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Transcript
Part II Splanchnology
Chapter 4 The general Description
Part II Splanchnology
Chapter 4 The general Description
I.
The definition and subdivisions of the splanchnology :
alimentary system
respiratory system
urinary system
genital system
•
The study of viscera.
•
Most of them are situated in the thoracic, abdominal and
pelvic cavities and are associated with the pleura or
peritoneum.
•
It also opened to outside of body directly or indirectly.
II . The main functions of viscera:
• The alimentary system: to ingest foods; secrete enzymes
that modify the sizes of food molecules; absorb the products
of this digestive action and to eliminate the unused residua.
• The respiratory system: to carry out the gass exchanges
--- supply of oxygen for the living cells and remove of carbon
dioxide resulting from cell metabolism.
• The urinary system: to keep the body in homeostasis by
removing and restoring selected amount of water and solutes.
It also excretes selected amount of various wastes.
• The genital system: to produce germ cells and to secrete
some hormones.
IV. The reference lines and abdominal regions
1. References lines of the thorax:
•
•
•
Anterior median line
Lateral sternal line
Midclavicular line
•
•
Parasternal line
Anterior axillary line
•
Midaxillary line
•
•
•
Posterior axillary line
Scapular line
Paravertebral line
•
Posterior median line
2. Reference lines of abdomen and abdominal regions:
• 2 transverse lines :
subcostal line
transtubercular line
• 2 longitudinal lines:
mid-inguinal lines
•
• 9 regions:
epigastric region
umbilical region
pubic (hypogastric) region
right and left hypochondriac regions
right and left lumbar(lateral)regions
right and left inguinal (iliac) regions
2. Reference lines of abdomen and abdominal regions:
• a transverse line through the
umbilicus and a vertical line
in the midline of the body.
• 4 regions: upper right ( RUQ )
upper left ( LUQ )
lower right ( RLQ )
lower left ( LLQ )
Part II Splanchnology
Chapter 5 The Alimentary System
Ⅰ. General Description:
* Constituents: 2 parts
Alimentary canal:
the mouth,
the pharynx,
the esophagus, the stomach,
the small intestines:
the duodenum, the jejunum,
the ileum
the large intestines:
the cecum and appendix,
the colon, the rectum,
the anal canal
Digestive glands:
the salivary glands:
the parotid gland
the submandibular gland
the sublingual gland
the liver,
the pancreas
* Functions:
ingest foods,
secrete enzymes,
absorb nutrients
eliminate unused residues
Ⅱ.The Mouth:
2 parts: oral vestibular, oral cavity proper.
* walls: oral lips, cheeks, palate,
Tongue.
isthmus of fauces
* contents: teeth, tongue.
* palate:
hard palate
soft palate
palatine velum
palatoglossal arch
palatopharyngeal arch
palatine tonsil
* isthmus of fauces:
uvula
free margin of palatine velum
palatoglossal arch
root of tongue.
* The teeth
deciduous teeth
permanent teeth
form
crown
root
neck of teeth
The structure:
dentine
enamel
cement
periodontal membrane
dental cavity, root canal
apical foramen
dental pulp
deciduous teeth: 20
2 pairs of incisors
1 pair of canine tooth
2 pairs of molars
permanent teeth: 28-32
2 pairs of incisors
1 pair of canine tooth
2 pairs of premolars
3 pairs of molars
(wisdom tooth)
• The tongue
3 parts--- root, apex and body
Dorsum: V-shaped terminal sulcus
4 kinds of papillae---Filiform papillae
no tastbuds
tastebuds associated with
Fungiform papillae
Foliate papillae
Vallate papillae
lingual tonsil
Inferior surface of tongue:
the Frenulum of tongue
the Sublingual caruncle
the Sublingual folds
Structures:
mucosa,
muscles of the tongue
Ⅲ. The pharynx:
• Position:
in front of the 1~6th
cervical vertebrae
• Parts: Nasopharynx
Oropharynx
Laryngopharynx
• Features and structures:
nasal part---opening of auditory tube
tubal torus
pharyngeal recess
oral part--palatine tonsil,
tubal tonsil
laryngeal part---piriform recess
• Communication of pharynx:
anteriorly: ---choanae---nasal cavity
---isthmus of fauces---oral cavity
---aperture of larynx---laryngeal cavity
inferiorly: ---esophagus
Laterally:---pharyngeal opening of auditory tube---tympanic cavity
Ⅳ.The Esophagus:
• 3 parts: cervical, thoracic and
abdominal parts
• 3 constrictions:
1st---at its commencement, 15cm
from the incisor teeth
2nd---where is crossed by the left
principal bronchus anteriorly,
25cm from the incisor teeth
3rd---where it passes through the
diaphragm, 40cm from the
incisor teeth
• position
• The Salivary glands:
The Parotid gland
The duct to this gland (Stensen’s duct ) (the inside
of the cheek buccal mucosa ) opposite the upper
second molar.
