DIGESTION ANATOMY A

7/27/2019 DIGESTION ANATOMY A

1/139

DIGESTIVE ANATOMY

9 Mei 2012 1dr Lucky Brilliantina, AnatomiFKUPN


2/139

TOPIK

Abdominal wall

Primary organ abdomen

Accessories organ abdomen

2dr Lucky Brilliantina, AnatomiFKUPN


3/139

ABDOMINAL WALL

3dr Lucky Brilliantina, AnatomiFKUPN


4/139

Abdomen is a closed cylinder with a musculo-

skeletal wall.

4

dr Lucky Brilliantina, Anatomi

FKUPN


5/139

Inside are the wall are the liver,

intestines, kidneys, etc.

5


FKUPN


6/139

Abdominal Muscles Increase Intra-abdominal pressure

6


FKUPN


7/139

Abdomen defined by diaphragm above, pelvic brim below, and

vertebral bodies ribs and muscles posteriorly, and laterally.

7


FKUPN


8/139

To get in the abdominal cavity you must go through skin, 2 superficial

fascias (fatty and membraneous). 3 muscles layers (or one),

transversalis fascia, parietal peritoneum.

8


FKUPN


9/139

MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL

LINEA ALBA

TENDINOUS

INTERSECTION

RECTUS

ABDOMINIS

INGUINAL

LIGAMENT

TRANSVERSUSABDOMINIS

INTERNAL OBLIQUE

EXTERNAL OBLIQUE

APONEUROSIS OF

EXTERNAL

OBLIQUE

SUPERFICIAL

INGUINAL RING

9


FKUPN


10/139


RECTUS SHEATH

APONEUROSES

TA

IO

EO

BELOW THE ARCUATE LINE ALL APONEUROSES PASS IN

FRONT OF THE RECTUS ABDOMINIS

ABOVE THE ARCUATE LINE THE APONEUROSIS

OF THE INTERNAL OBLIQUE SPLITS TO ENCLOSE

THE RECTUS ABDOMINIS

10


FKUPN


11/139

Vessels of the Anterolateral Abdominal

Wall

Internal

thoracic

vessels

Inferior

epigastric

vessels

Superiorepigastric

vessels

11


FKUPN


12/139

Nerves of the Abdominal Wall

Ventral Rami of T6 to L2

12


FKUPN


13/139


EXTERNAL OBLIQUE

BILATERAL ACTION:

ASSISTS RECTUS ABDOMINIS

IN FLEXING VERTEBRAL

COLUMN, COMPRESSING

ABDOMINAL WALL, AND

INCREASING INTRA-

ABDOMINAL PRESSURE

UNILATERAL ACTION:

AID BACK MUSCLES IN

ROTATION AND

LATERAL FLEXION

NN. = T7-T12

INTERNAL OBLIQUE

NN. = T7-T12, L1

13


FKUPN


14/139


RECTUS ABDOMINIS

RECTUS

ABDOMINIS

BILATERAL:

FLEXION OF VERTEBRAL

COLUMN, COMPRESSION

OF ABDOMEN, INCREASE

IN INTRA-ABDOMINAL

PRESSURE

UNILATERAL:

ASSISTS BACK MUSCLES IN

LATERAL FLEXION AND

ROTATION

NN. = T7-T12, L1

14


FKUPN


15/139

Psoas and quadratus lumborum form posterior wall.

15


FKUPN


16/139

Psoas + Iliacus = IliopsoasMost Major Hip FlexorCrosses under

Inguinal Ligament with Femoral Nerve, and External Iliacs (become

Femoral a and v.

16


FKUPN


17/139

Inguinal Ligamentinferior border of aponeurosis ofexternal oblique muscleattaches to ASIS and pubic tubercle

17


FKUPN


18/139

PERITONEUM

18


FKUPN


19/139

19

Peritoneum

Peritoneum Visceral : menutupi hampir

sebagian besar organ2 dalam rongga perut.

PeritoneumParietal : Lapisan dalam dari

dinding perut.

