Chapter 23 The Digestive System 875
Right and left
Mucosa
with folds
Gallbladder
Major duodenal
papilla
Hepatopancreatic
ampulla and sphincter Duodenum
Figure 23.21  The duodenum of the small intestine, and related organs. Ducts from the
pancreas, gallbladder, and liver empty into the duodenum.
and pancreas (digestive enzymes). We will also consider these
accessory organs in this section.
The Small Intestine
The small intestine is the body’s major digestive organ. Within
its twisted passageways, digestion is completed and virtually all
absorption occurs.
Gross Anatomy
The small intestine is a convoluted tube extending from the py-
loric sphincter to the ileocecal valve (sphincter) (il0e-o-se9kal)
where it joins the large intestine. It is the longest part of the
alimentary canal, but is only about half the diameter of the large
intestine, ranging from 2.5 to 4 cm (1–1.6 inches). Although 6–7
m long (approximately 20 ft, the height of a two-story building)
in a cadaver, the small intestine is only 2–4 m (7–13 ft) long dur-
ing life because of muscle tone.
The small intestine has three subdivisions: the duodenum,
which is mostly retroperitoneal, and the jejunum and ileum, both
intraperitoneal organs (see Figure 23.1). The relatively immovable
duodenum (du0o-de9num; “twelve finger widths long”), which
curves around the head of the pancreas, is about 25 cm (10 inches)
long (Figure 23.21). Although it is the shortest intestinal subdivi-
sion, the duodenum has the most features of interest.
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Title: Anatomy & Physiology      Server: S4C
hepatic ducts
of liver
Cystic duct
Common hepatic duct
Bile duct and sphincter
Accessory pancreatic duct
Tail of pancreas
Pancreas
Jejunum
Main pancreatic duct and sphincter
Head of pancreas
The bile duct, delivering bile from the liver, and the main
pancreatic duct, carrying pancreatic juice from the pancreas,
unite in the wall of the duodenum in a bulblike point called the
hepatopancreatic ampulla (hep0ah-to-pan0kre-at9ik am-pul9
ah; ampulla 5 flask). The ampulla opens into the duodenum via
the volcano-shaped major duodenal papilla. A smooth muscle
valve called the hepatopancreatic sphincter controls the entry 23
of bile and pancreatic juice.
The jejunum (jĕ-joo9num; “empty”), about 2.5 m (8 ft) long,
extends from the duodenum to the ileum. The ileum (il9e-um;
“twisted”), approximately 3.6 m (12 ft) in length, joins the large
intestine at the ileocecal valve. The jejunum and ileum hang in
sausagelike coils in the central and lower part of the abdominal
cavity, suspended from the posterior abdominal wall by the fan-
shaped mesentery (see Figure 23.30). The large intestine encir-
cles these more distal parts of the small intestine.
Nerve fibers serving the small intestine include parasym-
pathetics from the vagus and sympathetics from the thoracic
splanchnic nerves, both relayed through the superior mesen-
teric (and celiac) plexus.
The arterial supply is primarily from the superior mesenteric
artery (pp. 732–733). The veins parallel the arteries and typi-
cally drain into the superior mesenteric vein. From there, the
nutrient-rich venous blood from the small intestine drains into
the hepatic portal vein, which carries it to the liver.
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