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DIGESTIVE SYSTEM( SYSTEMA DIGESTIVA )

ORGANS WHICH FUNCTIONS ARE RELATED TO DIGESTION ( DIGESTIO ) AND ABSORBTION

( ABSORBTIO ) OF THE NUTRIENTS.

Bernard SM Hutabarat, dr, A!FACULT" #$ MEDICINE % UH

LIO !ARAWACI


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COMOSITION& . CANALIS ALIMENTARIUS ( ALIMENTAR" CANAL) '

&.&. CAUM ORIS&.. HAR"N*

&.+. OESOHAGUS

&.. TRACTUS GASTRO % INTESTINALIS.&..&. GASTER

&... INTESTINUM TENUE MESOSTENIALE

&...&. DUODENUM

&.... -E-UNUM

&...+. ILEUM

&..+. INTESTINUM CRASSUM

&..+.&. AENDI* ERMIFORMIS.

&..+.. CAECUM

&..+.+. COLON ASCENDENS

&..+.. COLON TRANSERSUM

&..+.. COLON DESCENDENS

&..+./. COLON SIGMOID

&..+.0. RECTUM

&..+.1. CANALIS ANALIS.

&..+.2. ANUS

. ORGANA DIGESTIA ACCESSORIAE .& GLD.SALIATORIAE

.&.&. GLD.AROTIS .&.. GLD.SUBMA*ILLARIS .&.+. GLD.SUBLINGUALIS

.. HEAR .+. ESICA FELLEA . ... ANCREAS

:


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TOPOGRAPHIC POINTS OF REFERENCES

&..INCISURA -UGULARIS STERNI ' T

. ANGULUS STERNALIS LUDOIGI (STERNAL ANGLE OF LUDWIG)' COSTAL CARTILAGE II ( CARTILAGO COSTAE II ) 3 T.

+. -UNCTURA *IHISTERNALIS (*IHISTERNAL-UNCTION)'INTERERT.DISC T24&5 3 COSTAL

CARTILAGE II

. LANUM TRANS"LORICUM 'IMAGINAR" LANE' . MID4OINT OF INCIS.-UG.STERNI % S"MH.UBIS 'L&4

/. SUBCOSTAL LANE'IMAGINAR" LANE THROUGH CAUDAL MARGIN OF RIB * ' L+

. UMBILICUS ( NAEL ) ' INTERERT.DISC L+4

0. CRISTA ILIACA ( ILIAC CREST )' L

1. LINEA TRANSTUBERCULARIS ' DRAWN THROUGHTUBERCLES OF ILIAC CRESTS ' L

1. UNCTUM MID4INGUINALE ( MID4INGUINAL OINT )' MID4OINT OF LIG.INGUINALE OUARTI (INGUINAL LIGAMENT OF OUART )


4/34

LOCATION &. CAUM ORIS 3 HAR"N* 3 GLD. SALIATORIAE ' HEAD . OESOHAGUS ' NEC! 6 ABDOMINAL CAIT"

+. THE REST ' ABDOMINAL CAIT" 3 WHICH BORDERS ARE '

+.&. CRANIAL ( SUERIOR ) +.&.&. DIAHRAGM

+.&.. COSTAL ARCH ( ARCUS COSTARUM )

+.&.+. *IHOID ROCESS ( ROC.*IHOIDEUS ) +.. ANTERIOR ( ENTRAL ) ' ABDOMINAL WALL

+.+. OSTERIOR ( DORSAL ) ' +.+.&. LUMBAR ERTBRAS ( ERTT.LUMBALES ) +.+.. SOAS MA-OR, SOAS MINOR AND

7UADRATUS LUMBORUM MUSCLES.

( MM. SOAS MA-OR,MINOR ET

7UADRATUS LUMBORUM )

+.. INFERIOR ( CAUDAL ) ' ELIC BRIM


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ABDOMINAL WALLS&.STRATUM SUERFICIALIS ( SUERFICIAL 8 E*TERNAL LA"ER )

&.&. CUTIS ( S!IN ) '

LINES OF S!IN TENSION LANGER ( LINEAE LANGER ) &.. SUBCUTIS ( FASCIA ABDOMINALIS SUERFICIALIS, SUERFICIAL ABDOMINAL

FASCIA ) &..&. LAMINA SUERF ( FASCIA CAMERI3 FATT" SUERFICIAL LA"ER OF CAMERI ) &... LAMINA ROFUNDA ( FASCIA SCARAE 3 DEE FIBROUS LA"ER OF SCARAE )

.STRATUM INTERMEDIUS ( INTERMEDIATE 8 INTERNAL LA"ER )

.&. FASCIA ABDOMINALIS ROFUNDUS ( FASCIA INNOMINATA GALLAUDETI 8INNOMINATE FASCIA OF GALLAUDET ).

