DIGESTIVE ANATOMY

9 Mei 2012

dr Lucky Brilliantina, Anatomi FKUPN

TOPIK
Abdominal wall Primary organ abdomen Accessories organ abdomen

dr Lucky Brilliantina, Anatomi FKUPN

ABDOMINAL WALL
dr Lucky Brilliantina, Anatomi FKUPN

Abdomen is a closed cylinder with a musculoskeletal wall.

dr Lucky Brilliantina, Anatomi FKUPN

Inside are the wall are the liver, intestines, kidneys, etc.

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Abdominal Muscles Increase Intra-abdominal pressure

dr Lucky Brilliantina, Anatomi FKUPN

Abdomen defined by diaphragm above, pelvic brim below, and vertebral bodies ribs and muscles posteriorly, and laterally.

dr Lucky Brilliantina, Anatomi FKUPN

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.

dr Lucky Brilliantina, Anatomi FKUPN

MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL

LINEA ALBA TENDINOUS INTERSECTION TRANSVERSUS ABDOMINIS INTERNAL OBLIQUE EXTERNAL OBLIQUE RECTUS ABDOMINIS

APONEUROSIS OF EXTERNAL OBLIQUE SUPERFICIAL INGUINAL RING

INGUINAL LIGAMENT dr Lucky Brilliantina, Anatomi FKUPN

MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL RECTUS SHEATH

TA IO EO
APONEUROSES

ABOVE THE ARCUATE LINE THE APONEUROSIS OF THE INTERNAL OBLIQUE SPLITS TO ENCLOSE THE RECTUS ABDOMINIS BELOW THE ARCUATE LINE ALL APONEUROSES PASS IN dr Lucky Anatomi FRONT OF THEBrilliantina, RECTUS ABDOMINIS
FKUPN

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Vessels of the Anterolateral Abdominal Wall

Internal thoracic vessels Superior epigastric vessels

Inferior epigastric vessels

dr Lucky Brilliantina, Anatomi FKUPN

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Nerves of the Abdominal Wall Ventral Rami of T6 to L2

dr Lucky Brilliantina, Anatomi FKUPN

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MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL

EXTERNAL OBLIQUE INTERNAL OBLIQUE

BILATERAL ACTION: ASSISTS RECTUS ABDOMINIS IN FLEXING VERTEBRAL COLUMN, COMPRESSING ABDOMINAL WALL, AND INCREASING INTRAABDOMINAL PRESSURE UNILATERAL ACTION: AID BACK MUSCLES IN ROTATION AND LATERAL FLEXION

NN. = T7-T12

NN. = T7-T12, L1 dr Lucky Brilliantina, Anatomi FKUPN

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MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL 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 dr Lucky Brilliantina, Anatomi FKUPN

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Psoas and quadratus lumborum form posterior wall.

dr Lucky Brilliantina, Anatomi FKUPN

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Psoas + Iliacus = IliopsoasMost Major Hip FlexorCrosses under Inguinal Ligament with Femoral Nerve, and External Iliacs (become Femoral a and v.

dr Lucky Brilliantina, Anatomi FKUPN

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Inguinal Ligamentinferior border of aponeurosis of

external oblique muscleattaches to ASIS and pubic tubercle

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PERITONEUM
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Peritoneum
Peritoneum Visceral : menutupi hampir sebagian besar organ2 dalam rongga perut. Peritoneum Parietal : Lapisan dalam dari dinding perut. Rongga Peritoneal : rongga yang terletak antara 2 lapisan peritoneum yang berisi cairan.
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Peritoneum & Mesenterium

Peritoneum(Selaput perut)

1 2

Visceral: menutup organ dalam rongga abdomen Parietal: menutup permukaan dalam dinding tubuh Retroperitoneal: dibelakang peritoneum seperti ginjal, pankreas, duodenum (tak ada mesenterium)

