Download intestine rectum aorta vena cava

THEABDOMEN
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SMALLINTESTINE
LARGEINTESTINE
RECTUM
ABDOMINALAORTA
INFERIORVENACAVA
THESMALLINTESTINE
THESMALLINTESTINE:
•  IsthelongestpartofthegastrointesAnaltract-lengthof5metres
(3–7metres)inthelivingadult
•  Consistsoftheduodenum,jejunum,andileum
•  ExtendsfromthepyloricopeningtotheileocecaljuncAon
•  IsthelocaAonofcompletedigesAonandabsorpAonofmostofthe
productsofdigesAonandwater,electrolytes,andmineralssuchas
calciumandiron
THESMALLINTESTINE
DUODENUM
quickreview
THEDUODENUM
TheduodenumpursuesaC-shapedcoursearoundtheheadofthe
pancreas.
Itbeginsatthepylorusontherightsideandendsatthe
duodenojejunalflexure(juncAon)ontheleVside.
THEDUODENUM
SUPERIOR(FIRST)PARTOFTHEDUODENUM:
•  L1level
•  proximal2cmhasamesenteryandismobile,calledtheampulla
•  distal3cm(andtheotherthreepartsoftheduodenum)haveno
mesenteryandareimmobile-theyareretroperitoneal
•  peritoneumcoversanterioraspect
•  itisbareofperitoneumposteriorly,exceptfortheampulla
•  hepatoduodenalligament(partofthelesseromentum)a[achesto
theproximalpart
THEDUODENUM
DESCENDING(SECOND)PART:
•  alongtherightsidesoftheL1–L3vertebrae
•  liestotherightofandparalleltotheIVC
•  thebileandmainpancreaAcductsenteritsposteromedialwall
•  isenArelyretroperitoneal
•  anteriorsurfaceofitsproximalanddistalthirdsiscoveredwith
peritoneum
•  peritoneumreflectsfromitsmiddlethirdtoformthedoublelayeredmesenteryofthetransversecolon,thetransverse
mesocolon
THEDUODENUM
INFERIOR(THIRD)PART:
•  passingovertheIVC,aorta,andL3
•  iscrossedbytheSMA
•  posteriorly:rightpsoasmajor,IVC,aorta,andtherighttesAcularor
ovarianvessels
•  anteriorsurfaceiscoveredwithperitoneum(exceptwhereitis
crossedbythesuperiormesentericvessels)
THEDUODENUM
Ascending(fourth)part:
•  runssuperiorlyfromL3–L2vertebra
•  runsalongtheleVsideoftheaorta
•  supportedbythea[achmentofasuspensorymuscleofthe
duodenum(ligamentofTreitz)
•  anteriorsurfaceiscoveredwithperitoneum
THEDUODENUM
THEJEJUNUM
THEJEJUNUM
THEJEJUNUM
Thejejunumandileum,6–7mlong,occupythecentralandlowerparts
oftheabdominalcavityandusuallyliewithintheboundaryformedby
theabdominalcolon.
ThereisnocleardisAncAonbetweenthetwoparts,butthereisa
gradualchangeinmorphologyfromtheproximaltodistalendsofthe
smallbowel.
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thejejunumbeginsattheduodenojejunalflexure
thejejunum-proximal2/5
theileum–distal3/5
theileumendsattheileocecaljuncNon
THEJEJUNUM
MostofthejejunumliesintheleVupperquadrant(LUQ)
Mostoftheileumliesintherightlowerquadrant(RLQ)
THEJEJUNUM
Themesenterya[achesthejejunumandileumtotheposterior
abdominalwall-rootofthemesentery(15cmlong).
Therootofthemesentery:
•  directedobliquely
•  inferiorly
•  andtotheright
FromtheduodenojejunaljuncNonon
theleVsideofvertebraL2
totheileocolicjuncNonandtheright
sacro-iliacjoint.
Therootofthemesenterycrossesthe:
•  ascendingandinferiorpartsoftheduodenum,
•  abdominalaorta,
•  IVC,
•  rightureter,
•  rightpsoasmajor,
•  righttesAcularorovarian
vessels.
THEJEJUNUM
Betweenthetwolayersofthemesenteryarethe:
•  superiormesentericvessels,
•  lymphnodes,
•  avariableamountoffat,
•  autonomicnerves.
THEJEJUNUM
TheSMAsuppliesthejejunumandileumvia
jejunalandilealarteries
TheSMAusuallyarises
fromtheabdominal
aortaatthelevelofthe
L1vertebra
-
1cminferiorceliac
trunk.
