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DUODENUM

 The first portion of the small intestine which is directly and firmly
attached to the posterior abdominal wall
 It forms a spirally curved ring, open to the left and above
 In the concavity of which the pancreas is inserted
 Consist : - pars superior (shortest portion)
- pars descendens papilla vateri
- pars inferior
 It lies to the right and in front of the pars lumbalis of diaphragm,
of the v.portae, a.hepatica and ductus choledocus, behind and
below the lobus quadratus of the liver
 Bends around markedly to the right and forward to go over into
the intestinum jejenum flexura duodenojejunalis
JEJENUM AND ILEUM
Infront and lateralward jejenum and ileum is covered by the great
omentum (omentum majus)

The mucous membrane presents the special structur :


 Plica circularis (Kerckring) :
- the constant fold
- In jejenum , they are longer and higher than in ileum
 Lymph node
- in jejenum, they are usually single (noduli lymphatici
solitary )
- in ileum, they are numerous and higher and in part
are crowded together , Peyer Patcher (noduli
lymphatici agregati)
LARGE INTESTINE ( INTESTINUM CRASSUM)
Following upon the small intestine, its begins as the intestinum
caecum in the fossa iliaca dextra
Part of intestinum crassum :
Caecum
Appendix vermiformis
Colon ascendens
Colon transversum
Colon descendens
Colon sigmoideum
Rectum
The large intestine is caracterized, its surface is not smoothly
cylindrical, but presents a nodular appearance due to the three
rows of irregular, flask like projection haustra

These rows of haustra are separated from one another by three


bands- like strips of the longitudinal muscle
taenia coli (taenia libera, taenia omentalis and taenia mesocolica)
Small intestine

• The 4- to 7-meter-long small intestine is divided into


three sequential segments:
• 1.Duodenum.
• 2.Jejunum.
• 3.Ileum.
• The wall of the small intestine consists of four layers
• 1. The mucosa.
• 2. The submucosa.
• 3. The muscularis.
• 4. The serosa, or peritoneum.
Intestinal wall
• The intestinal wall shows an increase in the
total surface of the mucosa that reflects the
absorptive function of the small intestine.
• Four degrees of folding amplify the absorptive
surface area of the mucosa
• 1. The plicae circulares (circular folds; also known as
the valves of Kerkring ).
• 2. The intestinal villi.
• 3. The intestinal glands.
• 4. The microvilli on the apical surface of the lining
epithelium of the intestinal cells (enterocytes).
Histologic differences between the
duodenum, jejunum, and ileum
• The duodenum has Brunner's glands in the submucosa, and the villi
are broad and short (leaflike).
• The jejunum has long villi (finger-like), each with a prominent lacteal.
Brunner's glands are not present in the submucosa.
• The ileum has shorter finger-like villi. A relevant feature are
the Peyer's patches.
• Paneth cells are found at the base of the glands of Lieberkühn in the
jejunum and ileum.
Large Intestine
• The large intestine consists of:
• (1) The cecum and associated appendix.
• (2) The ascending, transverse, and descending colon.
• (3) The sigmoid colon.
• (4) The rectum.
• (5) The anus.
• The mucosa of the large intestine is lined by a
simple columnar epithelium formed by
enterocytes and abundant goblet cells.
• Glands of Lieberkühn are observed. They contain
enteroendocrine cells and stem cells. Paneth
cells are not observed (they may be present in
the cecum).
• Three characteristic features of the large intestine are:
• (1) The taeniae coli, formed by fused bundles of the outer smooth muscle
layer.
• (2) The haustra, periodic saccular structures formed by the contraction of the
taeniae coli and the inner circular smooth muscle layer.
• (3) The appendix epiploica, aggregates of adipose tissue covered by the
serosa (peritoneum).
• The appendix is a diverticulum of the cecum. Prominent lymphoid
follicles or nodules are seen in the mucosa and submucosa.
Appendiks
• The rectum, the terminal portion of the large
intestine and a continuation of the sigmoid colon,
consists of two regions:
• (1) The upper region, or rectum proper.
• (2) The lower region, or anal canal, which extends from
the anorectal junction to the anus.
• The mucosa of the rectum displays long glands of
Lieberkühn; glands disappear at the level of the anal
canal.
• Anal columns are present in the anal canal. The anal
columns are connected at their base by valves,
corresponding to transverse folds of the mucosa.
Small pockets, called anal sinuses, or crypts, are
found behind the valves.
• Mucous glandular crypts behind the valves secrete
lubricating mucus.
• The anal mucosa is lined by a keratinizing stratified
squamous epithelium and the submucosa contains
sebaceous and sweat glands (circumanal glands).
• The external anal sphincter, formed by skeletal
muscle, is present.
Summary from lower Digestive
tract

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