Rongga Peritoneal : rongga yang terletakantara 2 lapisan peritoneum yang berisi

cairan.dr Lucky Brilliantina, Anatomi

FKUPN


20/139

20

Peritoneum & MesenteriumPeritoneum(Selaput

perut)Visceral: menutup organ

dalam rongga abdomen

Parietal: menutuppermukaan dalam dindingtubuh

Retroperitoneal: dibelakangperitoneum seperti ginjal,pankreas, duodenum (tak adamesenterium)

Mesenterium

Meletakkan organ padatempatnya

Jalur dimana saraf danpembuluh darah berjalandari dinding badan ke organ.

1

2

Omentum : lipatan/kantong di dalam peritoneum

Omentum Mayusbanyak lemak, dari kurvatura mayor lambung dancolon transversalis

Omentum Minus berhubungan dg kurvature minor lambung dan

ujungatas duodenum , hati , diafragma membentuk mesenterium usus halus

dr Lucky Brilliantina, AnatomiFKUPN


21/139

21

Fungsi peritoneum:

Menutupi sebagian organ perut dan pelvis

Pembatas halus sehingga organ dalam

rongga peritoneum tak saling gesek

Jaga posisi dan hubungan organ dengan

dinding belakang perutTempat kelnjar limfe dan pembuluh darah

untuk membantu melindungi infeksi

kumandr Lucky Brilliantina, Anatomi

FKUPN

I t it l Abd i l O d i d f f t (B)


22/139

Intraperitoneal Abdominal Organs derived from foregut (B)

have a dorsal and ventral mesentery. Midgut derived organs

(A) lack a ventral mesentery.

A

A

B

B

22


FKUPN

b li i


23/139

Parietal peritoneum serous membrane lining

the abdominal cavity (spacebetween)

Visceral peritoneum serous membrane covering theinternal organs

23


FKUPN


24/139

24


FKUPN

Ri h d L f C li Fl


25/139

Right and Left Colic Flexures

25


FKUPN


26/139

Some Organs Lose Their Mesentery

and Become Retroperitoneal

26


FKUPN


27/139

INTRAPERITONEAL

VS.

RETROPERITONEAL

INTRAPERITONEAL ORGANS ARE ALMOST COMPLETELYCOVERED WITH VISCERAL PERITONEUM

THEY are suspended or protrude in into the peritoneal

cavity, but are not actually in i t.

RETROPERITONEAL ORGANS ARE LOCATED between the

paeietal perinoneum and the body wall itself. -They may be partiall y

covered by parietal peri toneum

Subperitonealsome organs lie below the

peritoneum in the pelvis, e.g. The uterus and

bladder.27


FKUPN

PARIETAL PERITONEUM Bl


28/139

PARIETAL PERITONEUMBlue area

28


FKUPN


29/139

MESENTERY PROPER

TRANSVERSEMESOCOLON

NOT SHOWN: MESOAPPENDIX, SIGMOID MESOCOLON

The Adult Mesenteries

29


FKUPN


30/139

LESSER OMENTUM

A double layer of

peritoneum extending

from the porta hepatis

of the liver to the lesser

curvature of the stomach

and the beginning of

the duodenum

GREATER OMENTUM

a double layer of peritoneum

attached to the greater

curvature of the stomachsuperiorly and the transverse

colon inferiorly; it hangs down

like a fatty apron over the

abdominal viscera

GREATER AND LESSER OMENTA

30


FKUPN


31/139

LESSER SAC OR

OMENTAL BURSA

GREATER SAC

SUPRACOLIC

GREATER SAC INFRACOLIC

TWO PERITONEAL

SACS

TRANSVERSE

MESOCOLON

31


FKUPN


32/139

Rotation of the Stomach Forms the Lesser Sac of the

Peritoneal Cavity and Starts to Form the Greater Omentum

32


FKUPN

The Peritoneum


33/139

The Peritoneum

The parietal peritoneum

The visceral peritoneum

The peritoneal cavity

33


FKUPN


34/139

kidneys

ureters

suprarenal glands

duodenum

pancreas

aorta

inferior vena cava

nerves

ascending colon

descending colon

The retroperitoneal space

34


FKUPN

The Peritoneum


35/139

The Peritoneum

The parietal peritoneum

The visceral peritoneum

The peritoneal cavity

35


FKUPN


36/139

The visceral

peritoneum

The peritoneal

cavity

36


FKUPN

2 l f ld f h i


37/139

1. The peritoneal ligaments

falciform ligament

ligamentum teres

median umbilical ligament

medial umbilical ligaments

lateral umbilical ligaments

2 layer folds of the peritoneum

1. The peritoneal ligaments

2. Lesser and Greater Omenta

3. The mesenteries

37


FKUPN

2. Lesser and Greater Omenta


38/139

38


FKUPN


39/139

Lesser and Greater Omenta

Lesser

Omentum

hepatogastric ligament

hepatoduodenal ligament

the epiploic foramen

(of Winslow)