TheSMArunsbetweenthelayers
ofthemesentery,
sending15–18branchestothe
jejunumandileum
THEJEJUNUM
Thearteriesunitetoformloopsorarches,
calledarterialarcades,
whichgiverisetostraightarteries,
calledvasarecta
TheSMVdrainsthejejunumandileum.TheSMVendsposteriorto
theneckofthepancreas,whereituniteswiththesplenicveinto
formthehepaNcportalvein
SpecializedlymphaAcvesselsintheintesNnalvillithatabsorbfatare
calledlacteals.
THEJEJUNUM
Withinthemesentery,thelymphpassessequenAallythroughthree
groupsoflymphnodes:
•  juxta-intesNnallymphnodes:locatedclosetotheintesAnalwall.
•  mesentericlymphnodes:sca[eredamongthearterialarcades.
•  superiorcentralnodes:locatedalongtheproximalpartofthe
SMA.
EfferentlymphaAcvesselsfromthemesentericlymphnodes
draintothesuperiormesentericlymphnodes.
LymphaAcvesselsfromtheterminalileumfollowtheilealbranchof
theileocolicarterytotheileocoliclymphnodes.
THEJEJUNUM
TheinnervaNonofthesmallintesNneisbytheentericnervous
system,whichinthesmallintesAneconsistsofthe:
•  submucosalplexusofMeissnerand
•  myentericplexusofAuerbach.
THEJEJUNUM
SYMPATHETIC
Preganglionicneuronalcellbodiesarelocatedinthe
intermediolateralcellcolumnofthespinalcord(T8–12).
Preganglionicaxonsformthe:
•  greatersplanchnicnerve,
•  lessersplanchnicnerve,
•  leastsplanchnicnerve.
SYMPATHETIC
Postganglionicneuronalcellbodiesarelocatedintheceliacganglion
andsuperiormesentericganglion.
THEJEJUNUM
PARASYMPATHETIC
Preganglionicneuronalcellbodiesarelocatedinthedorsalnucleusof
thevagus.
PreganglionicaxonsruninCNXandreachthesmallintesAneviathe
posteriorvagaltrunk.
Postganglionicneuronalcellbodiesarelocatedintheentericnervous
system;someofthesearethe“tradiAonal”postganglionic
parasympatheAcneuronsthatreleaseAChasaneurotransmi[er.
Thepostganglionicaxonsterminateonmucosalglandsandsmooth
muscle.
THEJEJUNUM
SympatheNcsAmulaAonreducesperistalAcandsecretoryacAvityof
theintesAneandactsasavasoconstrictor,reducingorstopping
digesAonandmakingblood(andenergy)availablefor“fleeingor
fighAng.”
ParasympatheNcsAmulaAonincreasesperistalAcandsecretory
acAvityoftheintesAne,restoringthedigesAonprocessfollowinga
sympatheAcreacAon.
THEJEJUNUM
ThesmallintesAnealsohassensory(visceralafferent)fibers.The
intesAneisinsensiAvetomostpainsAmuli,includingcuingand
burning;however,itissensiAvetodistensionthatisperceivedascolic
(“intesAnalcramps”).
THEABDOMEN
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SMALLINTESTINE
LARGEINTESTINE
RECTUM
ABDOMINALAORTA
INFERIORVENACAVA
THELARGEINTESTINE
ThelargeintesNneconsistsofthe:
•  cecum
•  appendix
•  ascending
•  transverse
•  descending
•  sigmoidcolon
•  rectum
•  analcanal
THELARGEINTESTINE
•  ExtendsfromtheileocecaljuncNontotheanusandis
approximately1.5m(5V)long.
•  FuncAonstoconverttheliquidcontentsoftheileumintosemisolid
fecesbyabsorbingwater,salts,andelectrolytes.
THELARGEINTESTINE
ThelargeintesNnecanbedisAnguishedfromthesmallintesAneby:
•  Omentalappendices:small,fa[y,omentum-likeprojecAons.
•  Teniaecoli:threedisAnctlongitudinalbands:1.mesocolictenia,to
whichthetransverseandsigmoidmesocolonsa[ach;2.omental
tenia,towhichtheomentalappendicesa[ach;and3.freetenia,
towhichneithermesocolonsnoromentalappendicesare
a[ached.
•  Haustra:sacculaAonsofthewallofthecolonbetweentheteniae
•  Amuchgreatercaliber(internaldiameter).
