DUG training course

Anatomy

Marketing Department 2018 For in-house use

 Anatomy of the digestive system

➢ Digestive tract
• Oesophagus
• Stomach
• Small intestine
• Colon
• Rectum

➢ Liver and biliary tract

• Liver
• Biliary tract
• Pancreas

➢ Abdominal wall
 Anatomy of the digestive system OESOPHAGUS

Location: between pharynx and stomach, passing through the diaphragm

Size: length 25 centimeters, diameter 2 centimeters

Function: brings food down by the wall's peristaltic action

3 Segments: cervical - thoracic - abdominal

Oesophagus wall:
4 tissue layers: mucosa - sub-mucosa – muscle - connective tissue.

1 sphincter:
Cardio-oesophageal or lower oesophageal sphincter: controls
passage of the food bolus into the stomach and prevents reflux
 Anatomy of the digestive system STOMACH

Location: between oesophagus and duodenum, covered by liver

and diaphragm and overlying the transverse colon.

Size: length 15-20 centimeters

Capacity: 0.5 liters empty, can hold up to 4 liters

Function: to break down the food bolus through physical action

and the secretion of gastric juice.

Different parts: see figure

 PERITONEUM
Anatomy of the digestive system OMENTUM

Peritoneum: a membrane that lines the inner abdominal wall and

covers the visceral organs therein.

Omentum (epiploon) formed by double folds of the Blood vessels in the stomach
peritoneum
• The greater omentum extends down from the stomach to the
transverse colon. Forms a protective fatty apron over the
surfaces of the gut

• The lesser omentum extends from stomach to liver

lesser omentum stomach

greater omentum
 Anatomy of the digestive system SMALL INTESTINE

Size: length 5-7 meters, diameter 3 centimeters

Wall:
composed of 4 layers: mucosa - sub-mucosa - muscle - serosa or peritoneum

Duodenum
3 Segments:

• Duodenum: located between pyloric sphincter and duodenojejunal flexure.

Excretory ducts from the pancreas and biliary tract open into this segment to inject
the enzymes needed for digestion. Jejunum

• Jejunum: arises at the duodenojejunal flexure and continues into the ileum.

• Ileum: carries on from the jejunum as far as the ileocaecal valve where it opens Ileum
into the large intestine

Most products of digestion are absorbed in the small intestine, especially the
duodenum and jejunum.
 Anatomy of the digestive system COLON

Location: forms a frame around the small intestine; comprised of 6 segments:

• Caecum
• Ascending colon: climbs straight up to the right colic flexure
• Transverse colon: runs between the right and left colic flexures
• Descending colon: drops down to the sigmoid colon
• Sigmoid colon: extends from the descending colon to the rectum
• Rectum: turns downwards and opens at the anus

Size: Length 1.5 meters, diameter 4 centimetres

 Anatomy of the digestive system COLON

Function:

• Motile: grinds food up, pushes it through, stores material

• Absorbs water and nutrients
• Bacterial digestion: Bacteria in the colon digest certain substances
(cellulose).

Blood vessels:
The superior and inferior mesenteric arteries give rise to the vessels
that supply the colon.
 Anatomy of the digestive system RECTUM / ANUS

Location: terminal part of the digestive tract ending at the

junction between anal canal and anus.

Comprises:
• the rectal ampulla (dilated) and anal canal (narrow)
• encircled by two sphincters (internal and external).

The upper part is supplied by the inferior mesenteric artery and

the lower part by the internal iliac artery.

The anus is at the end of the digestive tract and opens onto the
posterior perineum. It is encircled by the subcutaneous band of
muscle of the external sphincter of the anus.
 LIVER
Anatomy of the liver and biliary tract
Accessory glands of the digestive tract

Location: Separated from lungs and heart by the diaphragm

Located to the right of the stomach, above the duodenum and right
colic flexure.

Size: the body's biggest organ and one of the most vascular (over
10% of all the blood)

Function: the body's energy centre and the organ that produces bile,
generating the substances secreted to help digest food.
 LIVER
Anatomy of the liver and biliary tract
Accessory glands of the digestive tract

Divided between four unequal lobes:

• Right hepatic lobe, the biggest

• Left hepatic lobe
• Two smaller lobes located between the two major lobes

Each lobe of the liver is divided into different segments, eight

segments in total

These anatomical partitions are important when it comes to

surgical intervention which follows the corresponding anatomical
lines
 LIVER
Anatomy of the liver and biliary tract
Portal system: Portal vein and hepatic artery

• Blood is drained into the portal vein from the oesophagus, stomach and
gut. The blood brought to the liver in the portal vein contains little
oxygen but is rich in nutrients.
• The hepatic artery comes from the heart bringing oxygen-rich blood.

When these two vessels enter the liver, they divide to form a series of
branches that supply the different segments.