.. AONEUROSES ET MUSCULI ABDOMINALES ( AONEUROSIS ANDMUSCLES OF THE ABDOMINAL WALL )

+.STRATUM ROFUNDA ( DEE 8 INNERMOST LA"ER )

+.&. FASCIA TRANSERSALIS ( TRANSERSAL FASCIA OF ABDOMINALWALL )

+.. ANNICULUS ADIOSUS REERITONEALIS ( REERITONEAL FATTISSUE )

+.. ERITONEUM ARIETALE ( ARIETAL ERITONEI )


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MM. ABDOMINALES ( MUSCLES OF ABDOMINAL WALL )&.MM. ENTROLATERALES ( ENTROLATERAL MUSCLES ) '

&.&.MUSCULI OBLI7UA ( OBLI7UE MUSCLES ) 4 OBLI7UUS E*TERNUS ABDOMINIS (E*TERNAL OBLI7UE MUSCLE)

4 OBLI7UUS INTERNUS ABDOMINIS (INTERNAL OBLI7UE MUSCLE )

4 TRANSERSUS ABDOMINIS ( TRANSERSE MUSCLE )

&.. MM.RECTI ABDOMINIS ( STRAIGHT ) 4 M. RECTUS ABDOMINIS

( STRAIGHT MUSCLE )

4 M. "RAMIDALIS ("RAMIDAL MUSCLE)

. MM. DORSALES ( DORSAL MUSCLES )


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MUSCULI ABDOMINALES

. MM.DORSALES ABDOMINALES

(OSTERIOR ABDOMINAL MUSCLES.) .. M. SOAS MINOR ( SOAS MINOR MUSCLE )

.&. M. SOAS MA-OR ( SOAS MA-OR MUSCLE )

.+. M. ILIACUS (ILIAC MUSCLE )

AONEUROSES OBLI7UE MUSCLES

AGINA MM.RECTI ABDOMINIS ( RECTUS ABDOMINIS SHEATH )

LAMINA ANTERIOR ( ANTERIOR LA"ER )

LAMINA OSTERIOR ( OSTERIOR LA"ER )


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LAMINA ANTERIOR AGINA MM.RECTI ABDOMINIS.

FORMED B" '

4 CRANIAL ' AONEUROSIS OF E*TERNAL OBLI7UE4 9 CRANIAL '

AONEUROSES OF '

4 E*TERNAL OBLI7UE

4 INTERNAL OBLI7UE.

4 : CAUDAL 'AONEUROSES OF '

4 E*TERNAL OBLI7UE

4 INTERNAL OBLI7UE

4 TRANSERSUS ABDOMINIS .

CONTENT OF RECTUS SHEATH '&. M. RECTUS ABDOMINIS. M. "RAMIDALIS

+. A8 EIGASTRICA SUERIOR

. A8 EIGASTRICA INFERIOR

. RR NN INTERCOSTALES


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CONJOINT TENDON

AONEUROSES OF INTERNALOBLI7UE AND TRANSERSE

ABDOMINIS MUSCLES'

FAL* AONEUROTICA INGUINALIS( INGUINAL AONEUROTIC FAL* ,

CON-OINT TENDON) '

HERNIORRHAH"

( REAIRMENT OF HERNIA )


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CANALIS INGUINALIS ( INGUINAL CANAL )ANNULUS INGUINALIS ROFUNDUS

( DEE INGUINAL RING )

CANALIS INGUINALIS

ANNULUS INGUINALIS SUERFICIALIS

( SUERFICIAL INGUINAL RING )

CONTENT '

; ' FUNICULUS SERMATICUS

( SERMATIC CORD )< ' LIGAMENTUM TERES UTERI

( LIG.ROTUNDUM, ROUND LIGAMENT OF

THE UTERUS ) RUTURA UTERI MEMBA!AT

( THREATENING OF UTERINE RUTURE )