THELARGEINTESTINE
Theteniaecoli,thickenedbandsofsmoothmusclerepresenAngmost
ofthelongitudinalcoat,beginatthebaseoftheappendixasthethick
longitudinallayeroftheappendixseparatesintothreebands.
ThececumisthefirstpartofthelargeintesAneandisablind
intesAnalpouch.
Itliesintheiliacfossaoftherightlowerquadrantoftheabdomen
Itmaybedisplacedfromtheiliacfossa,butitiscommonlyboundto
thelateralabdominalwallbyoneormorececalfoldsofperitoneum
THELARGEINTESTINE
Theilealorificeentersthececumbetweenileocoliclips(superior
andinferior),foldsthatmeetlaterallyformingridgescalledthe
frenulaoftheilealorifice.
TheappendixisablindintesAnaldiverAculum(6–10cminlength)
thatcontainsmassesoflymphoidAssue.
TheappendixhasashortTRIANGULARmesentery,
themeso-appendix
TheposiAonoftheappendixisvariable,butitisusuallyretrocecal
THELARGEINTESTINE
Thearterialsupplyofthececumisfromtheileocolicartery,the
terminalbranchoftheSMA.
Theappendicularartery,abranchoftheileocolicartery,suppliesthe
appendix.
Venousdrainagefromthececumandappendixflowthrougha
tributaryoftheSMV,theileocolicvein.
THELARGEINTESTINE
LymphaNcdrainageofthececumandappendixpassesto
lymphnodesinthemeso-appendixandtotheileocoliclymph
nodesthatliealongtheileocolicartery.
Thenervesupplytothececumandappendixderivesfrom
thesympatheAcandparasympatheAcnervesfromthesuperior
mesentericplexus.
THELARGEINTESTINE
Thecolonhas4parts:
•  ascending
•  transverse
•  descending
•  andsigmoid.
Theascendingcolonpassessuperiorlyontherightsideofthe
abdominalcavityfromthececumtotherightlobeoftheliver,where
itturnstotheleVattherightcolicflexure-hepaAcflexure.
THELARGEINTESTINE
Thearterialsupplytotheascendingcolonandrightcolicflexureis
frombranchesoftheSMA,theileocolicandrightcolicarteries.
Venousdrainagefromtheascendingcolonflowsthroughtributaries
oftheSMV,theileocolicandrightcolicveins.
THELARGEINTESTINE
Thetransversecolonisthethird,longest,andmostmobilepartofthe
largeintesAne.FromtherightcolicflexuretotheleVcolicflexure.
ThedescendingcolonisbetweentheleVcolicflexureandtheleViliac
fossa,whereitisconAnuouswiththesigmoidcolon.
THELARGEINTESTINE
Thele_colicflexure(splenicflexure)isusually:
•  moresuperior,
•  moreacute,
•  lessmobile.
Themesenteryofthetransversecolon(transversemesocolon)is
adherenttoorfusedwiththeposteriorwalloftheomentalbursa.
Therootofthetransverse
mesocolonliesalongthe
inferiorborderofthe
pancreasandisconAnuous
withtheparietal
peritoneumposteriorly.
THELARGEINTESTINE
Intallthinpeople,thetransversecolonmayextendintothepelvis
Thearterialsupplyofthe
transversecolonismainly
fromthemiddlecolicartery,a
branchoftheSMA.
Thearterialsupplyofthe
transversecolonismainly
fromthemiddlecolicartery,a
branchoftheSMA.
Thetransversecolonmayalso
receivearterialbloodfromthe
rightandleVcolicarteriesvia
anastomoses.
THELARGEINTESTINE
VenousdrainageofthetransversecolonisthroughtheSMV.
ThelymphaNcdrainageofthe
transversecolonistothe
middlecoliclymphnodes,
whichinturndraintothe
superiormesentericlymph
nodes.
THELARGEINTESTINE
Theperitoneum
coversthe
descendingcolon
anteriorlyand
laterally.
Venousdrainagefromthe
descendingcolon
isprovidedbytheIMV,
flowingusuallyintothe
splenicveinandthenthe
hepaAcportalveinonits
waytotheliver.
Thearterialsupplyofthe
descendingisfromthele_
colic,branchesoftheIMA.
THELARGEINTESTINE
Thesigmoidcolon,characterizedbyitsS-shapedloopof
variablelength,linksthedescendingcolonandtherectum.
