Dr: Azza Zaki

The Digestive System

The digestive system is
concerned with the:
 uptake
 digestion
 and absorption of food

excretion of non-digested
food.
The digestive system
:divided into
A- Gastro-intestinal tract
B- Digestive glands
Dr: Azza Zaki
Digestive tract
(alimentary canal): is
continuous tube with
2 openings, the
mouth and the anus.
it includes the
following:
Mouth
 pharynx
 oesophagus
stomach
 small intestine
 & large intestine.
Digestive glands
include:
Salivary glands
 liver
& pancreas Dr: Azza Zaki
•Most of the organs of the digestive system
lie in the abdominal cavity, except:
Mouth cavity, pharynx and salivary glands
which lie in the head region.
Oesophagus which traverses the neck and
thorax.
The abdominal cavity:
is bounded superiorly by the diaphragm which
separates it from the thoracic cavity and
continuous inferiorly with the pelvic cavity.

Dr: Azza Zaki

 Abdominal Regions
the abdominal cavity
is divided into 9
regions by:
 2 vertical planes
 right & left. Each
one extends from
the mid-clavicular
point to the mid-
inguinal point.
 2 horizontal
planes 
1. Upper
horizontal plane:
level of 3rd lumbar
vertebra.
2. Lower
horizontal plane:
level of 5th lumbar Dr: Azza Zaki
vertebra.
Dr: Azza Zaki
 The Peritoneum
• The abdominal cavity is
lined by the
Peritoneum which is
the largest serous
membrane in the body,
and it consists of a
double layer:
A. Outer layer: is
called the parietal
peritoneum, lines the
abdominal cavity.
B. Inner layer: is called
the visceral
peritoneum, covers
the abdominal viscera.
The space between the 2
layers is a potential
space and contains
small amount of fluid
(peritoneal cavity)

Dr: Azza Zaki

 Mouth Cavity
• The mouth cavity is
the first portion of the
digestive tube.
• It extends from the lips
anteriorly and opens
posteriorly in the
oropharynx.
• It is divided into:
Vestibule
Mouth cavity
proper

Dr: Azza Zaki

 Vestibule
• is the narrow space between
the teeth and gums internally
and lips and cheeks
externally.
• It communicates posteriorly
with the mouth cavity proper
by the interval behind the last
molar tooth. It receives the
opening of the parotid duct
opposite to the upper 2nd
molar tooth.

Dr: Azza Zaki

Mouth Cavity Proper
It is bounded:
•Laterally and in front:
by the teeth and gums.
•Above: by the hard and
soft palates.
•Below: by the mucous
membrane, which covers
the floor of mouth.
–It communicates:
•Anteriorly with outside
through the oral fissure.
•Posteriorly with the
oropharynx through the
isthmus of fauces.
Dr: Azza Zaki
 Palate
• It separates mouth cavity from
nasal cavity & consists of:
• The hard palate
• The soft palate has a
downward median projection,
called "uvula". During
swallowing, the uvula ascends
upwards to close posterior
nasal apertures.
• The mouth cavity contains:
– Tongue
– Teeth
Dr: Azza Zaki
 The Tongue
It is a highly mobile
muscular organ
which is formed of
striated muscle fibers
and covered by
mucous membrane.
The mucous
membrane on the
dorsum of the tongue
is rough, and it is
covered with small
projections called
lingual papillae.
Some of the papillae
contain taste buds. Dr: Azza Zaki
Dr: Azza Zaki
 Superior Surface of the Tongue
Tongue papillae
Filiform papillae
Fungiform papillae
Circumvallate
papillae
Sulcus terminalis:
“V”-shaped sulcus:
separates anterior 2/3
from posterior 1/3 of
the tongue.
Posterior 1/3 of tongue
lies in oropharynx
•Lymphatic follicles lie
posterior to this sulus
and called "lingual Dr: Azza Zaki
tonsils".
• Its under surface is
covered by smooth
mucosa which is
connected to mouth
floor by frenulum.
• Function of the tongue:
tongue
• The tongue helps in
deglutition, taste and
speech.

Dr: Azza Zaki

Nerve Supply Of The Tongue

Dr: Azza Zaki

 Nerve Supply Of The Tongue
•The tongue has motor
and sensory nerve
supply:
Motor for most of the
muscles from the
hypoglossal nerve.
Sensory:
anterior ⅔ ; by trigeminal
nerve for general sensation
and facial nerve for taste.
posterior ⅓; by
glossopharyngeal nerve for
both general sensation and
taste. Dr: Azza Zaki
 Teeth
• Deciduous (milky teeth): they are 20 teeth (4
incisors& 2 canines & 4 molars). The 1st tooth to erupt
is the central incisor (6th month).
• Permanent teeth: they are 32 teeth (4 incisors & 2
canines & 4 premolars & 6 molars). The 1st to erupt is
the 1st molar. The last to erupt is the 3rd molar
(wisdom tooth).

