anatomy teaching of stomach and intestine

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ANATOMY TEACHING ON

STOMACH AND INTESTINE

Ms. HemlataM.Sc.Nursing 1st year

INTRODUCTION

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ANATOMY OF STOMACH

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• Muscular sac, dilated part of the alimentary canal between the esophagus and the small intestine

• occupies the left upper quadrant, Epigastric, and umbilical regions, and much of it lies under cover of the ribs

• located at level of T10 and L3 vertebral

ORGAN ASSOCIATED WITH STOMACH

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•Anteriorly -left lobe of liver and anterior abdominal wall.

•Posteriorly – abdominal aorta, pancreas, spleen, left kidney and adrenal gland.

•Superiorly – diaphragm, esophagus, and left lobe of liver.

•To the right liver and duodenum.•To the left diaphragm and spleen.

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STRUCTURE OF STOMACH

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Parts of STOMACH

Oesophagus1 Fundus

2

3

CardiaPyloric

Sphincter

7 4

Body

Duodenum 6 5

Pylorus

Stomach Human Anatomy – With Highlighted Part

Oesophagus

CARDIA

FUNDUS

Stomach Human Anatomy – With Highlighted Part

Body

Stomach Human Anatomy – With Highlighted Part

Pylorus

Stomach Human Anatomy – With Highlighted Part

Duodenum

WALL OF THE STOMACH

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There are 4 layers of tissue1. Serosa 2.Muscle layer3.Submucosa4. Mucosa

SEROSA

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a) the outermost layer of the stomach.

b) It is composed of simple squamous epithelium and areolar connective tissue

c) it has a dense network of blood vessels(arteries and veins )that supply the stomach.

d) The serosa is part of the wider visceral peritoneum.

MUSCLE LAYER

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•An outer layer of longitudinal fiber.•A middle of circular fibers.•A inner layer of oblique fibers

a) An outer layer - longitudinal fiber.b) A middle - circular fibers.c) A inner layer - oblique fibers

SUBMUCOSA

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Areolar loose connective tissue that contains blood vessels, lymphatic vessels, and nerve

connects the mascularis to the mucosa layers of the stomach

MUCOSA

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•When the stomach is empty the mucosa membrane lining is thrown into longitudinal folds or rugae, and when full the rugae are ‘ironed out’ and the surface has a smooth, velvety appearance

•Numerous gastric glands are situated below the surface in the mucous membrane. They consist of specialized cells that secrete gastric juice into the stomach.

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MAIN CONSTITUENTS

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About 2 liter of gastric juice are secreted daily by specialized secretary glands

•Water•Mineral salts•Mucus secreted by goblet cells in the glands•Hydrochloride acid•Intrinsic factors•Inactive enzyme precursor pepsinogen secreted by chief cells

SECREATION OF GASTRIC JUICE

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Cephalic

phase

Gastric

phase

Intestinal

phase

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HOW IT WORKS

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See this video

WHAT GASTRIC JUICE DO

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Mixing with the gastric juice takes place gradually

When a meal has been eaten the food accumulates in the stomach in layers, the last part of the meal

remaining in the fundus for the some time

Gastric muscle contraction consist of a churning movements that breaks down the bolus and mixes

it with gastric juice, and peristaltic waves that propel the stomach content towards the pylorus

WHAT GASTRIC JUICE DO

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When the stomach is active the pyloric sphincter close . Strong peristaltic contraction of the pyloric antrum forces CHYME (gastric content

after they are sufficiently liquefied), through the pylorus into the duodenum in small spurts

 FUNCTIONS OF GASTRIC JUICE

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Mucus prevents

mechanical injury to

the stomach wall by

lubricating the

contents

Pepsinogens--------

These are activated to pepsin by

hydrochloric acid and by pepsins

already present in

the stomach

Intrinsic factors(prot

ein) is necessary

for the absorption of vitamin B12 from the ileum.

Water further

liquefies the food swallowe

d

Hydrochloric acid-

Acidifies the food

Kills ingested microbeseffective

digestion by pepsins.

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FUNCTIONS OF THE STOMACH

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Temporary storage allowing time for the digestive enzymes , pepsins, to act

Chemical digestion- pepsin converts protein to polypeptides

Mechanical breakdown

Limited absorption of water , alcohol and some lipid soluble drugs.

FUNCTIONS OF THE STOMACH

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Non-specific defense against microbes

Preparation of iron for absorption further along the tract

Production and secretions of intrinsic factor needed for absorption of vitamin B12 in the terminal ileum

Regulation of the passage of gastric contents into the duodenum

Secretion of hormone gastrin.

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DISEASE CONDITION

Achlorhydria

GERD

INTESTINE

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SMALL INTESTINE

LARGE INTESTINE

SMALL INTESTINE

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LENGTH-- 6.5m (loss of muscle tone)

DIAMETER:- 4cm in gastro duodenal & 2.5cm at i-c junction.