39


FKUPN

G t O t


40/139

Greater Omentum

40


FKUPN

3. The mesenteries


41/139

41


FKUPN

The mesenteries


42/139

The mesenteries

transverse mesocolon

sigmoid mesocolon

mesentery of the

small intestine

Contents ?

42


FKUPN

Lesser Sac


43/139

Lesser Sac

43


FKUPN

Oth Li t


44/139

Other Ligaments

Lesser Omentum

Greater Omentum

falciform ligament

ligamentum teres

phrenicocolic ligament

gastrocolic ligament

gastrophrenic ligament

gastrosplenicligament

hepatogastric ligament

hepatoduodenal ligament.

Lienorenal ligament

44


FKUPN


45/139

Lesser Sac

45


FKUPN


46/139

Lesser Sac

46


FKUPN


47/139

Lesser Sac

(Omental Bursa)

47


FKUPN

Lesser Sac


48/139

Morisons pouch

left subhepatic spaceVestibule

Superior recess

epiploic foramen (of Winslow)

48


FKUPN

Epiploic foramen (of Winslow)


49/139

Epiploic foramen (of Winslow)

Ant: hepatoduodenal ligament

Post: inferior vena cava

Sup: caudate lobe

Inf: first part of the

duodenum

49


FKUPN


50/139

PRIMARY ORGANS

50


FKUPN


51/139

ACCESSORY ORGANS

PAROTID SALIVARY GLAND

SUBLINGUAL SALIVARY GLAND

SUBMANDIUBULAR SALIVARYGLAND

LIVER

GALL BLADDER

PANCREAS

51


FKUPN


52/139

ORAL CAVITY


53/139

53

Mulut

Rongga mulut sejati:dimulai dari

belakang gigi

memanjangkebelakang sampai

oropharing.

Vestibulum oris:

ruang yang terletak

antara gigi dengandr Lucky Brilliantina, Anatomi

FKUPN

Cavitas OralMulut/cavitas oral


54/139

54

Cavitas OralVestibulum: Ruang

antara bibir danprocessus alveolaris

Oral cavity proper

Bibir (labia)Palatum (langit2mulut):Durum/keras dan

molle/halusTonsila Palatina

Lidah: berguna untukbicara, merasakan,kunyah dan menelan

Faucium - lubangtenggorokan ke arahfaring

Frenulummenghubungkan bibirdengan processusalveolaris

1

2

2

34

5

6 7


FKUPN

BIBIR


55/139

55

BIBIRLuar : Kulit

Dalam : mukosa

Otot :M.levator anguli oris : angkat ujung mulut

M. depresor anguli oris : menekan ujung mulut

M. orbicularis oris : menutupi bibir

Pipi :Dalam : mukosa dilapisi papilaLuar : kulitOtot : M. buccinator

Palatum/Langit-langit :Palatum durum/langit2 keras

dari 2 tulang palatum, letak depan tulang rahang depan

Palatum molle/langit2 lunak

dari jaringan fibrosa dan selaput lendir, letak di belakangdr Lucky Brilliantina, Anatomi

FKUPN

Lidah


56/139

56

Lidah

Menempati hampir sebagian besarrongga mulut dan disusun terutamaoleh otot skelet.

Otot Intrinsik berasal dan menyusunkontur lidah yang berfungsi untukperubahan bentuk dan ukuran tetapitidak untuk posisi.

Otot Ekstrinsik: berasal dari tulang atau

palatum mole dan berfungsi untukperubahan posisi lidah.

Frenulum lingualis, menghubungkan lidahdengan dasar mulut.


FKUPN


57/139

57

Lidah

Frenulum

lingualis,

menghubungkan

lidah dengan

dasar mulut.