11/34

LOCUS MINORIS RESISTENSIAE INGUINALIAE(ART OF INGUINAL WITH MINOR RESISTENC" )

&. CANALIS INGUINALIS ( INGUINAL CANAL )

. TRIGONUM INGUINALE HASSELBACHI ( INGUINAL TRIANGLE OF HASSELBACH ) ' 2.1. CAUDOMEDIAL

LATERAL BORDER OF RECTUS

ABDOMINIS MUSCLE

2.2. CRANIOLATERAL : A/V EPIGASTRICA INFERIOR ( INFERIOR EPIGASTRIC VESSELS )

2.3. CAUDOMEDIOLATERALE :

LIG.INGUINALE POUPARTI ( INGUINAL LIGAMENT OF

POUPART )

LOCUS MINORIS RESISTENSIAE HERNIAINGUINALIS


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HERNIA INGUINALIS ( INGUINAL HERNIA )

INDIRECTA DIFFERENCES DIRECTA

CANALISINGUINALIS

LOCATION TRIGONUM INGUINALEHASSELBACHI

LATERAL OSITION MEDIAL

CONGENITAL BASED ON A7UISITA ( A7UIRED )

"OUNG AGE AGE OLD AGE

"ES TOTALIS( SCROTALIS3COMLETUS )

NO


13/34

RO-ECTION OF ABDOMINAL ORGANS&. 7UADRANT OF ( CLINICIANS )

HORI=5NTAL > ERTICAL LINES THROUGH NAEL (UMBILICUS)' &.&. RIGHT UER 7UADRANT' &.. LEFT UER 7UADRANT 4 R4LOBE OF LIER 4 L % LOBE OF LIER

4 ESICA FELLEA 4 GASTER (STOMACH)

( GALL BLADDER ) 4 CORUS ANCREATICA

4 "LORUS ( BOD" OF ANCREAS )

4 CAUT ANCREATICA 4 FLE*URA SLENICA COLI

( HEAD OF THE ANCREAS) (SLENIC FLE*. OF COLON) 4 FLE*URA HEATICA COLI 4 ARTES COLI TRANS

4 ARTES COLI ASC.ET TRANS DESC.( ORTIONS OF

(ORTIONS OF ASC 6 TRANS. TRANS.6DESC.COLON)

COLON )

&.+. RIGHT LOWER 7UADRANT &.. LEFT LOWER 7UADRANT

4 CAECUM 6 AENDI* 4 COLON SIGMOIDEA 4 ARS RO*IMALIS COLON ( SIGMOID COLON )

ASCENDENS ( RO*IMAL 4 ARS DISTALIS COLON

ORTION OF ASCENDING DESCENDENS ( DISTAL

COLON ) ORTION OF DESCEN.

DING .COLON )


14/34

RO-ECTION OF ORGANAE ABDOMINALES


15/34

RO-ECTION OF ABDOMINAL ORGANS . REGION OF 2' (ANATOMISTS3 MORE DETAIL 6 RECISE)' 4 HORI=ONTAL LINES ' SUBCOSTAL 6 TRANSTUBERCULARIS '

4 ERTICAL LINES THROUGH MID4 INGUINAL OINTS.

REGIONES ABDOMINALES '

.&. CRANIALIS ( SUERIOR ABDOMINAL ) .&.&. H"OCHONDRICA DE*TRA

.&.. EIGASTRICA .&.+. H"OCHONDRICA SINISTRA .. MEDIA ( MESOGASTRICA, MIDDLE ABD.) ..&. LATERALIS (LUMBALIS) DE*TRA

... UMBILICALIS ..+. LATERALIS ( LUMBALIS ) SINISTRA .+. CAUDALIS ( H"OGASTRICA,INFERIOR ABD)

.+.&. INGUINALIS ( ILIACA ) DE*TRA.+.. UBICA ( H"OGASTRICA ) .+.+. INGUINALIS ( ILIACA ) SINISTRA


16/34

RO-ECTION OF ORGANAE ABDOMINALES


17/34

OESOHAGUS

FIBROMUS!ULER CANAL OF +%+5 CM,BEGIN AT HAR"N* ( CARTILAGOCRICOIDEA3C/ ) % CARDIA ( TH4*I ). CONSISTS OF '

&. CERICAL ART( ARS CERICALIS )

. THORACAL ART

( ARS THORACALIS )

+. ABDOMINAL ART

( ARS ABDOMINALIS )

NARROW ARTS ' '

&. HAR"NGO4ESOHAGEAL ( -UNCTURA HAR"NGO 4

OESOHAGEALIS ).

