Lecture -5-

Anatomy of small intestine

( part II )

Dr. Raya AbdulAmeer

MBCHB,CABHS-RAD

The jejunum
• The jejunum is the second part of the small
intestine.
• It begins at the duodenojejunal flexure and
ends at ileum -is found in the upper left
quadrant of the abdomen.
• The jejunum is entirely intraperitoneal as the
mesentery proper attaches it to the posterior
abdominal wall.
• It is about 2/5 of total length of small intestine
( 1.5-3.5 meters )

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• There is no clear line of demarcation between
the jejunum and ileum, but there are some
anatomical and histological differences that
distinguish them:
• The jejunum represents the proximal two-fifths
of the jejunum-ileum continuum
• The wall of the jejunum is thicker and its lumen
is wider than in ileum
• The jejunum contains more prominent circular
folds in the mucosa called ( valve of
Kerckring) or (plica circularis ) or ( vulvulae
conniventes)
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• Arterial supply
• Jejunal branches ( about five branches )
from superior mesenteric artery with
arterial blood. These form arcades with the
other arteries of the small intestine.
Venous drainage
Corresponding to arteries and drain to
superior mesenteric vein
Lymphatic drainage
To superior mesenteric Lymph nodes

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Nerve supply
• Sympathetic
Spinal segments T9-T10 , celiac plexus and
superior mesenteric plexus
• Para sympathetic
Vagus nerve

Anatomy of the ileum

• Last of the three parts of the small intestine, found
between the jejunum and large intestine
• Its completely intraperitoneal
• At the distal end, the ileum is separated from the
large intestine, into which it opens, by the
ileocecal valve.
• The ileum itself is very rich in lymphoid follicles
• and is attached to the posterior abdominal
wall by the mesentery.

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• The ileum makes up about 3/5 of the total
length of the small intestine (2.5 to 3.5
meters).
• Compared to the jejunum, the parallel
running circular folds in the mucosa
(valves of Kerckring) are less prominent.
• it is rich in lymphoid follicles( pyres
patch )

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Arterial supply of ilieum
• About twelve ileal arteries called straight
arteries (branches of the superior mesenteric artery )
supply the ileum with arterial blood. These form
arcades with the other arteries of the small intestine.
• Venous drainage
• Superior mesenteric vein
Nerve supply :
• Sympathetis … coeliac plexus and the superior
mesenteric plexus
• Para sympathetic
• vagus nerve (cranial nerve X)
. Lymphatic drainage
To superior mesenteric Lymph nodes

Ileocecal valve
• It lies at the junction between the ileum
and the cecum
• a functional sphincter formed by the
circular muscle layers of both the ileum
and cecum.
Function: it regulates the passage of
ileal contents into the cecum & prevents
reflux from cecum to ileum.

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Pyers. Patches
• Are group of lymphoid follicles that found in
the mucous membrane of the small bowel (
ileum )
• Has important role in immune function
• One patch is around 2 to 5 centimeters long
and consists of about 300 aggregated lymphoid
follicles

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Mesentric window :
• Thin translucent membrane in between the
artery /vein pairs feeding the small intestine

Anatomy of The mesentery

• It is a double fold of peritoneal tissue that
suspends the small intestine and large intestine
from the posterior abdominal wall
Function
The mesentery has several functions in the
abdomen:
1-Suspends the small and large intestine from the
posterior abdominal wall; anchoring them in place,
whilst still allowing some movement.
2-Provides a conduit for blood vessels, nerves
and lymphatic vessels
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Three mesentries
1-Mesentery proper ( small bowel mesentery )
• From jejunum and ilium to the posterior
abdominal wall
2-Transverse mesocolon
• From transverse colon to posterior abdominal
wall
3-Sigmoid mesocolon
• From sigmoid colon to posterior abdominal
wall –pelvic wall

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Mesentery of Small Intestine
It is a peritoneal fold enclosing the free part of the
small (jejunum & ileum) & connecting it to the post.
Abdominal wall.
Shape: fan-shaped fold having broad free border &
narrow attached border:
(a) Free border: is 6 meters (20feets) long & encloses
the jejunum & ileum.
(b) Attached border: (Root of mesentery): 6 inches
long & 6 inches away from the free border

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-It is attached to the posterior . Abdominal
wall extending from the duodenojejunal
flexure (on the left side of L2) to ileocecal
junction (above the Rt. Sacroiliac joint).-
-The root crosses 6 structures on the -
posterior . Abdominal . wall.
1) two parts of duodenum( 3rd and 4th -
parts)
2) two large vessels ( abdominal aorta and
inferior vena cava )
3)two muscles ( RT iliacus muscle and RT
psoas major muscle ) :

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Contents of the mesentery:
1. Coils of jejunum & ileum in the free
margin of the mesentery.
2. Superior mesenteric artery & its branches(
jejunal and ilial branches )
It runs downwards & to the Rt. In the root of
mesentery
3. Superior . Mesenteric Vein. & its
tributaries:
- Runs in the root of mesentery on the Rt.
Side of the superior . Mesenteric artery

4. Lymphatics & 3 raws of mesenteric

Lymph nodes .
(a) Small lymph nodes near the
intestine in the free border.
(b) Medium-sized L.Ns in the middle
of the mesentery
(c) Large L.Ns: lie along the superior
. Mesenteric vessels
5-plexuses of autonomic nerve fibers
around the arteries.
6. Extraperitoneal fatty tissue

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