Anatomy of Gastrointestinal Tract

Embriologi

Muhammad Bimo Harmaji

Departemen Anatomi
Fakultas Kedokteran
Universitas Lambung Mangkurat
Desember, 2015

 The GI tract
(gastrointestinal tract)

The muscular alimentary

canal
Mouth
Pharynx
Esophagus
Stomach
Small intestine
Large intestine
Anus

The accessory
digestive organs
Supply secretions
contributing to the
breakdown of food
Teeth & tongue
Salivary glands
Gallbladder
Liver

THE ABDOMIN
The Abdomen is the region of the
trunk that lies between the
diaphragm above & the inlet of the
pelvis below.

The abdominal wall:

Superiorly , the abdominal wall is

formed by the diaphragm ,which
separates the abdominal cavity from
the thoracic cavity .
Inferiorly the abdominal cavity is
continuous with the pelvic cavity
through the pelvic inlet.
Anteriorly ,the abdominal wall is
formed by the lower part of thoracic
cage & below by the rectus

9 Regio
Abdomen:
1.Hipokondrium
kanan
2.Epigastrium
Embriologi
3.Hipokondrium
kiri
4.Lumbalis
kanan
5.Umbilikalis
6.Lumbalis kiri

Struktur dinding abdomen

Superior : diafragma
Inferior : rongga
pelvis
Embriologi
Anterior : otot dan fascia rectus abdominis,
m.obliquus externus, m.obliquus internus,
dan m.transversus abdominis
Posterior: 5 vert lumbalis dan discus
intervertebralisnya, costa XII, bag atas
tulang pelvis, m.psoas, m.quadratus
lumborum, aponeurosis origo m.transversus
abdominis

Embriologi

1. Skin
2. Superficial fatty layer of
subcutaneous tissue ( Camper
Facia)
3. Deep membranous layer
( Scarpa fascia)
4. External oblique muscle
5. Intermediate fascia
6. Internal oblique muscle
7. Deep fascia
8. Transverse abdominal muscle
9. Endoabdominal fascia
(transfersalis)
10.Extraperitoneal fat
11.Parietal peritonium

Embriologi

Netter

Embriologi

Netter

THE ABDOMINAL CAVITY

The peritoneum
It is a serous membrane lining the wall of
the abdomen & the pelvic cavities (=
parietal P.) & clothing the abdominal &
pelvic viscera (=visceral P) , the space
between them called the peritoneal cavity
which contain small amount of fluid
.Between the parietal P. & the fascia
covering the abd. Is a layer of connective
tissue called the extra-peritoneal tissue.
The organs which are covered totally with
visceral P. called intraperitoneal organs while
those covered partially or lying behind the P.

The omentum: is 2- layers folds of P.

that connects the stomach to other
viscus.
The greater omentum connects the
stomach to transverse colon ,The
lesser omentum connect the
stomach to liver.
The mesentery is a 2-layers folds of P.
connecting parts of intestine to the
post. abd. wall. e.g. mesentery of
small int., the transverse colon, The
sigmoid colon.
The Parietal P. is sensitive to
pain,temp.,touch & pressure &
supplied by lower 6 thoracic & 1st

The gastrointestinal tract

The osophagus : is a muscular collapsible
tube ,25 cm long, joins the pharynx to the
stomach, its major part in the thorax,
enters the abdomen through an opening
in the right crus of the diaphragm &enter
the stomach on its right side.
The stomach :It is J-shape organ lies under
cover of the lower ribs, has cardiac orifice
above & pyloric orifice below,& has
greater & lesser curvitures , & ant. &
post. Surfaces.
It devided to :fundus,body ,incisura

The Stomach
The lesser curvature :forms the right border &
extends from the cardiac orifice to the pylorus.
It is suspended from the liver by the lesser
omentum.
The greater curvature :forms the left border, the
greater omentum extends from the lower part
to the transverse colon & the gastro-splenic
omentum extend from the upper part to the
spleen .
The mucus membrane forms many folds called
rugae that are longitudinal in direction.
It has 3 muscular layers:longitudinal , circular &
oblique.

The small intestine

It extends from the pylorus to the ileocecal valve & divided to duodenum ,
the jejunum & the ileum.
The duodenum : is a C- shape tube ,25
cm long, joins the stomach to the
jejunum . It receives the opening of
the bile & pancreatic ducts & curves
around the head of pancreas. It
divided to 4 parts :
1st part is 5cm long, begins at pylorus
& runs upward & backward on the
right side of L1 vertebra.