Thesigmoidcolonhasalongmesentery,thesigmoidmesocolon,and
thereforehasconsiderablefreedomofmovement
Theomental
appendicesofthe
sigmoidcolonare
long.
Thearterialsupplyof
thesigmoidcolonis
fromthesigmoid
arteries,branchesof
theIMA.
THELARGEINTESTINE
TheSMAsupplyingbloodtotheleVcolicflexure-derivedfromthe
embryonicmidgut.
TheIMAsupplyingbloodfromtheleVcolicflexure-derivedfromthe
embryonichindgut.
Venousdrainagefromthe
sigmoidcolonisprovidedby
theIMV,flowingusually
intothesplenicveinand
thenthehepaAcportalvein
onitswaytotheliver.
LymphaNcdrainagefrom
thedescendingcolonand
sigmoidcolonisconducted
throughvesselspassingto
theepicolicandparacolic
nodes,andthenthroughthe
intermediatecoliclymph
nodesalongtheleVcolic
artery.
THELARGEINTESTINE
ThesympatheNcnervesupplyofthedescendingandsigmoid
colonisfromthelumbarpartofthesympatheNctrunkvialumbar
(abdominopelvic)splanchnicnerves.
TheparasympatheNcnervesupplyisfromthepelvic
splanchnicnervesviatheinferiorhypogastric(pelvic)plexus
andnerves(S2-S4).
THEABDOMEN
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SMALLINTESTINE
LARGEINTESTINE
RECTUM
ABDOMINALAORTA
INFERIORVENACAVA
THERECTUM
Therectumisthefixed(primarilyretroperitonealand
subperitoneal)terminalpartofthelargeintesAne.
TherectumisconAnuouswiththesigmoidcolonatthelevelof
S3vertebra,isconAnuousinferiorlywiththeanalcanal.
THEABDOMEN
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SMALLINTESTINE
LARGEINTESTINE
RECTUM
ABDOMINALAORTA
INFERIORVENACAVA
THEABDOMINALAORTA
Theabdominalaorta
beginsat
theaorNchiatus
inthediaphragmatthe
levelofthe
T12vertebra
andendsatthe
levelofthe
L4vertebra
bydividingintothe
rightandle_common
iliacarteries.
Theabdominalaortais
approximately
13cminlength.
Thebranchesoftheaorta
aredescribedas:
•  anterior,
•  lateraland
•  dorsal.
THEABDOMINALAORTA
Theanteriorandlateral
branchesaredistributed
totheviscera.
Thedorsalbranches
supplythebodywall,
vertebralcolumn,
vertebralcanalandits
contents.
Theaortaterminatesby
dividingintothe
rightandle_common
iliacarteries.
THEABDOMINALAORTA
Thebranchesoftheaorta:
•  inferiorphrenica.
•  celiactrunk
•  superiormesenterica.
•  middlesuprarenala.
•  renala.
•  tesAcularorovariana.
•  fourlumbaraa.
•  inferiormesenterica.
•  mediansacrala.
•  commoniliaca.
THEABDOMINALAORTA
THEBRANCHESOFTHEAORTA
INFERIORPHRENICA.
Pairedarteriesthatsupplythediaphragm,whichtheyenterfrom
below.Itsuppliesdiaphragmandgivessuperiorsuprarenalarteries.
CELIACTRUNK
CommonstemoftheleVgastric,commonhepaAcandsplenic
arteriesatthelevelofT12.
Anteriortotheceliactrunkliesthelessersac.Theceliacplexus
surroundsthetrunk,sendingextensionsalongitsbranches.Thebody
ofthepancreasandthesplenicveinareinferiortotheceliactrunk.
THEABDOMINALAORTA
THEBRANCHESOFTHEAORTA
SUPERIORMESENTERICARTERY
Unpairedbranchoftheaortaarisingabout1cmbelowtheceliac
trunk.Itextendsfrombehindthepancreastotheuncinate
processandpasseswithitsbranchesintothemesenteryand
mesocolon.
MIDDLESUPRARENALARTERY
Arisesfromthelateralaspectoftheabdominalaorta,levelwiththe
superiormesentericarteryandsuppliesthesuprarenalgland.
RENALARTERY
Thelargestbranchesoftheabdominalaorta,itarisesfromtheaorta
infrontofL1anddividesintoseveralbrancheswhichenterthe
kidney.
THEABDOMINALAORTA
THEBRANCHESOFTHEAORTA
RENALARTERY
TherightislongerandusuallyarisesslightlyhigherthantheleV.It
passesposteriortotheinferiorvenacava,rightrenalvein,headofthe
pancreasandsecondpartoftheduodenum.