FKUPN


58/139

58

Lidah

Pergerakan lidah untuk mencampur makanan dengan saliva

menjadi masa padat disebut sebagai bolusLapisan atas dari lidah mempunyai banyak tonjolan yang

disebut papilae.

Membantu dalam pengunyahan material lembut dan terdapat

reseptor pengecap.


FKUPN

Indra KecapP ill ( b d k )


59/139

59

Indra KecapPapillae (nama berdasar ukuran)

c. Vallata (dikelilingi olehdinding)

Terbesar, tak

banyake. Fungiform (bentuk jamur)

Tersebar takteratur

d. Foliate (leaf shape)

Tersebar padalipatan sisi lidah.Paling sensitif.

b. Filiform (bentukbenang/filamen)

Terletak pada epitel lidahdan mulut

drLucky Brilliantina, Anatomi

FKUPN

Kelenjar Air Liur Hasilkan air liur


60/139

60

Kelenjar Air LiurCegah infeksi bakteri

Lubrikasi

Mgd amilase salivarius

Hancurkan makanan

Mukosa

Dikeluarkan oleh kelanjarsubmandibularis dansublingualis

lubrikasiTiga pasang

Parotis: Terbesar, letakanterior telinga.

Submandibularis: bawah

mandibula/rahang bawahSublingualiis: Terkecil,

dibawah lidah.


FKUPN


61/139

61

Kelenjar ludah


FKUPN


62/139

ORAL CAVITY ANATOMY

OROPHARYNX

LARYNGOPHARYNX

62


FKUPN


63/139

PHARYNX


64/139

PHARYNX ANATOMY

The pharynx is dividedinto three regions. The

nasopharynx, oropharynx,and the laryngopharynx.The mucosa is composedof stratified squamous

epithelium which issupplied with mucusproducing glands.

64


FKUPN


65/139

PHARYNX ANATOMY

The external muscle layerconsists of 2 skeletal

muscle layers. Theinternal layers runlongitudinally. The outerlayer encircles the wall ofthe pharynx. Contractionsof these muscles propelfood into the esophagus.

65


FKUPN


66/139

ESOPHAGUS


67/139

ESOPHAGUS ANATOMY

. Tabung otot dari otot skelet danotot polos .

Diawali dari ujung orofaringmenuju hiatus esofagus (pintumasuk) menembus diafragma

dan berakhir pada gasterHubungkan pharing dengan

gaster(25 cm)

Mempunyai sfingter padasambungan esofagus dan

faring, yi: sfingter esofageal(cardiac sphincter) yg berfungsimenghentikan aliran makanandari gaster kembali keesofagus

ESOPHAGUS

67


FKUPN


68/139

ESOPHAGUS ANATOMY

68


FKUPN


69/139

ESOPHAGUS ANATOMY

The esophageal mucosacontains nonkeratinized

stratified squamousepithelium. At theesophageal stomachjunction the epitheliumchanges to simplecolumnar epithelium.

69


FKUPN


70/139

ESOPHAGUS ANATOMY

The submucosa containsmucus secreting glands.

As a bolus moves throughthe esophagus, itcompresses these glands,causing them to secretemucus which aids in themovement of food.

70


FKUPN


71/139

ESOPHAGUS ANATOMY

The muscularis externa isskeletal muscle in its

superior third, a mixtureof skeletal and smoothmuscle in its middlethird, and entirely smoothmuscle in its inferiorthird.

71


FKUPN


72/139

ESOPHAGUS ANATOMY

The serosa is entirely

connective tissue whichblends with surroundingstructures along its route.

72


FKUPN


73/139

ESOPHAGUS ANATOMY

The pharynx propels foodinto the esophagus

through the upperesophageal sphincter.

Upper esophagealsphincter

73


FKUPN


74/139

ESOPHAGUS ANATOMY

The bolus of food ispropelled within theesophagus by peristalsis.

74


FKUPN


75/139

ESOPHAGUS ANATOMY

The bolus of food ispropelled within theesophagus by peristalsis.