. AORTIC ARCH(ARCUS AORTICUS).+. TRACHEAL BIFURCATION ( BIFURCATIO TRACHEAE )

. ESOHAGEAL HIATAL ( HIATUS OESOHAGEALIS )


18/34

GASTER ' BOLUS ALIMENTARIUS CH"ME

CAACIT" ' &55 % &/55 CC

ARTS OF THE STOMACH&. ANTERIOR ART (ARIES ANT. ENTRICULI). OSTERIOR ART

(ARIES OST. ENTRICULI).+. LESSER CURATURE (CURATURA ENTR.MINOR).. GREATER CURATURE (CURATURA ENTR.MA-OR). FUNDUS ENTRICULI/. BOD" OF STOMACH ( CORUS ENTRICULI )0. STOMACH ORIFICES ( ORIFICIAE ENTRICULI ). 0.&.OSTIUM CARDIACUM

( CARDIA ) 0..OSTIUM "LORICUM


19/34

INNER SURFACE OF STOMACH

LICA MUCOSAE

ENTRICULUS MINOR

MAGENSTRASSE WALDE"ERI


20/34

INTEST. TENUE MESOSTENIALE ' ABSORBTION

/ % 0 M3DUODENO4-E-UNAL FLE*ION % ILEO4CECAL -UNCTION( FLE*URA DUODENO-E-UNALIS 4 -UNCTURA ILEO % CAECALIS ).

CHARACTERISTICS '&. INTESTINE ILLOUS

( ILLI INTESTINALIS )

. CIRCULAR FOLDS OF !ERC!RING ( LICAE

CIRCULARES !ERC!RINGI )

+. L "MHATIC FOLLICLES ( FOLLICULI L"MHATICI ) '

+.&. Nn.L? AGREGATII

+.. N.L.SOLITARIUS


21/34

DUODENUM


22/34

COMARISON BETWEEN -E-UNUM AND ILEUM JEJUNUM DIFFERENCES ILEUM

LARGER ( 4 CM ) DIAMETRE SMALLER ( @ CM )

THICKER( VELVET )

!ALL THINNER

MORE VASCULARI"ATION LESS

REDDISH COLOR COLOR PALISH COLOR

THICK # TALL FOLDS OF

KERCKRING

THIN$SOMETIMES

ABSENT

SHORT # !IDE INTESTINEVILLOUS

SLENDER LIKETHREAD

LONG VASA RECTA SHORT

NO STORE ARCADE ( ARCADEN)

MULTISTORES

LESS$NOT REACH!ALL

MESENTERIC FAT MAN$ REACH THE!ALL

PRESENT MESENTERIC!INDO!

ABSENT

MAN SOLITAR LMPH LESS


23/34

LARGE BOWEL ( INTESTINUM CRASSUM )

LENGTH '& 4 + M , ILEO % CECAL ALE ( ALULA ILEOCAECALIS ) % ANUS .FECAL FORMATION

CHARACTERISTICS'&.TAENIA COLI'

&.&. MESOCOLICA CA.

&.. OMENTALIS &.+. LIBERAE

.HAUSTRAE

+.AENDICES

EILOICAE


24/34

ILEUM

CAECUM

ILEO % CECAL -UNCTION(-UNCTURA ILEO 4CAECALIS )

ILEO % CECAL ALE

( ALULA ILEO4AECALISBAUHINI )

LINE OF MONRO4RICHTER(LINEA MONRO4RICHTER) 'UMBILICUS % R4SIAS

MC BURNE"


25/34

ERMIFORM AENDI* ( AENDI* ERMIFORMIS )

OSITION ( WA!ELE" )

&.RETROCAECAL ' /,1

.CAUDOOSITIO (ELIC) ' +&,5&+.LATEROOSITIO ' ,/

. MEDIO % OSITIO'

.&. ANTERO4ILEAL' &

.. RETRO % ILEAL' 5,

TAENIA COLI 8 LIBERAE

RO-ECTION OF OSTIUM AENDICIS ERMIFORMIS ' LAN= OINT ' OINT

BETWEEN : R % LATERAL AND : MIDDLE RIGHT LINE OF LAN=.LINE OF LAN= ' LINE THAT CONNECT RIGHT AND LEFT SIAS.AENDICITIS ACUTA ' OINT OF M BURNE" ' OINT BETWEEN : LATERAL

AND MID : LINE OF MONRO % RICHTER.