TESTICULAROROVARIANARTERY
Thegonadalarteriesaretwolongvessels,thatarisefromthe
aortainferiortotherenalarteries.Eachpassesinferolaterally
undertheparietalperitoneumonpsoasmajor.
FOURLUMBARARTERIES
Theyarisefromtheposterolateralaspectoftheaorta,which
correspondtotheintercostalarteries.
THEABDOMINALAORTA
THEBRANCHESOFTHEAORTA
INFERIORMESENTERICARTERY
ItarisesfromtheanteriororleVanterolateralaspectoftheaorta.The
inferiormesentericarteryisusuallysmallerincalibrethanthesuperior
mesentericartery.
MEDIANSACRALARTERY
Arisesfromtheposterioraspectoftheaortaali[leaboveits
bifurcaAon.Itdescendsinthemidlineandendsinthecoccygealbody.
COMMONILIACARTERY
ItextendsfromthebifurcaAonofthedescendingaortaatL4/L5toits
divisionintotheinternalandexternaliliacarteriesinfrontofthe
sacroiliacjoint.
THEABDOMINALAORTA
Thebranchesoftheaorta:
•  inferiorphrenica.
•  celiactrunk
•  superiormesenterica.
•  middlesuprarenala.
•  renala.
•  tesAcularorovariana.
•  fourlumbaraa.
•  inferiormesenterica.
•  mediansacrala.
•  commoniliaca.
THEABDOMINALAORTA
Thecommoniliacarteriesdivergeandruninferolaterally,following
themedialborderofthepsoasmusclestothepelvicbrim.
•  Theinternaliliacarteryentersthepelvis.
•  Theexternaliliacarteryfollowstheiliopsoasmuscle,givesriseto
theinferiorepigastricanddeepcircumflexiliacarteries
RELATIONSOFABDOMINALAORTA:
•Celiacplexusandganglion
•Bodyofthepancreasandsplenicvein
•LeVrenalvein
•Horizontalpartoftheduodenum
•CoilsofsmallintesAne
THEABDOMINALAORTA
RELATIONSOFABDOMINALAORTA:
Ontheright,theaortaisrelatedtotheazygosvein,cisternachyi,
thoracicduct,rightcrusofthediaphragm,andrightceliac
ganglion.
Onthele_,theaortaisrelatedtotheleVcrusofthediaphragmand
theleVceliacganglion.
THEABDOMEN
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SMALLINTESTINE
LARGEINTESTINE
RECTUM
ABDOMINALAORTA
INFERIORVENACAVA
THETHEINFERIORVENACAVA
TheIVCleavesthe
abdomenbypassing
throughthecaval
openinginthediaphragm
andentersthethoraxat
theT8
vertebrallevel.
Theinferiorvenacava
(IVC)beginsanteriortothe
L5vertebrabytheunionof
thecommoniliacveins.
THETHEINFERIORVENACAVA
THEINFERIORVENACAVA
TheinferiorvenacavaisformedbythejuncAonofthecommoniliac
veinsanteriortothefiVhlumbarvertebralbody,ali[letoitsright.
Itascendsanteriortothevertebralcolumn,totherightoftheaorta,
andiscontainedinadeepgrooveontheposteriorsurfaceofthe
liver.
TheabdominalporAonoftheinferiorvenacavaisdevoidofvalves.
TRIBUTARIES
•  thecommoniliacveinsatitsorigin
•  lumbar,
•  rightgonadal,
•  renal,
•  rightsuprarenal,
•  inferiorphrenic,
•  hepaAcveins
THETHEINFERIORVENACAVA
THETHEINFERIORVENACAVA
THEINFERIORVENACAVA
TheveinsoftheposteriorabdominalwallaretributariesoftheIVC,
exceptforthele_tesNcularorovarianvein,whichenterstheleV
renalveininsteadofenteringtheIVC
TheIVCreturnsbloodfromthe:
•  lowerlimbs,
•  mostoftheback,
•  abdominalwalls,
•  abdominopelvicviscera.
THETHEINFERIORVENACAVA
Bloodfromtheabdominalviscerapassesthroughtheportalvenous
systemandtheliverbeforeenteringtheIVCviathehepaNcveins.
TheIVCcollectsbloodfromthelowerlimbsandnon-portalblood
fromtheabdomenandpelvis.