75


FKUPN


76/139

ESOPHAGUS ANATOMY

76


FKUPN


77/139

STOMACH


78/139

STOMACH ANATOMY

78


FKUPN

Ventrikulus


79/139

79

Ventrikulus Dibagi

Regio

Cardia(penyimpanan),

Fundus(penyimpanan),

Corpus

(penyimpanan),Piloricum

(digesti)

Spingter pyloricmencegah aliran

bolus makanankembali dariduodenum ke gaster

Rugae: lipatan dalamgaster


FKUPN

GASTER


80/139

GASTER :

N.Vagus

N.VagusDextra,Sinistra

Plexus

OesophagusTruncus

Vagalis

Anterior

( Rami Gastrici

Anteriores )

80


FKUPN


81/139

VASCULARISASI

Jantung Arcus aortaAorta Truncus

CoeliacusA.Gastrica sinistra,

A.Splenica, A. Hepatica ComunisA.SplenicaAa.Gastricae breves

A. Hepatica Comunis

A.Gastroduodenalis,A.Hepatica propria

A.Hepatica propriaA.Gastrica Dextra

81


FKUPN

Jantung Arcus aortaAorta Truncus Coeliacus


82/139

A.Gastrica Dextra, A.Gastrica sinistra,

Aa.Gastricae breves, A.Gastroduodenalis

82


FKUPN


83/139

83


FKUPN

V.Cava Inferior V. Porta HepaticaV.Gastrica Sinistra,


84/139

V.Gastroomentalis dextra et sinistra

84


FKUPN


85/139

SMALL INTESTINES

Intestinum Tenue/Usus Halus


86/139

86

Tempat utama digesti dan absorpsi

dimulai dari spincter pilory sampai

katup ileocecalPembagian :

Duodenum

Jejunum

Ileum: Plaques Peyer/

limponodi di lapisan mukosa

dan submukosa dimana terjadi

absorpsi sari-sari makanan

Spincter Illeocecal

sambungan antara ileum dan

usus besar/ intestinum crassum


FKUPN


87/139

87

Duodenum

Duodenum panjang 12 inci(18 cm)= usus 12 jari, yang dilingkupi oleh caput dari pankreas

Retroperitoneal.

Duktus biliaris komunis (saluran untuk empedu darihepar dan kandung empedu) dan duktus pankreatikus(saluran untuk keluarnya sekret dari kelenjar pankreas)

bergabung di dinding duodenum pada ampullahepatopancreatic.

Tempat utama proses pencernaan.


FKUPN


88/139

88


FKUPN


89/139

SMALL INTESTINES ANATOMY

The duodenum is about10 in long and is mostlyretroperitoneal. The

bile duct and thepancreatic duct join toform thehepatopancreaticampulla which opensinto the duodenum.

DUODENUM

HEPATOPANCREATIC

AMPULLA

MAJOR DUODENAL

PAPILLA

89


FKUPN

VASCULARITATIO


90/139

A. Gastrica dextra

A. Pancreatico-duodenalis superior

A. Pancreatico-duodenalis inferior

INNERVATIO

Plexus coeliacus

Plexus mesentericus superiorSTRUKTUR

Dinding intestinum tenue mesostineale terdiri atas 4 lapisan, yaitu

:

Tunica mucosa (membrane mucosae)Tela submucosa

Tunica muscularis

Tunica serosa

90


FKUPN


91/139


The small intestine is highlyadapted for absorption. Itslength, together with its

plicae circulares, villi, andmicrovilli amplify its surfacearea enormously.

The plicae circularies aredeep permanent folds of themucosa and submucosa.

91


FKUPN


92/139


Villi are fingerlikeprojections of the mucosa.

The epithelial cells of thevilli are absorptivecolumnar cells. In thecore of each villus is densecapillary bed and a lymphcapillary the lacteal.

92


FKUPN


93/139


Villi are fingerlikeprojections of the mucosa.

The epithelial cells of thevilli are absorptivecolumnar cells. In thecore of each villus is densecapillary bed and a lymphcapillary the lacteal.

93


FKUPN


94/139


Microvilli, tiny projections

of the plasma membraneof the absorptive cells ofthe mucosa, give themucosal surface a fuzzy

appearance called thebrush border.