Mesenterium
Meletakkan organ pada tempatnya Jalur dimana saraf dan Omentum : lipatan/kantong di dalam peritoneum Omentum Mayus banyak lemak, dari kurvatura mayor lambung dan pembuluh darah berjalan colon transversalis dari dinding badan ke organ.
Omentum Minus berhubungan dg kurvature minor lambung dan dr Lucky Brilliantina, Anatomi ujung FKUPN atas duodenum , hati , diafragma membentuk mesenterium usus halus 20

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 perut Tempat kelnjar limfe dan pembuluh darah untuk membantu melindungi infeksi kuman
dr Lucky Brilliantina, Anatomi FKUPN

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Intraperitoneal Abdominal Organs derived from foregut (B) have a dorsal and ventral mesentery. Midgut derived organs (A) lack a ventral mesentery.

B A B A
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Parietal peritoneum serous membrane lining the abdominal cavity (space between)
Visceral peritoneum serous membrane covering the internal organs

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Right and Left Colic Flexures

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Some Organs Lose Their Mesentery and Become Retroperitoneal

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INTRAPERITONEAL VS. RETROPERITONEAL

INTRAPERITONEAL ORGANS ARE ALMOST COMPLETELY
COVERED WITH VISCERAL PERITONEUM
THEY are

suspended or protrude in into the peritoneal cavity, but are not actually in it.

RETROPERITONEAL ORGANS ARE LOCATED between the paeietal perinoneum and the body wall itself. -They may be partially covered by parietal peritoneum

Subperitonealsome organs lie below the peritoneum in the pelvis, e.g. The uterus and bladder. dr Lucky Brilliantina, Anatomi
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PARIETAL PERITONEUMBlue area

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The Adult Mesenteries

TRANSVERSE MESOCOLON

MESENTERY PROPER

NOT SHOWN: MESOAPPENDIX, SIGMOID MESOCOLON

dr Lucky Brilliantina, Anatomi FKUPN

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GREATER AND LESSER OMENTA

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 stomach superiorly and the transverse colon inferiorly; it hangs down like a fatty apron over the abdominal viscera

dr Lucky Brilliantina, Anatomi FKUPN

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TWO PERITONEAL SACS

LESSER SAC OR OMENTAL BURSA

GREATER SAC SUPRACOLIC

TRANSVERSE MESOCOLON

GREATER SAC INFRACOLIC

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Rotation of the Stomach Forms the Lesser Sac of the Peritoneal Cavity and Starts to Form the Greater Omentum

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The Peritoneum

The parietal peritoneum

The visceral peritoneum

The peritoneal cavity

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The retroperitoneal space kidneys suprarenal glands ureters duodenum pancreas aorta inferior vena cava

nerves
ascending colon descending colon
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The Peritoneum

The parietal peritoneum

The visceral peritoneum

The peritoneal cavity

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The visceral peritoneum The peritoneal cavity

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2 layer folds of the peritoneum 1. The peritoneal ligaments 2. Lesser and Greater Omenta 3. The mesenteries

1. The peritoneal ligaments falciform ligament ligamentum teres median umbilical ligament medial umbilical ligaments lateral umbilical ligaments
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2. Lesser and Greater Omenta

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Lesser and Greater Omenta

hepatogastric ligament hepatoduodenal ligament

the epiploic foramen (of Winslow)

Lesser Omentum

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Greater Omentum

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3. The mesenteries

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The mesenteries

Contents ?

mesentery of the small intestine transverse mesocolon sigmoid mesocolon

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Lesser Sac

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Other Ligaments falciform ligament ligamentum teres Lesser Omentum

hepatogastric ligament hepatoduodenal ligament.

gastrophrenic ligament gastrosplenic ligament

Lienorenal ligament

phrenicocolic ligament

gastrocolic ligament
dr Lucky Brilliantina, Anatomi FKUPN

Greater Omentum
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Lesser Sac

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Lesser Sac

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Lesser Sac
(Omental Bursa)

dr Lucky Brilliantina, Anatomi FKUPN

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Lesser Sac epiploic foramen (of Winslow)