The duodenum
The 2nd part: is 8 cm long runs vertically
downward in front of the right kidney & on
right side of L1,2 vertebrae. Its medial
border receives the bile duct & the main
pancreatic ducts in major duodenal papilla
& receive the accessory panc. Duct higher
up in the minor duod. Papilla .
The 3rd part: is 8 cm long ,runs horizontally
to the left, in front of the vertebral
column& the lower margin of the head of
panc.
The 4th part: is 5 cm long, runs upward & to
the left to the duodeno-jejunal flexure.

The Jejunum & The

Ileum
It is 6 m long. The jejunum is the

upper 2/5th of this length start in

duodeno-jejunal junction to merge
with the ileum which end in the ileocecal junction.
The coils of them are freely mobile &
attached to the post. abd. wall by
fan shape fold of peritoneum called
Mesentery of the small intestine.
The jejunum has wider-bored, thickerwalled , redder & less fat than the
ileum ,also the plicae circulares are
larger ,more numerous & closely set.

JEJUNUM
ILEUM
Dinding lebih tebal dan Dinding lebih tipis o.k.
merah, ada plica
Plica circularis
circularis yg
berjauhan dan lebar,
berdekatan, lebih
pada bag bawah tdk
banyak dan lebih besar ada
Embriologi
Tdk terdapat kel.
Terdapat kel. Jaringan
Jaringan lymphoid
lymphoid (plaques
(plaques peyeri)
peyeri)
PD mesenterium :
PD mesenterium:
arcade 1-2 dengan
arcade lebih banyak
cabang jarang dan
(3-4) dan pendekpanjang
pendek
Jar lemak mesenterium Jar lemak mesenterium
sedikit
banyak

The Large Intestine

It extends from the end of the ileum to the anus.
It divided to Cecum , Appendix ,ascending colon
,Transverse colon ,Descending colon ,Sigmoid
colon , Rectum & Anal canal.
Its function is absorption of water & electrolytes&
the storage of undigested material until it can
be expelled from the body as feces .
The Cecum : It is a blind-ended pouch located in
the right iliac fossa , attached to its posteromedial surface is the appendix. The
longutudinal Mm. folded in 3 strips called the
teniea coli which covered the base of the
appendix.The ileum enter the large int. at the
junction of the cecum with the ascending colon
in the ileo-cecal valve.

The Large Intestine

The Appendix :is a narrow muscular tube

contain large amount of lymphoid
tissue ,its base lies below the ileo-cecal
junction & attached by the mesoappendix to the mesentery of the small
int.The tip lies in many positions like
retrocecal, pelvic, paracecal, subhepatic
& retro-ileal sites.

The Large Intestine

The Ascending Colon :It is 13 cm
long ,extend upward from the cecum
to inf. surface of the liver where it
turns to the left forming the hepatic
flexure & become continuous with
the transverse colon.
The Transverse Colon : It is 40 cm long
, begins at hepatic flexure extend
across the abd. suspended by the
transverse meseocolon, to the
splenic flexure where turns
downward to start the descending

The Large Intestine

The Descending Colon :
It
is 25 cm long , extend
from the splenic
flexure downward to
pelvic brim to continue
with sigmoid colon,
The Sigmoid Colon :It is
35
cm long ,begins at the
pelvic brim to continue
with the rectum at S3
vertebra .Its attached to
post. pelvic wall

The Large Intestine

The rectum :It is 13 cm long
begins in front of S3 as
continuation of sigmoid
colon to pass downward
fallowing the curve of the
sacrum & coccyx to the tip
of the coccyx where pierce
the pelvic diaphragm &
become continuous with
the anal canal . The
dialated lower part called
the rectal ampulla.
The Anal Canal :is 5 cm long
extend from the pelvic
diaphragm to the anus

The blood supply of

GIT.

The arterial supply of the GIT related to the

development of deferent parts of the gut .
The celiac A. is the A. of the foregut &
supplies from the lower 1/3 of the
osophagus to the middle of the 2nd part of
the duodenum.
The sup. Mesenteric A .is the A. of the
midgut & supplies from the middle of the
2nd part of the duodenum to distal 1/3 of
the transverse colon.
The inf. Mesenteric A. is the A. of the
hindgut &supplies the large int. from
distal 1/3 of the transverse colon down to

The celiac artery

It arise from the abdominal aorta at
T12 level, It gives 3 branches :
1- The left gastric A. to lesser curvature
of the stomach &lower Esophagus to
anastamose with the right gastric A..
2- The splenic A: run on the upper
border of the pancreas & behind the
stomach to enters the spleen . It
gives:
2-1- pancreatic branches.
2-2- left gastro-epiploic A. on the
greater curvature of the stomach to
anastamose with the right gastro-