94


FKUPN


95/139


The cells of the microvilliinclude simple columnarepithelial cells, goblet cells,

scattered enteroendocrinecells, and T cells. Theplasma membrane of theepithelial cells haveenzymes called brush

border enzymes whichcomplete the digestion ofcarbohydrates and proteins.

95


FKUPN


96/139


Between the villi, the mucosa isstudded with pits that lead intotubular intestinal glands calledintestinal crypts.

The epithelial cells that linethese crypts secrete intestinal

juice. The intestinal juice is awaterly mixture containingmucus that serves as a carrier

fluid for absorbing nutrientsfrom chyme.

96


FKUPN

j & l


97/139

97

Jejunum & Ileum

Jejunum panjangnya 8 inci , terletak antar duodenum dan

ileum, dimana tempat ini merupakan tempat proses

penyerapan nutrien yang utama

Ileum merupakan kelanjutan dari jejunum dan berakhir di

katup ileocecal, panjangnya kurang lebih 12 inci.

Plaques Peyer/ limponodi di lapisan mukosa dan

submukosa dimana terjadi absorpsi sari-sari makanan


FKUPN

J j d il


98/139

98

Jejenum dan ileum

Ujung bawah ileum berhub dgn caecum :

lubang : orifisium ileosekalis

Diperkuat oleh sfingter ileosekalisTerdapat katub/valvula caecalis/valvula

Bauchini yang berfungsi mencegah

cairan dalam colon asenden tak masuk ke

ileumdr Lucky Brilliantina, Anatomi

FKUPN

Kontraksi otot intestinum

tenue menyebabkan


99/139

99

tenue menyebabkan

gerakan peristaltik &

segmental yang

membantu mencampur& menggerakkan

makanan ke usus

besar/intestinum

crassumDiatur oleh sfingter

ileocecal yg terdpt pd

sambungan antara ileum

dan cecum yangmencegah makanan

yang tak diabsorpsi

kembali ke usus halusdr Lucky Brilliantina, Anatomi

FKUPN


100/139

LIVER

LIVER ANATOMY


101/139

LIVER ANATOMY

The liver is the largestgland in the body,weighing about 1.4 Kg.It is located under thediaphragm, within therib cage in the upperright quadrant of the

abdomen. The liver isan accessory digestivegland.

LIVER

GALL

BLADDER

101


FKUPN

LIVER ANATOMY


102/139

LIVER ANATOMY

4 LobesMajor: Left and rightMinor: Caudate and

quadrateDucts

Common hepaticCystic

From gallbladder

Common bileJoins pancreatic duct at

hepatopancreatic ampulla

102


FKUPN

LIVER ANATOMY


103/139

LIVER ANATOMY

The liver is composed ofliver lobules which areroughly hexagonalstructures consisting ofhepatocytes. The hepato-cytes radiate outwardfrom a central vein. Ateach of the six corners of

a lobule is a portal triad.Between the hepatocytesare the liver sinusoids.

103


FKUPN


104/139

104

4 lobus Lobus kanan dan lobus kiri dipisahkan oleh ligamen falciform.

Berhubungan dengan lobus kanan,bagian bawahnya terdapat lobus

quadratus ,sedang dibag. Belakang lobus caudatus.dr Lucky Brilliantina, AnatomiFKUPN

Left and righthepatic ducts


105/139

105

CysticDuct

p

Lesser

omentum


FKUPN

V. Umbilicalis

V Porta Hepatica


106/139

V. Porta Hepatica

Rr. Dex et Sin

HEPARVv. Hepatica Dex,

Intrmediate, Sin

V. Cava Inverior.

Sobotta Jilid 2 hal : 142,148106


FKUPN

LIVER ANATOMY


107/139

LIVER ANATOMY

The hepatocytes produce bilewhich flows through canals,called bile canaliculi to a bileduct. The bile ducts eventually

leave the liver via the commonhepatic duct.

The hepatocytes also processnutrients into macromolecules,

store fat-soluble vitamins, andplay an important part indetoxification.

107


FKUPN

LIVER ANATOMY


108/139

LIVER ANATOMY

Bile is a yellow green alkalinesolution containing bile salts,bile pigments, cholesterol,neutral fats, phospholipids, anda variety of electrolytes. The

liver produces to 1 liter ofbile daily.