Superior recess left subhepatic space Vestibule

Morisons pouch dr Lucky Brilliantina, Anatomi

FKUPN 48

Epiploic foramen (of Winslow) Ant: hepatoduodenal ligament

Post: inferior vena cava

Sup: caudate lobe

Inf: first part of the duodenum

dr Lucky Brilliantina, Anatomi FKUPN

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PRIMARY ORGANS

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ACCESSORY ORGANS
PAROTID SALIVARY GLAND SUBLINGUAL SALIVARY GLAND

SUBMANDIUBULAR SALIVARY GLAND

LIVER

GALL BLADDER

PANCREAS

dr Lucky Brilliantina, Anatomi FKUPN

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ORAL CAVITY

Mulut
Rongga mulut sejati: dimulai dari belakang gigi memanjang kebelakang sampai oropharing. Vestibulum oris: ruang yang terletak antara gigi dengan

dr Lucky Brilliantina, Anatomi FKUPN

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Cavitas Oral

3 4 5

6 7 1 2

Mulut/cavitas oral Vestibulum: Ruang antara bibir dan processus alveolaris Oral cavity proper Bibir (labia) Palatum (langit2mulut): Durum/keras dan molle/halus Tonsila Palatina Lidah: berguna untuk bicara, merasakan, kunyah dan menelan Faucium - lubang tenggorokan ke arah faring Frenulum menghubungkan bibir dengan processus alveolaris
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dr Lucky Brilliantina, Anatomi FKUPN

BIBIR
Luar : 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 papila Luar : kulit Otot : 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 belakang
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Lidah
Menempati hampir sebagian besar rongga mulut dan disusun terutama oleh otot skelet. Otot Intrinsik berasal dan menyusun kontur lidah yang berfungsi untuk perubahan bentuk dan ukuran tetapi tidak untuk posisi. Otot Ekstrinsik: berasal dari tulang atau palatum mole dan berfungsi untuk perubahan posisi lidah. Frenulum lingualis, menghubungkan lidah dengan dasar mulut.
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Lidah

Frenulum lingualis, menghubungkan lidah dengan dasar mulut.

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Lidah

Pergerakan lidah untuk mencampur makanan dengan saliva menjadi masa padat disebut sebagai bolus

Lapisan atas dari lidah mempunyai banyak tonjolan yang disebut papilae.
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Membantu dalam pengunyahan material lembut dan terdapat dr Lucky Brilliantina, Anatomi reseptor pengecap. FKUPN

Papillae (nama berdasar ukuran) c. Vallata (dikelilingi oleh dinding) Terbesar, tak banyak e. Fungiform (bentuk jamur) Tersebar tak teratur d. Foliate (leaf shape) Tersebar pada lipatan sisi lidah. Paling sensitif. b. Filiform (bentuk benang/filamen) Terletak pada epitel lidah dan mulut

Indra Kecap

dr Lucky Brilliantina, Anatomi FKUPN

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Kelenjar Air Liur

Hasilkan air liur Cegah infeksi bakteri Lubrikasi Mgd amilase salivarius Hancurkan makanan Mukosa Dikeluarkan oleh kelanjar submandibularis dan sublingualis lubrikasi Tiga pasang Parotis: Terbesar, letak anterior telinga. Submandibularis: bawah mandibula/rahang bawah Sublingualiis: Terkecil, dibawah lidah.

dr Lucky Brilliantina, Anatomi FKUPN

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Kelenjar ludah

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ORAL CAVITY ANATOMY

OROPHARYNX

LARYNGOPHARYNX

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PHARYNX

PHARYNX ANATOMY
The pharynx is divided into three regions. The nasopharynx, oropharynx, and the laryngopharynx. The mucosa is composed of stratified squamous epithelium which is supplied with mucus producing glands.
dr Lucky Brilliantina, Anatomi FKUPN

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PHARYNX ANATOMY
The external muscle layer consists of 2 skeletal muscle layers. The internal layers run longitudinally. The outer layer encircles the wall of the pharynx. Contractions of these muscles propel food into the esophagus.
dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS

ESOPHAGUS ANATOMY
. Tabung otot dari otot skelet dan otot polos . Diawali dari ujung orofaring menuju hiatus esofagus (pintu masuk) menembus diafragma dan berakhir pada gaster Hubungkan pharing dengan gaster(25 cm) Mempunyai sfingter pada sambungan esofagus dan faring, yi: sfingter esofageal (cardiac sphincter) yg berfungsi menghentikan aliran makanan dari gaster kembali ke esofagus
dr Lucky Brilliantina, Anatomi FKUPN

ESOPHAGUS

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ESOPHAGUS ANATOMY

dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS ANATOMY
The esophageal mucosa contains nonkeratinized stratified squamous epithelium. At the esophageal stomach junction the epithelium changes to simple columnar epithelium.

dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS ANATOMY
The submucosa contains mucus secreting glands. As a bolus moves through the esophagus, it compresses these glands, causing them to secrete mucus which aids in the movement of food.

dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS ANATOMY
The muscularis externa is skeletal muscle in its superior third, a mixture of skeletal and smooth muscle in its middle third, and entirely smooth muscle in its inferior third.

dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS ANATOMY

The serosa is entirely connective tissue which blends with surrounding structures along its route.

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ESOPHAGUS ANATOMY
The pharynx propels food into the esophagus through the upper esophageal sphincter.

Upper esophageal sphincter

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ESOPHAGUS ANATOMY

The bolus of food is propelled within the esophagus by peristalsis.

dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS ANATOMY

The bolus of food is propelled within the esophagus by peristalsis.

dr Lucky Brilliantina, Anatomi FKUPN

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ESOPHAGUS ANATOMY

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STOMACH

STOMACH ANATOMY

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 Dibagi Regio Cardia (penyimpanan), Fundus (penyimpanan), Corpus (penyimpanan), Piloricum (digesti) Spingter pyloric mencegah aliran bolus makanan kembali dari duodenum ke gaster Rugae: lipatan dalam gaster

Ventrikulus

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GASTER : N.Vagus N.Vagus Dextra,Sinistra Plexus Oesophagus Truncus Vagalis Anterior ( Rami Gastrici Anteriores )
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VASCULARISASI
Jantung Arcus aorta Aorta Truncus Coeliacus A.Gastrica sinistra, A.Splenica, A. Hepatica Comunis A.Splenica Aa.Gastricae breves A. Hepatica Comunis A.Gastroduodenalis, A.Hepatica propria A.Hepatica propria A.Gastrica Dextra
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Jantung Arcus aorta Aorta Truncus Coeliacus A.Gastrica Dextra, A.Gastrica sinistra, Aa.Gastricae breves, A.Gastroduodenalis

dr Lucky Brilliantina, Anatomi FKUPN

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V.Cava Inferior V. Porta Hepatica V.Gastrica Sinistra, V.Gastroomentalis dextra et sinistra

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SMALL INTESTINES

Intestinum Tenue/Usus Halus

Tempat utama digesti dan absorpsi dimulai dari spincter pilory sampai katup ileocecal Pembagian : 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

dr Lucky Brilliantina, Anatomi FKUPN

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Duodenum
Duodenum panjang 12 inci(18 cm)= usus 12 jari, yang di lingkupi oleh caput dari pankreas Retroperitoneal. Duktus biliaris komunis (saluran untuk empedu dari hepar dan kandung empedu) dan duktus pankreatikus (saluran untuk keluarnya sekret dari kelenjar pankreas) bergabung di dinding duodenum pada ampulla hepatopancreatic. Tempat utama proses pencernaan.
dr Lucky Brilliantina, Anatomi FKUPN 87

dr Lucky Brilliantina, Anatomi FKUPN

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SMALL INTESTINES ANATOMY

The duodenum is about 10 in long and is mostly retroperitoneal. The bile duct and the pancreatic duct join to form the hepatopancreatic DUODENUM ampulla which opens into the duodenum.
MAJOR DUODENAL HEPATOPANCREATIC PAPILLA dr Lucky Brilliantina, Anatomi AMPULLA

