Chapter 4 The general Description Part II Splanchnology Chapter 4 The general Description

Chapter 4 The general Description Part II Splanchnology Chapter 4 The general Description 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 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 )

Chapter 5 The Alimentary System 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 root of tongue.

* The teeth The structure: dentine 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 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

mucosa, muscles of the tongue 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 Sublingual 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

Ⅴ.The stomach : The shape and parts 2 openings: cardia, pylorus 2 surfaces: anterior and posterior 2 curvatures: greater curvature lesser curvature angular incisure 4 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: diaphragm left pleura the base of the left lung anteriorly--- 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 Structure--- 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

the posteromedial wall of the cecum. common positions of the tip: 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---- transverse colon descending colon sigmoid colon ascending colon transverse colon descending colon sigmoid colon

position--- It lies in the posterior part of less pelvis, 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

mucous membrane--- anal columns The Anal Canal: position: structures: anal valves anal sinuses dentate line anal pecten (hemorrhoidal ring ) white line submucosa--- muscular layer--- sphincter ani internus sphincter ani externus

The external features : 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 notch for ligamentum teres hepatis 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

the right colic flexure, the right kidney the right suprarenal gland 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: The external features: It’s a long, soft, finely lobulated gland. 4 parts: head, neck, body, tail 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 .