Duodenum and Celiac Trunk

Dr. Nivin Sharaf MD

LMCC- MCCQII

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Objectives

• To identify the surface anatomy of the duodenum

• To identify parts of the duodenum• Identify anatomical relations to the duodenum• Identify mucosal layers of the duodenum• Identify the blood supply to the duodenum• Lymphatic drainage of the duodenum• Identify branches of celiac truck

Overview• Duodenum is the 1st

, the widest and the shortest (25 cm) part of the small intestine (5-7 m), followed by the jejunum and ileum.

• The duodenum is a C-shaped or horseshoe-shaped structure that lies in the upper abdomen near the midline

Parts of the Duodenum

Parts Cont.• The duodenum is divided into 4

Parts:• 1st Superior 5 cm:begins at the

pylorus and includes the duodenal bulb(L1)

• 2nd decending 7-10 cm : ampulla of Vater(L1-3)

• 3rd horizontal 6-8 cm :traversed anteriorly by the superior mesenteric vessels (L3)

• 4th ascending 5 cm:terminates at the ligament of Treitz (duodenalejunal junction)(L3 to L2)

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Peritoneal covering

• The first part is retro peritoneal• 2nd, 3rd and 4th parts are intra peritoneal• Definitions?• Retro peritoneal• Intraperitoneal

Anatomical Relation

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Stones?

• Clinical significance!!

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Blood Supply

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Nerve Supply, and Lymphatic drainage

Nerves duodenum is supplied with parasympathetic nerves by hepatic and celiac branches of the anterior and posterior vagi, and with sympathetic nerves by branches of the celiac plexus.Lymphatic drainage Lymphatics from the duodenum drain into pancreatico duodenal, supra- and infrapyloric, superior mesenteric, and celiac lymph nodes (LNs).

QUIZ!

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Celiac Trunk

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Celiac trunk Cont.

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References

• www.emedicine.com

• www.medicalstudent.com

• www.netterimages.com