FKUPN

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VASCULARITATIO A. Gastrica dextra A. Pancreatico-duodenalis superior A. Pancreatico-duodenalis inferior INNERVATIO Plexus coeliacus Plexus mesentericus superior STRUKTUR Dinding intestinum tenue mesostineale terdiri atas 4 lapisan, yaitu : Tunica mucosa (membrane mucosae) Tela submucosa Tunica muscularis Tunica serosa dr Lucky Brilliantina, Anatomi
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SMALL INTESTINES ANATOMY

The small intestine is highly adapted for absorption. Its length, together with its plicae circulares, villi, and microvilli amplify its surface area enormously. The plicae circularies are deep permanent folds of the mucosa and submucosa.
dr Lucky Brilliantina, Anatomi FKUPN 91

SMALL INTESTINES ANATOMY

Villi are fingerlike projections of the mucosa. The epithelial cells of the villi are absorptive columnar cells. In the core of each villus is dense capillary bed and a lymph capillary the lacteal.

dr Lucky Brilliantina, Anatomi FKUPN

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SMALL INTESTINES ANATOMY

Villi are fingerlike projections of the mucosa. The epithelial cells of the villi are absorptive columnar cells. In the core of each villus is dense capillary bed and a lymph capillary the lacteal.

dr Lucky Brilliantina, Anatomi FKUPN

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SMALL INTESTINES ANATOMY

Microvilli, tiny projections of the plasma membrane of the absorptive cells of the mucosa, give the mucosal surface a fuzzy appearance called the brush border.

dr Lucky Brilliantina, Anatomi FKUPN

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SMALL INTESTINES ANATOMY

The cells of the microvilli include simple columnar epithelial cells, goblet cells, scattered enteroendocrine cells, and T cells. The plasma membrane of the epithelial cells have enzymes called brush border enzymes which complete the digestion of carbohydrates and proteins.
dr Lucky Brilliantina, Anatomi FKUPN 95

SMALL INTESTINES ANATOMY

Between the villi, the mucosa is studded with pits that lead into tubular intestinal glands called intestinal crypts. The epithelial cells that line these crypts secrete intestinal juice. The intestinal juice is a waterly mixture containing mucus that serves as a carrier fluid for absorbing nutrients from chyme.

dr Lucky Brilliantina, Anatomi FKUPN

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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

dr Lucky Brilliantina, Anatomi FKUPN

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Jejenum dan ileum

Ujung bawah ileum berhub dgn caecum : lubang : orifisium ileosekalis Diperkuat oleh sfingter ileosekalis Terdapat katub/valvula caecalis/valvula Bauchini yang berfungsi mencegah cairan dalam colon asenden tak masuk ke ileum
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Kontraksi otot intestinum tenue menyebabkan gerakan peristaltik & segmental yang membantu mencampur & menggerakkan makanan ke usus besar/intestinum crassum Diatur oleh sfingter ileocecal yg terdpt pd sambungan antara ileum dan cecum yang mencegah makanan yang tak diabsorpsi kembali ke usus halus
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LIVER

LIVER ANATOMY
The liver is the largest gland in the body, weighing about 1.4 Kg. It is located under the diaphragm, within the rib cage in the upper right quadrant of the abdomen. The liver is an accessory digestive gland.
dr Lucky Brilliantina, Anatomi FKUPN

LIVER

GALL BLADDER

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LIVER ANATOMY
4 Lobes Major: Left and right Minor: Caudate and quadrate Ducts Common hepatic Cystic Common bile
From gallbladder Joins pancreatic duct at hepatopancreatic ampulla
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LIVER ANATOMY
The liver is composed of liver lobules which are roughly hexagonal structures consisting of hepatocytes. The hepatocytes radiate outward from a central vein. At each of the six corners of a lobule is a portal triad. Between the hepatocytes are the liver sinusoids.
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4 lobus Lobus kanan dan lobus kiri dipisahkan oleh ligamen falciform. Berhubungan dengan lobus kanan,bagian bawahnya terdapat lobus quadratus ,sedang dibag. Belakang dr Lucky Brilliantina, Anatomi lobus caudatus
FKUPN