SITE:- It occupies all abdominal regions expect Epigastric and hypochondriac region normally.

FIXATION-It is stabilized by mesentery.

MESENTERY:-peritoneal fold attaching small intestine to posterior body wall.

STRUCTURE OF SMALL INTESTINE:-

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FOUR LAYERS OF TISSUES

1. Serosa Coat

2. Muscular Coat

3. Submucosa Coat

4. Mucous Membrane

a)Serosa Coat derived from the peritoneum

b)Muscular CoatIt consist of outer longitudinal and inner circular layers of smooth muscles, separated by the mysenteric plexus of nerves.

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c)Submucosa Coat

It consist of loose areolar tissue and contains plexuses of blood vessels, lymphatic and nerves..

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Mucous Membrane

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DUODENUM IS DIVIDED INTO FOUR PARTS

FIRST (SUPERIOR) PART

SECOND (DESCENDING) PART

THIRD (HORIZONTAL) PART

FORTH (ASCENDING) PART

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FIRST PART

•It is 5cm long

•Lies anterolateral to body of L1 vertebrae

•Most movable part

RELATION

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Peritoneal relation: 2.5cms movable and attached to lesser and greater omentum. Next 2.5cm is fixed and retroperitoneal

Visceral relation:Anteriorly- Quadrate lobe of liver and GBPosteriorly- Gastroduodenal , bile duct

Superiorly- floor of Epipolic foramen

Inferiorly- Head and neck of pancreas

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BLOOD & NERVE SUPPLY   a)Arterial Supply:-Pancreatic duodenal b)Venous drainage:-Superior pancreatic duodenal vein

drain into portal vein and inferior vein joins superior mesenteric vein

c)Lymphatic drainage: Lymph vessels follows arteries & drain upward via pancreaticoduodenal nodes to gastriduodenal nodes & then to celiac nodes.

d)Nerve supply : sympathetic & parasympathetic(vagus)

nerves from celiac & superior mesenteric plexuses.

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WATCH THIS

FUNCTION OF SMALL INTESTINE:-

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PeristalsisSecretion of intestinal juice, CCK hormoneDigestion and absorptionChemical digestion

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CHECK OUT THIS…….

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DIGESTION

•90% of digestion occurs in small intestine.•Carbohydrates– glucose•Proteins—amino acid•Fats– fatty acid & glycerol

CHEMICAL DIGESTIONWhen acid chyme passes into the small intestine it is mixed with pancreatic juice, bile and intestinal juice, and is contact with the enterocytes of the

LARGE INTESTINE

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COLON OR THE LARGE BOWEL

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the large intestine is about 1.5 metres (4.9 ft) long, which is about one-fifth of the whole length of the gastrointestinal tract.

Water is absorbed here and the remaining waste material is stored as feces before being removed by defecation.

Located at or below the waist, where it is joined to the end of the small intestine

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Retroperitoneal organs in general do not have a complete covering of peritoneum, so they are fixed in location.(ascending colon, descending colon and rectum )

Intraperitoneal organs are completely surrounded by peritoneum and are therefore mobile.(caecum, appendix, transverse colon and sigmoid colon )

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CAECUM AND APPENDIX

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1.First section of the large intestine

2.Ileocaecal valve

3.Appendix which develops embryo logically from it, is a structure of the colon, not involved in digestion

ASCENDING COLON

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1. connected to caecum

2. the ascending colon runs through the abdominal cavity, upwards toward the transverse colon for approximately eight inches (20 cm).

3. It curves in left at the hepatic flexure

TRANSVERSE COLON

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1. The hepatic flexure to the splenic flexure (the turn of the colon by the spleen).

2. The transverse colon hangs off the stomach, attached to it by a large fold of peritoneum called the greater omentum.

DESCENDING COLON

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1. From the splenic flexure to the beginning of the sigmoid colon.

2. One function of the descending colon in the digestive system is to store faeces that will be emptied into the rectum

3. Gut flora are very dense in this region.

SIGMOID COLON

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Descending colon and before the rectum.

The walls of the sigmoid colon are muscular, and contract to increase the pressure inside the colon, causing the stool to move into the rectum.

Sigmoidoscopy is a common diagnostic technique used to examine the sigmoid colon

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 FUNCTION OF LARGE INTESTINE

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1. Digestion and Absorption

 Digestion and Absorption

1. Absorption of water and certain electrolytes

2. Synthesis of certain vitamins by intestinal bacteria(vitamin k like E.coli)

3. Temporary storage of feces.4. Elimination of waste from

the body (defecation).

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FAECES•Fibre

•Dead and live microbes

•Epithelial cells

•Fatty acids

•MUCUS- help in lubricating

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DISEASE CONDITIONS

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SUMMARY

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