The Sublingual gland
the Sublingual folds
The Submandibular gland
the Sublingual caruncle
The Name,
Positions,
Opening of its ducts
The stomach :
The shape and parts
openings: cardia, pylorus
surfaces: anterior and posterior
curvatures: greater curvature
lesser curvature
angular incisure
parts: the cardiac part
the fundus of stomach
the body of stomach
the pyloric part
pyloric antrum
pyloric canal
 The position and relations
--- the position:
Its between the end of the
esophagus and the beginning
of the small intestine. It lies in
the epigastric, umbilical and
left hypochondriac regions of
abdomen.
cardiac orifice– at left side
of 11th thoracic vertebra
pyloric orifice– at right side
of 1st lumbar vertebra
- the relations:
teriorly--left costal margin
diaphragm
left pleura
the base of the left lung
the left pleural cavity
the pericardium
left and quadrate lobes of the liver
the anterior abdominal wall
transverse colon
posteriorly--the diaphragm
the spleen
the left suprarenal gland
the upper part of the
left kidney
the splenic artery
the left colic flexure
the anterior surface of the pancreas
the upper layer of the transverse mesocolon
“ stomach bed ”
omental bursa
Ⅵ.The duodenum
C-shaped
4 parts---superior part
descending part
horizontal part
ascending part
Structure---
Descending part has
longitudinal fold
major duodenal papilla
Position and relationshap--It encloses the head of the
pancreas; A retroperitoneal organ;
Most part of it attached the posterior abdominal wall.
Ⅶ.
Jejunum
and
Ileum:
Upper 2/5
Lower 3/5
Wider in diameter and wall is thicker;
Thine in diameter and wallis thinner
Color is redder and has more vascular
Color is not redder than jejunum and
has lesser vascular
The circular mucosal folds are larger and
more
The circular mucosal folds are shorter
and few
Only solitary lymphatic follicles
Solitary and aggregated lymphatic
follicles
Ⅷ. Large intestine:
Parts--- colon
cecum
rectum
anal canal
structures --except rectum anal canal and appendix
3 colic bands
haustra of colon
epiploic appendices
 The cecum and vermiform appendix :
position: in the right iliac fossa, above the
lateral half of the inguinal ligament and
below the ileocecal valves.
structure: ileocecal valves
opening of the vermiform appendix
Vermiform:
shape: worm shaped tube, 2—20 cm in length, about 8.3cm in
average
Position: right iliac or inguinal region ,
the posteromedial wall of the cecum.
common positions of the tip:
retrocecally,
inferior to the cecum,
behind or front of ileum,
into the lesser pelvis
Surface projection of the root of
vermiform appendix--McBurney’s point
McBurney’s point
At the junction of the meddle
and lateral thirds of a line that
joints the right anterior superior
iliac spine and the umbilicus.
 Colon:
4 parts---ascending colon
transverse colon
descending colon
sigmoid colon
 The
rectum:
position--- It lies in the posterior part of less pelvis,
anterior to the sacrum and coccyx.
shape--- 2 flexures:
Sacral flexure
Perineal flexure
Ampulla of rectum
structures—
3 transverse folds of rectum
 The Anal Canal:
position:
structures:
mucous membrane---
anal columns
anal valves
anal sinuses
dentate line
anal pecten
hemorrhoidal ring )
white line
submucosa--muscular layer--sphincter ani internus
sphincter ani externus
Ⅸ. The liver :
 The external features :
--- 1. 2 ~ 1. 5 kg (male)
1.0 ~ 1.3 kg (female)
--- cuniform :
2 extremities :
right (larger)
left (smaller)
2 surfaces:
diaphragmatic surface
visceral surface
2 borders:
anterior border
posterior border
• diaphragmatic (superior) surface:
--- 2 ligaments:
falciform ligament; coronary ligament
(right and left triangular ligaments)
--- 2 lobes:
right lobe (large)
left lobe (small)
--- bare area
• visceral (inferior) surface:
--- “H” shaped groove:
4 lobes the right and left lobes, the caudate lobe, the quadrate lobe
the fissure for ligamentum teres hepatis
the fissure for ligamentum venosum
the fossa for gallbladder
the fossa for vena cava (the secondary porta hepatis )
• hepatic veins
the transverse fissure ( porta hepatis) proper hepatic artery
• hepatic ducts. hepatic portal vein, nerves , lymphatic vessels
---
• The anterior border:
--- the notch for ligamentum teres hepatis
--- the notch for gallbladder
• The posterior border: bare area
 The position and relations:
Position: right hypochondriac and epigastric regions.
• right half of the anterior border at the same level of the right
costal arch
• at the middle line of the body, the
anterior border below the xiphoid
process about 2-4cm.
Relations:
superiorly--diaphragm, lungs,
pleura and pleural cavities,
heart,
pericardium and pericardial cavity
Relations:
superiorly--the esophagus,
the stomach,
the duodenum,
the gallbladder
the right colic flexure,
the right kidney
the right suprarenal gland
The function: it is very complicated, but one of them is secreting the
bile to digest the fat in the food
Ⅹ.The Extrahepatic apparatus:
1. The gallbladder
fundus
body
neck
cystic duct
2. formation:
the right and left hepatic ducts
the common hepatic duct
the gallbladder and cystic duct
the common bile duct
the hepatopancreatic ampulla (sphincter of hepatopancreatic ampulla)
the major duodenal papilla
Ⅺ. The Pancreas:
1. The external features:
It’s a long, soft, finely lobulated gland.
4 parts:
head, neck, body, tail
2. The structure and function:
• It’s a both an exocrine and
endocrine gland.
• Exocrine portion releases the
pancreatic joice to digest
the protein in the food mainly
• Endocrine portion is formed
by pancreatic islets and secretes
the glucagon and insulin.
• Pancreatic duct and accessory
pancreatic duct.
3. The position and relations:
•
on the posterior abdominal wall and across the first and second
vertebrae, abdominal aorta, inferior vena cava, hepatic portal vein ;
•
a retroperitoneal organ;
•
anteriorly: close to the
posterior wall of the stomach;
•
the head is surrounded
by the duodenum;
•
the tail is in contact with the
hilum of spleen .