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Left and right hepatic ducts

Cystic Duct
dr Lucky Brilliantina, Anatomi FKUPN

Lesser omentum
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V. Umbilicalis V. Porta Hepatica Rr. Dex et Sin HEPAR Vv. Hepatica Dex, Intrmediate, Sin V. Cava Inverior.

dr Lucky Brilliantina, Anatomi FKUPN

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LIVER ANATOMY
The hepatocytes produce bile which flows through canals, called bile canaliculi to a bile duct. The bile ducts eventually leave the liver via the common hepatic duct. The hepatocytes also process nutrients into macromolecules, store fat-soluble vitamins, and play an important part in detoxification.
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LIVER ANATOMY
Bile is a yellow green alkaline solution containing bile salts, bile pigments, cholesterol, neutral fats, phospholipids, and a variety of electrolytes. The liver produces to 1 liter of bile daily.

Bile salts emulsify fats. As a result, large fat globules entering the small intestine are physically separated into millions of small fat droplets to be digested and absorbed.
dr Lucky Brilliantina, Anatomi FKUPN

LIVER

GALL BLADDER

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LIVER ANATOMY

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GALLBLADDER ANATOMY
The gallbladder is a thin walled green muscular sac on the inferior surface of the liver. The gallbladder stores bile that is not immediately needed for digestion and concentrates it. When the muscular wall of the gallbladder contracts bile is expelled into the bile duct.
dr Lucky Brilliantina, Anatomi FKUPN

LIVER

GALL BLADDER

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LIVER GALLBLADDER ANATOMY

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Membran berotot, panjang 812 cm, isi 60 cm3 Duktus Cysticus menghubungkan kandung empedu dg ductus pancreaticus communis Struktur mirip kantung pada permukaan hati Empedu disimpan dan dikonsentrasikan Empedu dikirim ke usus halus Kemungkinan terjadi batu kandung empedu (dari empedu dan kolesterol yang berpresipitasi shg membtk kristal) krn diet drastis dg penurunan berat badan yang cepat
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Kandung empedu/ Vessica fellea

PANCREAS

PANKREAS
LOKASI Pancreas (kelenjar ludah perut) terletak melintang pada dinding dorsal abdomen di regio epigastrica dan hypochondrica sinistra. BENTUK DAN UKURAN Pancreas berbentuk huruf J yang di rebahkan, panjang 12.5-15 cm.
dr Lucky Brilliantina, Anatomi FKUPN

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BAGIAN-BAGIANNYA Caput Pancreatis Collum pancreatis Corpus pancreatis Cauda pancreatic VASCULARISATIO Arteri Pancreatico-duodenalis superior Arteri pancreatico-duodenalis inferior INNERVATIO Susunan saraf simpatis dan parasimpatis melalui plexus coeliacus.
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PANCREAS ANATOMY

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Vascularisatio : A. Pancreatico-duodenalis superior A. Pancreatico-duodenalis inferior Rr. Pancreatici A. Lienalis Innervatio : Susunan saraf simpatis dan parasimpatis melalui plexus coeliacus.

