Dr.

Jamila El-Medany
 OBJECTIVES
At the end of the lecture, students should:
List the different parts of small intestine.
Describe the anatomy of duodenum,
duodenum jejunum &
ileum regarding: the shape, length, site of
beginning & termination, peritoneal covering,
arterial supply & lymphatic drainage.
Differentiate between each part of duodenum
regarding the length, level & relations.
Differentiate between the jejunum & ileum
regarding the characteristic anatomical features
of each of them.
 What is
?MESENTERY

Anterior abdominal
wall

Loop of
intestine

Posterior
abdominal wall
FIXED (Retro peritoneal) FREE (MOVABLE) PART
PART (WITH MESENTERY)
1
(NO MESENTERY) 2 & ILEUM
JEJUNUM
DUODENUM
DUODENUM
 SHAPE: C-shaped loop
 LENGTH: 10 inches
 BEGINNING: at pyloro-
duodenal junction
 TERMINATION: at
duodeno-jejunal flexure
 PERITONEAL
COVERING:
retroperitoneal
PARTS
• The duodenum is
divided into (4) parts:
• 1st : Superior.
• 2nd : Descending
(vertical).
• 3rd : Inferior
(Horizontal)
• 4th : Ascending
 LENGTH – SURFACE ANATOMY
LEVEL LENGTH PART
L1 2 INCHES FIRST PART
(Transpyloric (Superior)
Plane)
DESCENDS 3 INCHES SECOND PART
FROM L1 TO (Descending
L3
L3 (SUBCOTAL 4 INCHES THIRD PART
PLANE) (Horizontal)
ASCENDS 1 INCHES FOURTH PART
FROM L3 TO (Ascending)
L2
 Structures Related

pancreas

psoas
 RELATIONS OF FIRST PART

3)
2)

1) X
X

Anterior
Liver

Posterior
1)Bile duct
2) Gastroduodenal artery
3)Portal vein
 RELATIONS OF SECOND PART
nterior Posterior
)Liver Right kidney
)Transverse Colon
)Small intestine

X
Lateral Medial
R Colic Pancreas
Flexure
 OPENINGS IN
SECOND PART OF DUODENUM
1. Common
opening of bile
duct & main
pancreatic duct:
on summit of
major duodenal
papilla.
2. Opening of
accessory
pancreatic duct
(one inch
higher): on
summit of minor
duodenal papilla.
RELATIONS OF THIRD PART
 Anterior:
a)Small intestine
b) Superior
mesenteric vessels
1 2 3
 Posterior:
1) Right psoas major
2) Inferior vena cava
3) Abdominal aorta
4) Inferior
mesenteric vessels.
 RELATIONS OF FOURTH PART
 Anterior:
Small intestine

 Posterior:
Left psoas major

psoas
Blood Supply & Lymph drainage
 Because the duodenum is
derived from both: Foregut &
Midgut,
 It has its Arterial Supply
from :
 Celiac & Superior mesenteric
arteries.
 Venous Drainage to :
 Superior mesenteric& Portal
veins.
 LYMPHATIC DRAINAGE:
Celiac & Superior mesenteric
lymph nodes.
JEJUNUM & ILEUM
 SHAPE: Coiled tube
 LENGTH: 6 meters (20 feet)
 BEGINNING: at Duodeno-
jejunal flexure
 TERMINATION: at Ilieo-
caecal junction
 EMBRYOLOGICAL
ORIGIN: Midgut
 Blood SUPPLY: Superior
mesenteric A & V
 LYMPHATIC DRAINAGE:
Superior mesenteric lymph
nodes
 ILEUM JEJUNUM
Longer (distal 3/5) of SI Shorter (proximal 2/5) of SI LENGTH

Narrower Wider DIAMETER

Thinner (less plicae circulares) Thicker (more plicae WALL

circulares)
Light red (less vascular) Dark red (more vascular) APPEARANCE

Low & More arcades (short High & Less arcades (long VESSELS
terminal branches terminal branches)
Large amount & close to Small amount & away from MESENTERIC FAT
intestinal border intestinal border
Numerous aggregations Few aggregations LYMPHOID TISSUE
(Peyer’s patches)
THANK YOU