Bile salts emulsify fats. As aresult, large fat globules

entering the small intestine arephysically separated intomillions of small fat droplets tobe digested and absorbed.

LIVER

GALL

BLADDER

108


FKUPN

LIVER ANATOMY


109/139

LIVER ANATOMY

109


FKUPN

GALLBLADDER ANATOMY


110/139

GALLBLADDER ANATOMY

The gallbladder is a thinwalled green muscular sacon the inferior surface ofthe liver. The gallbladderstores bile that is notimmediately needed fordigestion and concentratesit. When the muscular wall

of the gallbladdercontracts bile is expelledinto the bile duct.

LIVER

GALL

BLADDER

110


FKUPN

LIVER GALLBLADDERANATOMY


111/139

ANATOMY

111


FKUPN

Kandung empedu/ Vessica felleaM b b j 812 i i 60 3


112/139

112

Membran berotot, panjang 812 cm, isi 60 cm3

Duktus Cysticus menghubungkan kandung empedudg ductus pancreaticus communis

Struktur mirip kantung pada permukaan hati

Empedu disimpan dan dikonsentrasikanEmpedu dikirim ke usus halus

Kemungkinan terjadi batu kandung empedu (dari

empedu dan kolesterol yang berpresipitasi shgmembtk kristal) krn diet drastis dg penurunan

berat badan yang cepatdr Lucky Brilliantina, Anatomi

FKUPN


113/139

PANCREAS

PANKREAS


114/139

PANKREAS

LOKASI

Pancreas (kelenjar ludah perut) terletak

melintang pada dinding dorsal abdomendi regio epigastrica dan hypochondrica

sinistra.

BENTUK DAN UKURAN

Pancreas berbentuk huruf J yang di

rebahkan, panjang 12.5-15 cm. 114dr Lucky Brilliantina, Anatomi

FKUPN


115/139

BAGIAN-BAGIANNYA

Caput PancreatisCollum pancreatis

Corpus pancreatis

Cauda pancreatic

VASCULARISATIOArteri Pancreatico-duodenalis superior

Arteri pancreatico-duodenalis inferior

INNERVATIO

Susunan saraf simpatis dan parasimpatis melalui plexus

coeliacus.

115


FKUPN


116/139

116


FKUPN

PANCREAS ANATOMY


117/139

PANCREAS ANATOMY

117


FKUPN

Vascularisatio:


118/139

A. Pancreatico-duodenalis superior

A. Pancreatico-duodenalis inferior

Rr. Pancreatici A. Lienalis

Innervatio :Susunan saraf simpatis dan parasimpatis

melalui plexus coeliacus.

118


FKUPN


119/139

119


FKUPN

VARIANS DUCTUSPANCRETICUS


120/139

PANCRETICUS

Double Accessory Pancretic Ducts (Santorini).

Anastomosis between Ducts.

Crossing of Ducts.

Double Crossing of Ducts.

No Communication between Ducts.

Double (Principal) Pancretic Ducts (Wirsungi).

Tortuosity of Ducts.

Absence of Accessory Pancreatic Duct (Santorini).

120


FKUPN


121/139

121


FKUPN


122/139

LARGE INTESTINES

susBesar/Intestinum

4


123/139

123

CrassumDari sambungan ileocecal sampai

anus

Terbagi menjadi:

Cecum

Appendix

Colon

Ascending

Transverse

Descending

Sigmoid

Rectum

Anus.

Panjang1M, lebar 5-6 cm

Bergerak selama 18-24 jam

12

35

6


FKUPN

Caecum


124/139

124

Caecum

Di bawah : terdapat appendiks vermiformis

: bentuk cacing = umbai cacing, panjang

6 cmDitutupi peritonium

Mudah bergerak

Tak mempunyai mesenterium

Dapat diraba pada orang hidupdr Lucky Brilliantina, Anatomi

FKUPN

Colon asenden


125/139

125

Colon asenden

Panjang 13 cm

Pada perut kanan, membujur ke ataqs dari

ileum ke bawah hatiDi Bawah hati melengkung ke kiri :

fleksura hepatika

Melanjut sebagai colon transversum


FKUPN

Colon transversum Panjang 38 cm dari kolon asenden ke


126/139

126

Panjang 38 cm, dari kolon asenden ke

kolon desenden di bawah lambung

Kanan terdapat fleksura hepatika

Kiri terdapat fleksura lienalis

Colon Descendens

Adalah lanjutan flexura coli sinistra,

berjalan ke kaudal melalui region

hypochondrica sinistra dan regio

lumbalis sinistra di sepanjang tepi lateral

ren sinistra. dr Lucky Brilliantina, AnatomiFKUPN

Colon Sigmoid


127/139

Colon Sigmoid

SINONIM :

