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Anatomy Stomach, Small Intestine, Liver Ngo Ly Ly _ Class D_Group16 Content Stomach Small intestine Liver Abdomen • lines • regions Stomach • Position: epigastric and left hypochrondium region • Anterior: left lobe of the liver, the anterior abdominal wall, and the distal transverse colon • Posterior: the left hemidiaphragm, the spleen, the left kidney, and the pancreas (stomach bed) Stomach parts: cardia, fundus, body, pylorus The wall of the stomach is seen as layers: mucosa, submucosa, smooth muscle and serosa Stomach Blood supply Stomach Nerve supply Small intestine duodenum jejunum ileum Duodenum • 25 cm, C-shaped, upper abdomen near midline • parts: superior, descending, horizontal, ascending Duodenum • The Superior part, or duodenal bulb (5 cm), which is connected to the undersurface of the liver (porta hepatis) by the hepatoduodenal ligament (HDL), containing the proper hepatic artery, portal vein, and common bile duct (CBD); the quadrate lobe (segment IV) of the liver and the gallbladder are in front, whereas the CBD, the portal vein (PV), and the gastroduodenal artery (GDA) are behind it • The descending part (10 cm), which has an upper and a lower genu (flexure); the transverse mesocolon and transverse colon are in front, and the right kidney and inferior vena cava (IVC) are behind it; the head of the pancreas lies in the concavity of the duodenal C • The horizontal part (7.5 cm) runs from right to left in front of the IVC and aorta, with the superior mesenteric vessels (the vein on the right and the artery on the left) in front of it • The ascending part (2.5 cm) continues as the jejunum Blood supply of duodenum Jejunum and ileum jejunum ileum • • • • • 2/5 of small intestine • Thicker wall, wider lumen • Left upper and central abdomen Less mesenteric fat, mesentery vessels are well seen • 3/5 of small intestine Thinner wall, smaller lumen Central and right lower abdomen and pelvis More mesenteric fat, mesentery vessels are not well seen Small bowel mesentery •  It is fan-shaped with a root of about 15 cm extending obliquely from the left L2 transverse process level to the right sacroiliac joint and crossing a third part of the duodenum, aorta and inferior vena cava (IVC)right ureter, and a 4- to 6-m periphery, which covers the entire length of the jejunum and ileum Between the leaves of the mesentery are the mesenteric vessels and lymph nodes Small intestine Blood supply • Superior mesenteric artery (SMA) => jejunal and ileal arteries ( 12-15 branches) They form a series of arcades -> vasa recta • Ileocolic artery, The ileal branch of the ileocolic artery anastomoses with the terminal ileal branch of the SMA Small intestine Nerve supply • Meissner and Auerbach nerve plexus • sympathetic nerves by branches of the superior mesenteric plexus

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