After bathing the cells, the blood is drained via the hepatic vein which gives
into the inferior vena cava that takes it back to the heart.
 GALLBLADDER
Anatomy of the liver and biliary tract

Location: under the liver

Colour: green
Length: 7-12 centimeters
Capacity: on average about 50 milliliters of bile

Biliary ductules run through the liver collecting bile and channelling it
into the common bile duct.

Common bile duct: opens into the duodenum where bile participates
in digestion.

Bile is stored in the gallbladder which is continuous with the common

bile duct through the cystic duct.
 PANCREAS
Anatomy of the pancreas
Accessory glands of the digestive tract

Location: behind the stomach, in contact with the duodenum, the first part of the
gut. Next to the superior mesenteric artery and vein, and the coeliac trunk.

Three parts: head - body - tail

Wirsung's canal: collects pancreatic juice

Common bile duct: transports the bile produced in the liver

These two join up and the resultant mixture of bile and pancreatic juice
is injected into the gut via Vater's ampulla.
Dual functions:
• Endocrine: produces digestive hormones (insulin and glucagon)
responsible for regulating blood glucose concentration
(10% of pancreatic cells have an endocrine function)

• Exocrine: produces digestive enzymes essential for the process of

digestion (more than 90% of pancreatic cells have exocrine
function)
Anatomy of the abdominal wall
 ABDOMEN
Anatomy of the abdominal wall

Contains most of the digestive organs

Stress exerted from inside to outside

Not protected by any rigid structure (see chest)

 MUSCLES
Anatomy of the abdominal wall
 MUSCLES
Anatomy of the abdominal wall

Four muscle pairs

➢ Different orientations = solidity

➢ Support and retain viscera

Architectural vault consisting of:

➢ Flat muscles = vault

• 2: external oblique muscles
• 3: internal oblique muscles
• 4: transverse abdominal muscle

➢ Rectus abdominis muscle (1) = keystone of the vault

 MUSCLES
Anatomy of the abdominal wall

Musculoaponeurotic planes

System of flat muscles

• Two central, vertical pillars: rectus
abdominis muscle
• Lateral, transverse belt:
flat abdominal muscles
Aponeuroses extend the muscles
towards the median line
 EXTERNAL OBLIQUE
Anatomy of the abdominal wall

External oblique muscle Internal oblique muscle Transverse muscle

or musculus obliquus externus abdominis or musculus obliquus externus abdominis
 Anatomy of the abdominal wall

Rupture of the architectural vault and paired muscles

Muscle retraction and separation of edges

 Gynecological Surgery Training
Anatomy

Marketing Department 2018

For in-house use
Anatomy of the female reproductive system
 Anatomy of the female reproductive system

➢ Internal reproductive organs

• Two ovaries
• Two fallopian tubes
• Uterus
• Vagina

➢ External reproductive organs

• Vulva
• Labia majora
• Labia minora
• Clitoris
 UTERUS
Anatomy of the female reproductive system
Location: In the pelvis, behind the bladder and in front of the rectum

Structure: hollow organ with thick walls Two parts:

Body: the bigger part

Cervix, comprising two segments:
• Endocervix: innermost segment of the uterine cervix that goes from the isthmus to the
opening into the vagina
• Exocervix: the outermost segment of the cervix located at the top of the vagina

Wall, three layers:

• Perimetrium: outermost layer that covers the body of the uterus and part of the cervix
• Myometrium: middle layer composed of smooth muscle tissue
• Endometrium: innermost layer lining the uterus and containing glandular cells

Support: Uterosacral ligaments and round ligaments of uterus

Function:
• Pregnancy
• Menstrual cycle In the absence of fertilisation, the endometrium is shed ➔ menstruation
Anatomy of the male reproductive system
 PROSTATE
Anatomy of the male reproductive system

Seminal vesicles
Storage of prostatic secretions
Location: under the bladder, in front of the rectum. Surrounds
Upper sphincter
the urethra that channels urine from bladder to the exterior Smooth muscle

Size: similar to that of a plum (volume 15-20g) Urethra

Passage of sperm and urine

Vas deferens from the testicles

(spermatozoa supply)
Function: produces a fluid that mixes with spermatozoa from
Lower sphincter
the testicles to make semen Striated muscle

Ejaculatory ducts
Passage of sperm
(spermatozoa + prostatic
secretions)
 KIDNEY
Anatomy of the urinary system
Renal
parenchyma
Function:
• Purifies the blood and
maintains blood balance. Urinary cavities

• Filters out waste products

and disposes of them in a
liquid, namely urine (1-2
liters a day).
• Sends useful substances
required for body function
back into the blood.
 Anatomy of the urinary system BLADDER

Location:
• Men: in front of the rectum with the prostate (a gland that surrounds the urethra) below
• Women: in front of the vagina and uterus
Function: a hollow muscular organ that contains 200-500 milliliters of urine

Peritoneum
Right ureter Left ureter

Men
Ureter

Mucosa
Bladder
Opening of the ureter
Opening of the left ureter

Vesical trigone
Urethra

Urethra Women
Urethral sphincter

Urethral sphincter