 The stomach and the small and large intestines are the main

digestive organs, but they would not function without the aid of
other organs and glands.

 Accessory organs of the digestive system are those that assist with
digestion in some way, including by producing and secreting
digestive enzymes

 These organs include the pancreas, the liver and the gallbladder,
as well as several different glands.

 Without the aid of the accessory organs of the digestive system,

digestion would not occur within the stomach or small intestine.
 Each organ and gland plays a very specific role in the system. In
this way, they are as essential to the process as the main organs
where digestion actually takes place.
 Liver is the largest gland in human body after skin
 It weighs 1500 grams
 It comprises of 2.5% of the total body weight
 In a mature fetus it may even serve as an
Hematopoietic organ
 Except fat it absorbs all the nutrients from GIT by
portal system
 Liver stores glycogen and secretes bile for
emulsification of fats
 Liver lies mainly in right

upper quadrant of abdomen

under cover of 7-11 ribs on

right side occupying

predominantly right

Hypochonndium and

Epigastrium
 Primary Supports:
◦ IVC
◦ Hepatic Veins
◦ Coronary and triangular ligaments
 Secondary Support:
◦ Right kidney
◦ Right colonic angle
◦ Duodenopancreatic complex
 ◦ Tertiary supports:
attachment of liver to the anterior abdomnal wall and
diaphragm by falciform ligament.
› a diaphragmatic surface in the anterior, superior, and

posterior directions;

› The visceral surface of the liver is covered with

visceral peritoneum except in the fossa for the

gallbladder and at the porta hepatis ( entry & exit to

and from liver ).

 › Diaphragmatic surface of liver is dome shaped

› Smooth in outline where it lies under the concavity of inferior surface

of diaphragm

› It separates from pluerae, pericardium and lungs.

2 recesses have an importance in this surface …

1) The subphrenic recess separates the diaphragmatic surface of the liver

from the diaphragm and is divided into right and left areas by the
falciform ligament, a structure derived from the ventral mesentery in the
embryo.

2) The hepatorenal recess is a part of the peritoneal cavity on the right side
between the liver and the right kidney and right suprarenal gland.
 Covered by visceral peritoneum except porta hepatis and gall
bladder bed.

 The visceral surface is related to:

› Right side of the stomach i.e. gastric and pyloric areas

› Superior part of the duodenum i.e. duodenal area

› Lesser omentum

› Gall bladder

› Right colic flexor and right transverse area ; colic area

› Right kidney and suprarenal gland; Renal area

 Presents on the
diaphragmatic surface
of liver and is directly
in contact with the
undersurface of
diaphragm devoid of
peritoneum
 Almost all surface of
liver is coverd by
visceral peritoneum
except the bare area !!!
 This area is bounded by
peritoneal reflections
that will form ligaments
!!!
 Falciformligament

 Anterior coronary ligament

 Posterior coronary ligament

 Round ligament

 Ligamentum venosum

 Lessser omentum has 2 parts:

› Hepatogastric ligament

› Hepatoduodenal ligament
 Liver is composed of

two anatomical lobes

namely:

› Right

› Left
 Right lobe is the largest in
volume and contributes to
all surfaces of the liver.
 On the diaphragmatic
surface It is divided from
the left lobe by falciform
ligament superiorly and
ligamentum venosum
inferiorly.
 On the visceral surface
left sagittal fissure
separates the two.
The triangular smaller lobe

that lies lateral to the left

saggital fissures and

occupies the epigastrium

and extends till the left

hypochondrium is called

the left lobe of liver

 The quadrate and caudate lobes are described as arising from the right lobe
of liver, but functionally are distinct:
 Quadrate lobe
 Quadrate lobe is visible on the upper part of the visceral surface of the
liver and is bounded on the left by the fissure for ligamentum teres and
on the right by the fossa for the gallbladder.
 Functionally it is related to the left lobe of the lever.
 Caudate lobe
› Caudate lobe is visible on the lower part of the visceral surface of the
liver and is bounded on the left by the fissure for the ligamentum
venosum and on the right by the groove for the IVC.
› Functionally, it is separate from the right and the left lobes of the live
 Liver like lungs has dual blood supply. The hepatic portal vein
brings 75-80% blood to liver.