Colon pelvicum

Flexura sigmoidea

BENTUK DAN UKURAN, Colon sigmoid

adalah lanjutan colon descendens mulai dari

crista illiaca (apertura pelvis superior) sampai

ke discus intervertebralis SII-SIII. Membentuksuatu lengkungan dengan panjangrata-rata 40

cm.127


FKUPN


128/139

128


FKUPN

APPENDIK VERMIFORMIS


129/139

APPENDIK VERMIFORMIS

Sinonim: Processus vermiformis, Umbai Cacing, Usus

buntu.

Bentuknya seperti cacing,panjang 2-23 cm (rata-rata

8cm), diameter 5-10mm, mulai dibagian dorsomedial caecum kira-kira 2,5-3,7cm kaudal dari

orificium ileo-caecalis.

VASKULARISASIA.Appendicularis, dipercabangkan dari A.ileo-caecalis

129


FKUPN


130/139

130


FKUPN


131/139

131


FKUPN

RECTUM


132/139

RECTUM

Rectum adalah lanjutan dari colonsigmoideum dan mulai dari junctura

rectosigmoidea setinggi ruas ketiga

sacrum. Pada rectum tidak lagi terdapatketiga tanda khas untuk kolon.

Panjang kira-kira 12 cm15 cm dengan

penampangnya dalam keadaan kosong

2.5 cm. rectum mempunyai kemampuan

untuk dilatasi sampai sebesar 7 5 cm132


FKUPN

CANALIS ANALIS


133/139

CANALIS ANALIS

Kadang-kadang dinamakan juga pars analis

recti

Canalis analis adalah bagian akhir dariintestinum crassum panjangnya 2.5 cm

sampai 4 cm. mulai dari flexura

parinealis recti. Biasanya canalis analisdalam keadaan tertutup dan baru terbuka

pada waktu defekasi ( buang air besar).133


FKUPN


134/139

134


FKUPN

Pembuangan Feses olehRectum & Anus

B t k k i (b t


135/139

135

Bantu ekskresi (bantu

membuang limbah

makanan dari usus).

Rectum

Pada rongga pelvis,

depan os sacrum & oscoccygeus

Bergabung dg colon

sigmoid dg canalis anal

Tabung pendek& lurus

dari lapisan otot tebal


FKUPN

ANUSHubungkan Rectum dg


136/139

136

dunia luar

Diperkuat 3 sfingter

1. Spingter ani interna :atas, bekerja takmemenuhi kehendak,kaya lapisan otot

polos tebal2.Spingter ani eksterna :

bawah, bekerjamenuruti kehendak,kaya otot skelet

3. Sfingter levator ani :bekerja tak menurutkehendak


FKUPN

Proses DefekasiCanalis Anal adalah bagian

akhir dari organ cernaj


137/139

137

menuju anus.

Defekasi adalah yangmenurut perintah

Transpor feces ke rectum-regangan dinding rektum& kontraksi colon

sigmoid - rangsangrefleks defekasi-relaksasi dari spincter aniinternus -m. levator anirelaksasi secara sadar-

tekanan ditimbulkan olehotot perut.

drLucky Brilliantina, Anatomi

FKUPN

LARGE INTESTINE ANATOMY


138/139

LARGE INTESTINE ANATOMY

The last segment of thelarge intestine is the analcanal. The anal canal isabout 3 cm long. It begins

where the anus penetratesthe pelvic floor and itopens to the body exteriorat the anus. The analcanal has 2 sphincters, an

internal and external. Itis lined with stratifiedsquamous epithelial tissue.

138


FKUPN


139/139

QUESTION????

DIGESTION ANATOMY A

Documents

Transcript of DIGESTION ANATOMY A