Alimentary glands

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Alimentary glands

• SHANDONG UNIVERSITY
• Liu Zhiyu

2
The Liver

• Shape -two surfaces
• Diaphragmatic surface
• Convex and smooth
• Divided into right and left lobes by falciform
  lig. of liver
• Visceral surface

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The Liver

• Visceral surface -has a H-shaped fissures and
  grooves
• Cross-bar of H porta hepatis
• Traversed by
• Right and left hepatic ducts
• Left and right branches of proper hepatic artery
  and hepatic portal vein
• Nerves and lymphatic vessels
• These structures which are surrounded by
  connective tissue called hepatic pedicle
• Four lobes left, right, quadrate and caudate
  lobes

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The Liver

• Left limb of H
• Anteriorly fissure for ligamentum teres hepatis
• Posteriorly fissure for ligamentum venosum
• Right limb of H
• Anteriorly fossa for gallbladder
• Posteriorly
• Sulcus for vena cava
• Secondary porta of live

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The Liver ?

• Inferior border thin and sharp
• Notch for ligamentum teres hepatis
• Nothch for gallbladder

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The Liver

• Position
• Most of liver lies in the right hypochondriac
  region and epigastric region
• less part extending into the left hypochondriac
  region

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The Liver

• Surface projection
• Upper border on the right midclavicular line it
  extends the level of 5th rib

8
The Liver

• Surface projection
• Lower border
• Normally, the right lobe extends just beneath the
  costal margin, it doesnt down beyond the costal
  margin
• on the anterior median line its lower border
  crosses a point about 35cm below the xiphoid
  process.
• In children, the liver being larger in proportion
  to the body than in the adult stage, it extends
  below the costal arch within in 2cm.

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The Liver

• The segments of the liver
• The segmentation of the liver, bases upon the
  principal divisions of the proper hepatic artery
  and accompanying hepatic ducts and hepatic portal
  vein-Glisson system.
• The hepatic veins, however do not follow the same
  pattern and vary their main tributaries tend to
  run rather intersegmental.

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Gallbladder

• Position
• lies in fossa for gallbladder on visceral
  surface of liver
• Four parts
• Fundus of gallbladder
• Surface projection at the junction of right
  midclavicular line and right costal arch
• Body of gallbladder
• Neck of gallbladder
• Cystic duct
• Function stores and concentrate bile

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Extrahepatic Biliary Apparatus

• Consists of
• Gallbladder
• Left and right hepatic ducts
• Common hepatic duct
• Common bile duct

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Biliary duct system

• Left and right hepatic ducts unite outside of
  liver to form the common hepatic duct
• Cystic duct joins common hepatic duct to form
  common bile duct

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Biliary duct system

• Hepatopancreatic ampulla (ampulla of Vater)
• Common bile duct and pancreatic duct run
  obliquely through the wall of the descending part
  of duodenum where the two ducts usually unite to
  form the hepatopancreatic ampulla
• Which rounded by sphincter of hepatopancreatic
  ampulla (sphincter of Oddi), each has an
  independent sphincteric mechanism for regulating
  flow, and opens at the major duodenal papilla

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Biliary ductuli
Bile is secreted by the liver cells
Right and left hepatic ducts
Gallbladder (store, concentrate)
Common hepatic duct
Cystic duct
when the fat enters the small intestine, the
gallbladder contracts, the sphincter of
hepatopancreatic ampulla relax
Common bile duct
Major duodenal papilla
Duodenal cavity
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Extrahepatic Biliary Apparatus
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The Pancreas

• Shape and Position
• A soft yellowish lobulated gland
• Lies behind the peritoneum on the posterior
  abdominal wall, roughly at the level of of L1L2

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The Pancreas

• Four parts
• Head
• Lies within the cancavity of the C-shaped
  curvatune of duodenum
• Uncinate process- a projection to the left from
  the lower part of the head behind the superior
  mesenteric vessels.
• Neck-narrow part, overlies the superior
  mesenteric vessels and beginning of the portal
  vein
• Body-triangular in cross section, passes upward
  ang to the left across the midline
• Tail-extends to the hilum of spleen in the
  splenorenal ligament

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Cystohepatic triangle (Calots Triangle)

• Boundaries
• Common hepatic duct on the left
• Cystic duct on the right
• Live superiorily
• Content cystic artery

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The Pancreas

• Pancreatic duct
• Main Pancreatic duct
• Begins at tail and throughout gland
• Joins common bile duct before entering descending
  part of duodenum at major duodenal papilla
• Accessory pancreatic duct
• Opens 2cm above main duct at lesser duodenal
  papilla

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The Pancreas

• Function
• The pancreas is both an exocrine and an
  endocrine gland. The exocrine portion of the
  gland produces a secretion that contains enzymes
  that are capable of hydrolyzing proteins, fats,
  and carbohydrates. The endocrine portion of the
  gland, the pancreatic islet, produces the
  hormones insulin and glucagons that play a key
  role in carbohydrate metabolism.