 Portal vein contains 40% oxygen than blood returning to the heart
from systemic circuit.

 The hepatic portal vein contains virtually all nutrients absorbed

from the alimentary tract to the liver with the exception of lipids
which is absorbed through the hepatic artery.
 The gall bladder is a storage organ

 It has a storage capacity of 30-50ml

 LOCATION

› Its located in the right hypochondrial region of the abdomen

› Lies within the fossa formed between the inferior aspect of the

right and quadrate lobes of the liver

 PRIMARY FUNCTION

› It concentrate and stores bile

 The entirety of gall bladder is surrounded by peritoneum

 Its directy related to the viscera surface of the liver

› Anteriorly and Superiorly: inferior border of the liver and

Anterior abdominal wall

› Posteriorly: Transverse colon and proximal duodenum

› Inferiorly: Biliary tree and the remaining part of the

duodenum
 The structure of the gall bladder is divided into three parts(3)

› FUNDUS

› BODY

› NECK

 FUNDUS: Its a rounded end of the gallbladder, which project into the inferior
border of the liver at the midclavicular line.

 BODY: a major part in the fossa (largest part of the gallbladder) , which lies
adjacent to the transverse colon and the superior part of the duodenum.

 NECK: a narrow part of the gallbladder with mucosal folds forming the spiral
fold called Hartmann’s Pouch(common site for gallstone lodgement), which is
continuous with the cystic duct leading into the biliary tree.
 The arterial supply
to the gallbladder is
the cystic artery
from the right
hepatic artery (a
branch of the hepatic
artery proper) .
 VENOUS : • Cystic vein

 LYMPHATICS : • A cystic LN at the neck of GB

 NERVES : • Autonomic from coeliac plexus

• Cholecystokinin
 Is a series of GIT duct allowing newly stabilized bile from the liver
to be concentrated and stored in the gallbladder, prior to the release
into the duodenum
 Bile is initially secreted from the hepatocytes and drains from both
lobes of the liver via the collecting ducts into the Right and Left
hepatic ducts
 The ducts join together to form Common Hepatic Duct (CHD)
which run alongside the hepatic vein
 As the CHD descends, its joined by the cystic duct which allows
bile to flow in and out of the gallbladder for storage and release
 At this point the CHD and cystic duct combine to form the
Common Bile Duct

 The common bile duct descends and passes posteriorly to the

first part of the duodenum and head of the pancreas, here its
joined by the main pancreatic duct forming the
HEPATOPANCREATIC AMPULLA (of Vater)

 Which then empties into the duodenum via the major

duodenal papilla, which is regulated by a muscular valve
called the sphincter of Oddi
The biliary system's main function includes the following:
 To drain waste products from the liver into the duodenum
 To help in digestion with the controlled release of bile

Bile is the greenish-yellow fluid (consisting of waste products, cholesterol, and

bile salts) that is secreted by the liver cells to perform 2 primary functions:
 To carry away waste
 To break down fats during digestion

Bile salt is the actual component that helps break down and absorb fats. Bile,
which is excreted from the body in the form of feces, is what gives feces its
dark brown color.
• The pancreas lies mostly posterior to the stomach

• It extends across the posterior abdominal wall from the duodenum, on

the right, to the spleen, on the left.

• The pancreas is (secondarily) retroperitoneal except for a small part

of its tail

• Soft, lobulated elongated gland with both exocrine and endocrine

functions

• Exocrine –pancreatic juice

• Endocrine-insulin, Glucagon

• consists of a head, uncinated process, neck, body, and tail.

