior rectal arteries. Its a site for porto systemic anastomosis.

16

Anal Canal: (1) Opens to exterior via anus. (2) Has 2 anal sphincters: -Internal Anal Sphincter (smooth m.) = involutary -External Anal Sphincter (skeletal m.)= voluntary

17

Anal Canal and Hemorrhoidal veins:-

18

19

Arterial supply of GIT

CELIAC TRUNK:
You should realize that arteries are named by their region of distribution, not by their origin or branching pattern. Celiac trunk arises from the anterior surface of the abdominal aorta at the level of the twelfth thoracic vertebra. The celiac trunk is very short (less than 2 cm in most cases) and divides into three branches: Common hepatic artery Left gastric artery Splenic artery

20

SUPERIOR MESENTERIC ARTERY:-

The superior mesenteric artery arises from the anterior surface of the abdominal aorta approximately 1 cm inferior to the celiac trunk. Branches: Ileocolic artery Right colic artery Middle colic artery Jejunal& ileal branches
21

Superior mesentric A.

22

INFERIOR MESENTERIC ARTERY:

The origin of the inferior mesenteric artery lies posterior to the third part of the duodenum.
It arises from the anterior surface of the abdominal aorta at the level of the intervertebral disk between vertebrae L2 and L3.

Branches: Left colic artery Sigmoid arteries Superior rectal artery:

It is the continuation of the inferior mesenteric artery.
23

Inferior mesentric A.

24

Veins of the stomach:

25

26

Portal vein :-

27

28

29