LINE OF MONRO % RICHTER ' LINE DRAWN FROM NAEL (UMBILICUS) TO R4

SIAS.


26/34

RO-ECTION OF AENDI* ERMIFORMIS

ASCULARISATIO ORGANAE DIGESTIAE (BLOOD SUL" OF


27/34

ASCULARISATIO ORGANAE DIGESTIAE (BLOOD SUL" OFABDOMINAL ORGANS ) AORTA

THORACALIS

HIATUS AORTICUS

DIAPHR.

( T12 )

AORTA ABDOMINALIS

1.TRIPUS HALLERI (A.

COELIACA)

( T 12 )

2.A. MESENTERICASUPERIOR

( L1 )

3. A.MESENTERICAINFERIOR


28/34


29/34

A. MESENTERICA SUERIOR (SUERIOR MESENTERICARTER" )ORIGIN ' A#. ABDOMINALIS ( L& )

BRANCHES '

&. A. COLICA MEDIA ( MIDDLE COLIC ARTER" )

. A. ANCREATICODUODENALIS

INFERIOR. ( INFERIOR ANCREATICODUODE

NAL ARTER" )

+. A. COLICA DE*TRA

( RIGHT COLIC ARTER" ) . A. ILEO4COLICA

( ILEO4COLIC ARTER" )

. AA.-E-UNALES ET ILEALES

( -E-UNO4ILEAL ARTER" )


30/34

A. MESENTERICA INFERIOR(INFERIOR MESENTERIC ARTER" )

ORIGIN ' AORTA ABDOMINALIS

(ABDOMINAL AORTA)

BRANCHES '

&. A. COLICA SINISTRA

( LEFT COLIC ARTER" )

. AA. SIGMOIDEAE

( SIGMOID ARTER" )

+. A. HAEMORRHOIDALIS SU. ( A. RECTALIS SUERIOR,

SUERIOR RECTAL ARTER" )


31/34

A.MARGINALIS DRUMMONDI (MARGINAL ARTER" OF DRUMMOND )

DEFINITION 'ANASTOMOSES OF ARTERIALRAMIFICATION FROM BRANCHESOF SUERIOR AND INFERIORMESENTERIC ARTERIES AT THEMARGIN OF INTESTINUMCRASSUM ( COLON 3 LARGE

BOWEL )

A*IOMA (ABSOLUT RINCILES )'&. A. COELIACA ' UER G I T AND ORGANA DIGESTIA ACCESSO

RIAE ( ACCESSOR" DIGESTIE ORGANS ).. A.MESENT.SU ' LOWER G I T %

FLE*.COLI SIN ( SLEENIC FLE*URE+. A. MESENT. INF. ' THE REST OF

LOWER G I T.


32/34

INNERATION OF ABDOMINAL ORGANSAUTONOMIC NEROUS S"STEM '&. S"MATHETIC

NERE S"STEM'' NN.SLANCHNICAE' &.&. MA-OR ( T42 )

&.. MINOR ( T24&5 )

. ARAS"MATHETIC NERE S"STEM'

.&. N. AGUS .. N.SLANCHNICUS

ELICUM (S4)


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SOURCES&. BAMA-IAN 3 - ' GRANTS METHOD OF ANATOM"3 THE WILLIAMS

6 WIL!INS COMAN" 3 CALCUTTA.. !AHLE, W3 LEONHARDT, H 6 LET=ER, W ' COLOR ATLAS AND

TE*TBOO! OF HUMAN ANATOM"3 GEORGE THIEMUBLISHER3 STUTTGART.

+. ROGERS, A W ' TE*TBOO! OF ANATOM"3 CHURCHILL 6

LIINGSTONE 3 LONDON % TO!"O.. SALTEHOL=, WERNER ' HANDATLAS UND LEHRBUCH DER

ANATOMIE DES MENSCHEN 3 SCHELTEMA 6 HOL!EMA N 3AMSTERDAM.


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