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dr Lucky Brilliantina, Anatomi FKUPN

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VARIANS DUCTUS 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).
dr Lucky Brilliantina, Anatomi FKUPN 120

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LARGE INTESTINES

Usus Besar/Intestinum Crassum

Dari sambungan ileocecal sampai anus Terbagi menjadi: Cecum
Appendix

4 5
3

Colon
Ascending Transverse Descending Sigmoid

Rectum Anus. Panjang1M, lebar 5-6 cm Bergerak selama 18-24 jam

1 2
dr Lucky Brilliantina, Anatomi FKUPN

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Caecum
Di bawah : terdapat appendiks vermiformis : bentuk cacing = umbai cacing, panjang 6 cm Ditutupi peritonium Mudah bergerak Tak mempunyai mesenterium Dapat diraba pada orang hidup
dr Lucky Brilliantina, Anatomi FKUPN 124

Colon asenden
Panjang 13 cm Pada perut kanan, membujur ke ataqs dari ileum ke bawah hati Di Bawah hati melengkung ke kiri : fleksura hepatika Melanjut sebagai colon transversum
dr Lucky Brilliantina, Anatomi FKUPN 125

Colon transversum
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, Anatomi FKUPN

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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. Membentuk suatu lengkungan dengan panjangrata-rata 40 cm. dr Lucky Brilliantina, Anatomi
FKUPN 127

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APPENDIK VERMIFORMIS
Sinonim: Processus vermiformis, Umbai Cacing, Usus buntu. Bentuknya seperti cacing,panjang 2-23 cm (rata-rata 8cm), diameter 5-10mm, mulai dibagian dorso medial caecum kira-kira 2,5-3,7cm kaudal dari orificium ileo-caecalis. VASKULARISASI A.Appendicularis, dipercabangkan dari A.ileo-caecalis
dr Lucky Brilliantina, Anatomi FKUPN 129

dr Lucky Brilliantina, Anatomi FKUPN

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RECTUM
Rectum adalah lanjutan dari colon sigmoideum dan mulai dari junctura rectosigmoidea setinggi ruas ketiga sacrum. Pada rectum tidak lagi terdapat ketiga tanda khas untuk kolon. Panjang kira-kira 12 cm 15 cm dengan penampangnya dalam keadaan kosong 2.5 cm. rectum mempunyai kemampuan untuk dilatasi sampai sebesar 7.5 cm.
dr Lucky Brilliantina, Anatomi FKUPN

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CANALIS ANALIS
Kadang-kadang dinamakan juga pars analis recti Canalis analis adalah bagian akhir dari intestinum crassum panjangnya 2.5 cm sampai 4 cm. mulai dari flexura parinealis recti. Biasanya canalis analis dalam keadaan tertutup dan baru terbuka pada waktu defekasi ( buang air besar).
dr Lucky Brilliantina, Anatomi FKUPN 133

dr Lucky Brilliantina, Anatomi FKUPN

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Pembuangan Feses oleh Rectum & Anus Bantu ekskresi (bantu membuang limbah makanan dari usus). Rectum Pada rongga pelvis, depan os sacrum & os coccygeus Bergabung dg colon sigmoid dg canalis anal Tabung pendek& lurus dari lapisan otot tebal
dr Lucky Brilliantina, Anatomi FKUPN 135

ANUS
Hubungkan Rectum dg dunia luar Diperkuat 3 sfingter 1. Spingter ani interna : atas, bekerja tak memenuhi kehendak, kaya lapisan otot polos tebal 2.Spingter ani eksterna : bawah, bekerja menuruti kehendak, kaya otot skelet 3. Sfingter levator ani : bekerja tak menurut kehendak
dr Lucky Brilliantina, Anatomi FKUPN 136

Proses Defekasi Canalis Anal adalah bagian akhir dari organ cerna menuju anus. Defekasi adalah yang menurut perintah Transpor feces ke rectumregangan dinding rektum & kontraksi colon sigmoid - rangsang refleks defekasirelaksasi dari spincter ani internus -m. levator ani relaksasi secara sadartekanan ditimbulkan oleh otot perut.
dr Lucky Brilliantina, Anatomi FKUPN

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LARGE INTESTINE ANATOMY

The last segment of the large intestine is the anal canal. The anal canal is about 3 cm long. It begins where the anus penetrates the pelvic floor and it opens to the body exterior at the anus. The anal canal has 2 sphincters, an internal and external. It is lined with stratified squamous epithelial tissue.
dr Lucky Brilliantina, Anatomi FKUPN 138

QUESTION????
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