The celiac
artery
2-3Short gastric Aa. to the fundus of the
stomach.
3- The Hepatic A. which gives :
3-1- right gastric A. runs on the lesser
curvature to anastamose with the left
gastric A.
3-2- Gastro-duodenal A. runs behind the 2nd
part of the duod. to divide to right gastroepiploic A (on the greater curvature) &
superior pancreatico-duodenal A. which
descend between the 2nd part of the duod.
& the head of pancreas.
3-3- Right & left hepatic Aa. that enter the

The superior mesenteric

It artery
is the A. of the midgut . It arise from
the abd. aorta below the celiac A. to
run downward behind the neck of
the panc.& in front of the 3rd part of
the duod. Its branches are :
1- the inf. Pancreatico-duodenal A.
2- middle colic A to supply the trans.
colon
3- right colic A. to supply the ascen.
colon.
4- Ileo-colic A. which supply the small

The inferior mesenteric A.

It is the A. of the hindgut,arise from
the aorta 4 cm above its bifurcation
to pass downward & to the left.Its
branches are:
1- left colic A.
2- sigmoid Aa.
3- superior rectal A.
The marginal A.: form from the
anastamosis of the colic Aa. Aroud
the concave margin of the large int. It
starts at the ileo-cecal junction to the
sup rectal A.

Inervasi GIT

N. Vagus (Parasimpatis)
N. Vagus kanan berjalan turun dalam
thorax membentuk plexus
pulmonalis posterior oesophagus
membentuk plexus oesophagus
dinding posterior lambung
N.Vagus kiri berjalan turun dalam
thorax membentuk plexus
pulmonalis permukaan anterior
oesophagus membentuk plexus
oesophagus dinding anterior

Truncus Symphaticus
Truncus Symphaticus thoracica truncus
symphaticus abdominalis truncus
symphaticus pelvica
Plexus Aorticum : plexus yang mengelilingi
sekitar a.coelica, a.renalis, a.mesenterica
superior dan a.mesenterica inferior.
Plexus Aorticum terdiri dari plexus coeliacus,
plexus renalis, plexus mesentericus superior
dan plexus mesentericus inferior

Inervasi Oesophagus
Oesophagus dipersarafi oleh serabut
saraf parasimpatis (n.vagus) dan
simpatis (trunkus simpatikus)
Pada bagian bawah dalam
perjalanannya pada thorax,
oesophagus dikelilingi oleh plexus
oesophagus.

Inervasi Gaster
Terdiri dari saraf simpatis (plexus
simpaticus coeliacus) dan parasimpatis
(n.vagus kanan dan kiri)
Simpatis menghantarkan rasa nyeri
Serabut parasimpatis sekretomotoris
untuk kelenjar lambung dan motoris
untuk otot dinding lambung

Inervasi Duodenum, Jejunum dan

Ileum
Duodenum terdiri dari saraf
parasimpatis (n. vagus) dan saraf
simpatis (plexus mesenterikus
superior dan plexus coeliacus)
Jejunum dan Ileum terdiri dari saraf
simpatis (plexus mesentericus
superior) dan parasimpatis (n.vagus)

Inervasi Caecum &

Appendix
Saraf caecum berasal dari saraf
simpatis (plexus mesentericus superior)
dan saraf parasimpatis (n.vagus)
Saraf appendix berasal dari saraf
simpatis (plexus mesentericus superior
dan saraf parasimpatis (n.vagus).
Serabut saraf aferen yang menghantarkan rasa nyeri
viseral dari appendix berjalan bersama saraf
simpatis dan masuk ke medula spinalis setinggi
segmen thoracica X

Inervasi Colon Ascenden

Berasal dari saraf simpatis (plexus
mesentericus superior) dan saraf
parasimpatis (n.vagus)

Inervasi Colon Transversum

Berasal dari saraf simpatis (plexus
mesentericus superior dan inferior)
dan saraf parasimpatis (n.vagus dan
dari saraf parasimpatis pelvis).
Serabut n.vagus hanya mempersarafi
2/3 proksimal colon transversum; 1/3
distal dipersarafi oleh saraf
parasimpatis n.pelvicus

Inervasi Colon Descenden

Berasal dari serabut saraf simpatis
(plexus mesentericus inferior) dan
saraf parasimpatis (n.pelvicus)

Inervasi Colon Sigmoid &

Rectum
Persarafan colon sigmoid berasal dari
plexus hypogastricus inferior, plexus
ini berjalan ke atas pada atap
mesocolon sigmoideum
Persarafan rectum juga berasal dari
plexus hypogastrica inferior

Inervasi Anus
Persarafan mukosa dan m.sphincter
ani internus oleh plexus hypogastrica
inferior
Persarafan m.sphincter ani eksternus
oleh n.rectalis inferior (cabang
n.pudendus)