Duodenum
Duodenum
Duodenum
Introduction
• Do-deka-dactulos
• C shaped
• Shortest
• Widest
• Most fixed
• Extent -
• Situation -
• Length – 25 cm
• Parts - 4
• I – 5cm
• II –7.5cm
• III –10cm.
• IV – 2.5cm
First part
• Begins –
• Course -
• Relations –
• Peritoneal -
• Visceral –
• Ant.
• Post.
• Superior
• Inferior
Arterial supply of first part
• Its supplied by series of end arteries-
• Supra duodenal branch of gastroduodenal artery.
• Retro duodenal branch of gastroduodenal artery
•
Peculiarities of first part
• It most movable part -behave like stomach
• Supply by end arteries
• May be affected peptic ulcer
• Its devoid of circular mucous fold.
• A triangular radio opaque shadow knows as
duodenal cap or bulb.
Second part
• Begins -
• Relations –
• Peritoneal
• Visceral –
Ant.
Post.
Medially
Laterally
• Begins -
Third part
• Relations –
• Peritoneal
• Visceral
• Posterior -
Fourth part
Relations -
Peritoneal
Visceral -
Anteriorly-
1. Transverse colon
and mesocolon
2. Lesser sac
3. Stomach
• Post. -
• Left
• Right
• Superior
INTERIOR OF DUODENUM
Ligament of treitz
Ligament of treitz
• It k/w suspensory ligament.
• Arises rt crus of diaphragm.
• Its passes downward and forward by side of coeliac artery.
• Upper one third –striated muscle
• Meddle one third elastic tissue
• Lower one third –unstriped plain muscle
1. Mucosa
Epithelium- It is made of simple columnar absorptive epithelium with
goblet cells.
The epithelium and the underlying lamina propria shows finger-like
evaginations called intestinal villi.
Epithelium also shows tubular invagination from the base of the villi
into the lamina propria known as crypts of Lieberkuhn (intestinal
glands), these crypts are lined by columnar and goblet cells.
Apart from these cells Paneth cells are found at the base, which secrete
lysozyme, an antibacterial enzyme controlling the intestinal flora.
The crypts open at the base of the villus in the intervillous space and the
Epithelium is renewed every 3–5 days.
• Lamina propria- It is the connective tissue that contains fibroblasts, mast cells,
plasma cells, lymphocytes + crypts of Lieberkuhn + lacteals + capillary loops.