 Head - lies within the C-shape concavity of the
duodenum.
 Uncinate process - Projecting from the lower part of
the head - passes posterior to the superior mesenteric
vessels .
 Neck - anterior to the superior mesenteric vessels . -
Posterior to it, the superior mesenteric and splenic
veins join to form the portal vein.
 Body - The body of the pancreas is elongate and
extends - from the neck to the tail of the pancreas.
 Tail - The tail of the pancreas passes between layers
of the splenorenal ligament
 Splenic Artery.
 Superior
pancreaticoduode
nal artery (from
coeliac trunk)
 Inferior
pancreaticoduode
nal A.(from
superior
mesenteric A)
 Splenic vein

 Superior mesenteric vein

 Portal vein
 Head & neck –
ventral & dorsal
pancreaticodudena
l grp LN.
 Body &tail by
pancreatico-
splenic LN.
 Parasympathetic by the vagus

nerve controlling secretion .

 Sympathetic from coeliac &

superior mesenteric plx.

 Secretion is also controlled by

hormone

secretinpancreozymine
 2nd lymphoid organ ,Oval in shape, 7 -14cm in length and 150 -
200 grams in weight.
 Lies just beneath the left half of the diaphragm close to 9 ,10
and 11 ribs and on the left side of abdomen.
 It is therefore in the left upper quadrant, or left hypochondrium,
of the abdomen.
 Pleural cavity separates spleen and diaphragm from the rib.
 Has Diaphragmatic ,visceral and colic surface
 It also has an anterior ,posterior and inferior border.
 Spleen forms parts of the reticuloendotelial system.
 Main function is hematopoiesis in fetal life and in
adults with reutilization of iron from hemoglobin of
destroyed red blood cells.
 Its has red and the white pulp, which are separated
by the marginal sinus.
 The spleen has :
• Three borders
• Two surfaces
• Hilum
Three BORDERS
 Superior border :-
presents one or two
notches near
anterior end.
 Notches indicate
spleen is lobulated
in development.
 Inferior border:- it
is rounded
 SURFACES OF THE SPLEEN
Diaphragmatic surface or phrenic surface :
 convex, smooth, and is directed upward, backward, and to the left,
except at its upper end, where it is directed slightly to the middle.
 It is under surface of the diaphragm, which separates it from the ninth,
tenth, and eleventh ribs of the left side, and the intervening lower
border of the left lung
 IT IS RELATED TO:•
› Diaphragm •

› Lt lung & lts pleura •

› Costodiaphragmatic recess •

› 9th, 10th & 11th ribs of left side.

visceral surface : divided by a ridge into two regions: an
anterior or gastric and a posterior or renal.

 The visceral surface is related to the

› left kidney,

› stomach

› splenic flexure of colon.

 Each surface is covered with visceral peritoneum, which
reflected as double layer onto the left kidney as splenicorenal
ligament.

 anteriorly border separated the surface from concave visceral

surface where hilus found

 Hilus is part where vessels enter and leave the organ.

 Gastric impression
 Renal impression
 Colic impression
 Pancreatic
impression (Tail)
 The spleen is connected to the:
› greater curvature of the stomach by the gastrosplenic
ligament, which contains the short gastric and
gastroomental vessels.
› left kidney by the splenorenal ligament which contains the
splenic vessels .
• Both these ligaments are parts of the greater omentum.
The spleen is surrounded by visceral peritoneum except in
the area of the hilum on the medial surface of the spleen
• The splenic hilum is the entry point for the splenic vessels,
and occasionally the tail of the pancreas reaches this area.
•
 Spleen is supplied with blood by splenic artery and
blood drains from splenic vein.
 Splenic artery is branch of celiac artery and follows
pancreas, short gastric artery and left gastroepiploic
to stomach.
 Splenic vein joins with superior mesenteric vein, to
form the hepatic portal vein and follows to the
pancreas.
 The arterial
supply to the
spleen is the
splenic artery
from the celiac
trunk.
NERVE SUPPLY

 • It is predominentaly supplied by the sympathetics from

coeliac plexus.The fibers supply the blood vessels and smooth
muscle of trabeculae