消化系统小肠疾病.ppt

Small intestine disease Department of general surgery Yaxu Wang Chapter 1 Anatomy and Physiology In this chapter, the normal anatomy and physiology of the small intestine are described, as well as disease processes involving the small bowel, which include: obstruction inflammatory diseases neoplasms Chapter 1 Anatomy and Physiology 1.Anatomy 2.Physiology 1.1 Neurovascular-Lymphatic Supply The small intestine is served by rich vascular, neural, and lymphatic supplies, all traversing through the mesentery. The base of the mesentery attaches to the posterior abdominal wall to the left of the second lumbar vertebra and passes obliquely to the right and inferiorly to the right sacroiliac joint. 1.1 Neurovascular-Lymphatic Supply The blood supply of the small bowel, except for the proximal duodenum that is supplied by branches of the celiac axis, comes entirely from the superior mesenteric artery. 1.1 Neurovascular-Lymphatic Supply The blood supply of the small bowel, except for the proximal duodenum that is supplied by branches of the celiac axis, comes entirely from the superior mesenteric artery. 1.1 Neurovascular-Lymphatic Supply The superior mesenteric artery courses anterior to the uncinate process of the pancreas and the third portion of the duodenum, where it divides to supply the pancreas, distal duodenum, entire small intestine, and ascending and transverse colon. Venous drainage of the small bowel parallels the arterial supply, with blood draining into the superior mesenteric vein, which joins the splenic vein,then to the the portal vein . The innervation of the small bowel is provided by both parasympathetic and sympathetic divisions of the autonomic nervous system, which in turn provide the efferent nerves to the small intestine. 1.2 Microscopic Anatomy The small bowel wall consists of four layers: serosa muscularis propria submucosa mucosa Chapter 1 Anatomy and Physiology 1.Anatomy 2.Physi