4-3-消化管2(咽-肛管-双语版).ppt

Mouth Pharynx Esophagus Stomach Duodenum Jejunum Ileum Large intestine Liver Pancreas Major salivary glands Alimentary System Anus Pharynx General features A fibromuscular tube,part of digestive and respiratory systems Extends from base of skull to the inferior border of cricoid cartilage(lower border of C6 level)Three segments Nasopharynx Oropharynx Laryngopharynx Pharynx Nasopharynx Position Posterior to nasal cavities Extends from the base of skull to the level of free border of palatine velum Features Pharyngeal opening of auditory tube Tubal torus Pharyngeal recess Tubal tonsil Pharyngeal tonsil Pharynx Oropharynx Position Posterior to oral cavity Extends from free border of palatine velum to the level of upper border of epiglottis Features Median glossoepiglottic fold Epiglottic vallecula Palatine tonsil Lies within tonsillar fossa Tonsillitis Tonsil inflammation Pharynx Laryngopharynx Position Posterior to larynx Extends from upper border of epiglottis to the level of lower border of C6 Piriform recess A deep depression on each side of aperture of larynx common side for lodgement of foreign bodies(for example,fish bones)Pharynx Lymphatic ring of pharynx Forming a circular band of lymphoid tissue at oropharyngeal isthmu Consists of Pharyngeal tonsil tubal tonsil Palatine tonsil lingual tonsil Esophagus General features A muscular tuber about 25cm long Connecting the pharynx at level of inferior border of vertebra C6 Passes through the diaphragm at level of vertebra T10 Ends at the cardia of the stomach,opposite vertebra T11 Division Cervical part:5cm Thoracic part:18-22cm Abdominal part:1-2cm Esophagus Three constrictions 1.Where it beginning,15cm from incisors,lies at level of inferior border of C6,is the narrowest part of the esophagus 2.Where it is crossed by left principal bronchus,25cm from incisors,lies at level of intervertebral disc between T4 and T5.3.Where it pierces the esophageal hiatus of diaphragm,40cm from incisors,at level of T10 Stomach Shape Two surface:anterior and posterior Two curvatures Lesser curvature of stomach short,concave and directed to the right and upward near its lower part is angular incisure Greater curvature of stomach long,convex and directed to the left and downward at the junction of left margin of esophagus and greater curvature is cardiac incisure Two openings Cardia Pylorus Two incisure Stomach Four parts Cardiac part Fundus of stomach（cardiac incisure）Body of stomach（angular incisure）Pyloric part Pyloric antrum Pyloric canal Stomach Cardiac part Fundus of stomach Body of stomach Pyloric antrum Pyloric canal Pyloric part Location Mainly parts is situated in the left hypochondriac region Small in the epigastric region The cardia is situated to the left of T11,the pylorus lies to the right of L1.Stomach Structure of stomach wall consists of four usual layers Mucous membrane Submucous(loose areolar tissue connecting the mucous and muscular layer)Muscular layer contains:Innermost oblique fibres Inner circular fibres Sphincter of pylorus Pyloric valve The most superficial longitudinal fibers Serous(visceral peritoneum)Stomach Variations in position of stomach Duodenum first and widest part of small intestine extends from pylorus to duodenojejunal flexure approximately 25cm long and 4-5 cm in diameter C-shaped and moulded around head of pancreas retroperitoneal,except for a small segment(1-3 cm)at the beginning common bile duct and pancreatic ductsopen into the second part General features Duodenum Four parts 1.Superior part Duodenal bulb Superior duodenal flexure 2.Descending part Inferior duodenal flexure 3.Horizontal part 4.Ascending part Duodenojejunal flexure Descending part Longitudinal fold of duodenum Major duodenal papilla common opening of the common bile duct and pancreatic duct 75cm from incisors Minor duodenal papilla Duodenum Duodenum Suspensory muscle of duodenum and Suspensory lig.of duodenum(lig.of Treitz)a surgical landmark,descends from the right crus of diaphragm to duodenal termination.Jejunum and ileum Jejunum and Ileum Characteristic Jejunum Ileum Position Upper 2/5,upper left part of abdominal cavity Lower 3/5,lower right part of abdominal cavity Diameter Greater Less Wall Thicker Thin Circular folds Larger,numerous and large villi Fewer，smaller and less abundant villi Vascularity Greater Less Color Deeper red Paler pink Lymphatic follicles Solitary Aggregated Fat in mesentery Less More Meckels diverticulum Persistence of proximal portion of yolk sac Common malformation of digestive tract(24%)，more prevalent in males About 25cm long and located 30100cm from ileocecal valve Usually asymptomatic but:May become inflamed(mimicking appendicitis)or bleed Jejunum and Ileum Large Intestine Approximately 1.5m long,Five parts:Cecum Vermiform appendix Colon Rectum Anal canal Colic bands Haustra of colon Epiploic appendices Large Intestine Features Cecum Position lies in right iliac fossa Shape:Blind sac,first part of large intestine,with largest diamete