ThetributariesoftheIVCcorrespondtothepairedvisceraland
parietalbranchesoftheabdominalaorta.
AllthebloodfromthegastrointesNnaltractiscollectedbythe
hepaAcportalsystemandpassesthroughthehepaAcveinstotheIVC.
Theveinsthatcorrespondtotheunpairedvisceralbranchesof
theaortaareinsteadtributariesofthehepa9cportalvein.
THETHEINFERIORVENACAVA
Thebranchescorrespondingtothepairedvisceralbranchesofthe
abdominalaortaincludethe:
•  rightsuprarenalvein,
•  rightandleVrenalveins,
•  rightgonadal(tesAcularorovarian)vein.
Thele:suprarenalandgonadalveinsdrainindirectlyintotheIVC
becausetheyaretributariesofthele:renalvein.
INTRAPERITONEAL
AND
RETROPERITONEALORGANS
THEPERITONEALCAVITY
INTRAPERITONEALANDRETROPERITONEALORGANS:
•  Intraperitonealorgansaresuspendedbyamesenteryandare
almostcompletelyenclosedinvisceralperitoneum.Theseorgans
aremobile.
•  RetroperitonealorgansareparAallycoveredononesidewith
parietalperitoneumandareimmobileorfixedorgans.Many
retroperitonealorganswereoriginallysuspendedbyamesentery
andbecomesecondarilyretroperitoneal.
THEPERITONEALCAVITY
INTRAPERITONEALANDRETROPERITONEALORGANS:
MajorlntraperitonealOrgans(suspendedbyamesentery)
•  Stomach
•  Liverandgallbladder
•  Spleen
•  Duodenum,1stpart
•  Tailofpancreas
•  Jejunum
•  Ileum
•  Appendix
•  Transversecolon
•  Sigmoidcolon
THEPERITONEALCAVITY
INTRAPERITONEALANDRETROPERITONEALORGANS:
MajorSecondaryRetroperitonealOrgans(lostamesenteryduring
development)
•  Duodenum,2ndand3rdparts
•  Head,neck,andbodyofpancreas
•  Ascendingcolon
•  Descendingcolon
•  Upperrectum
THEPERITONEALCAVITY
INTRAPERITONEALANDRETROPERITONEALORGANS:
MajorPrimaryRetroperitonealOrgans(neverhadamesentery)
•  Kidneys
•  Adrenalglands
•  Ureters
•  Aorta
•  lnferiorvenacava
•  Lowerrectum
•  Analcanal
THEPERITONEALCAVITY
ADULTSTRUCTURESDERIVEDFROM
EACHOFTHE3DIVISIONSOFTHEPRIMITIVEGUTTUBE
FOREGUT
Artery:celiac
ParasympatheNcinnervaNon:vagusnerves
SympatheNcinnervaNon:
•  preganglionics:thoracicsplanchnicnerves,T5-T9
•  postganglioniccellbodies:celiacganglion
ReferredPain:Epigastrium
ForegutDerivaNves:
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Esophagus
Stomach
Duodenum(firstandsecondparts)
Liver
Pancreas
Biliaryapparatus
Gallbladder
THEPERITONEALCAVITY
ADULTSTRUCTURESDERIVEDFROM
EACHOFTHE3DIVISIONSOFTHEPRIMITIVEGUTTUBE
MIDGUT
Artery:superiormesenteric
ParasympatheNcinnervaNon:vagusnerves
SympatheNcinnervaNon:
-Preganglionics:thoracicsplanchnicnerves,T9-T12
-Postganglioniccellbodies:superiormesentericganglion
ReferredPain:Umbilical
MidgutDerivaNves
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Duodenum(second,third,andfourthparts)
Jejunum
Ileum
Cecum
Appendix
Ascendingcolon
Transversecolon(proximaltwo-thirds)
THEPERITONEALCAVITY
ADULTSTRUCTURESDERIVEDFROM
EACHOFTHE3DIVISIONSOFTHEPRIMITIVEGUTTUBE
HINDGUT
Artery:inferiormesenteric
ParasympatheNcinnervaNon:pelvicsplanchnicnerves
SympatheNcinnervaNon:
•  preganglionics:lumbarsplanchnicnerves,L1-L2
•  postganglioniccellbodies:inferiormesentericganglion
ReferredPain:Hypogastrium
HindgutDerivaNves
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Transversecolon(distalthirdsplenicflexure)
Descendingcolon
Sigmoidcolon
Rectum
Analcanal(abovepecAnateline)