Dr: Azza Zaki

 The Pharynx
• It is a common
pathway for
digestive and
respiratory systems.
• It is musculo-
membranous tube
that lies behind the
nose, mouth and
larynx.
• It is about 12 cm in
length and extends
from the base of
skull down to the 6th
cervical vertebra,
where it continues
as oesophagus. Dr: Azza Zaki
• It consists of three parts:
– Nasopharynx: lies behind the nasal cavity and
communicating freely with it through posterior nasal
apertures. It communicates inferiorly with the
oropharynx through the pharyngeal isthmus. It
contains pharyngeal tonsil & auditory tube.
– Oropharynx: lies behind the oral cavity extending
from the level of soft palate to the upper end of the
epiglottis. It communicates with the mouth cavity
through the oropharyngeal isthmus. It contains
palatine tonsil.
– Laryngopharynx: lies behind the larynx
communicating with it through the laryngeal inlet. It
is continuous inferiorly with
Dr: Azza Zakithe oesophagus
 The Oesophagus
It is a muscular tube about
25 cm long.
It begins as the
continuation of the pharynx
(level of C6).
It passes in the neck, then in
the thorax through the
mediastinum & then through
the diaphragm to end in the
stomach.
Dr: Azza Zaki
 Most of its course is in
the middle line but
deviates to the left at
the level of T7 vertebra
where it passes in front
of descending aorta till
it passes through
opening of the
diaphragm at level of
T10.
 Through its course, it is
related:
Posteriorly  to the
cervical and thoracic
vertebrae, while
Anteriorly  it
descends behind the
trachea and heart
respectively Dr: Azza Zaki
The oesophagus

•It has the following

constrictions:
Distance from
Level
the incisor teeth
where it is  9 inches
crossed by the
aortic arch

where it is  11 inches
crossed by the left
bronchus

where it pierces  16 inches

the diaphragm
Dr: Azza Zaki
The Stomach

Dr: Azza Zaki

 The Stomach
• It lies in the upper
part of the abdominal
cavity, in the
epigastrium and left
hypochondrium.
• It is commonly J-
shaped that has:
– 2 orifices
– 2 curvatures
– 2 surfaces
– 2 portions
Dr: Azza Zaki
 2 orifices
Cardiac orifice
It lies at junction with oesophagus.
It lies 1 inch to left of the midline.
It is guarded by physiological
sphincter.
Pyloric orifice
It lies at the junction with
duodenum.
It lies ½ inch to left of the
midline.
It is guarded by anatomical
sphincter (thick circular fibers).

2 curvatures
Lesser curvature Greater curvature
It is the concave right border. It is the convex left border.

It gives attachment to lesser It gives attachment to greater

omentum. omentum.

It shows a depression called It is 4 times longer than the

Dr: Azza Zaki
angular notch. lesser curvature.
–2 surfaces:
•Anterior surface: it is related mainly to the left lobe of liver.
•Posterior surface: related to a group of structures called
"stomach bed" which include: upper part of left kidney, left
supra-renal gland, spleen, body of pancreas.

Dr: Azza Zaki

 2 Portions
•Cardiac portion:
–Fundus: is the part that lies
above and to the left of the cardiac
orifice.
–Body: is the part between the
fundus and an imaginary line
between the angular notch and
opposite point on the greater
curvature.
•Pyloric portion:
–Pyloric antrum: is the dilatation
following the body.
–Pyloric canal: is the cylindrical
part following the antrum.
–Pylorus: is the opening that is
surrounded by a muscular ring
called pyloric sphincter. Dr: Azza Zaki
Dr: Azza Zaki
Peritoneum of the
stomach
• It is completely
covered by
peritoneum except
the area on the back
of the fundus.
• The lesser
omentum: extends
from lesser
curvature to the
liver.
• The greater
omentum is
attached to greater
curvature then
attached to the
transverse colon
&pancreas Dr: Azza Zaki
 Arterial Supply
Short gastric

Left gastric artery arteries

Hepatic artery Celiac artery

Right gastric artery

Gastroduodendal

Left gastroepiploic

Splenic artery
Right gastroepiploic Dr: Azza Zaki
 The Small Intestine
• It is 6 meters
long and takes
the shape of
coiled loops that
fill most of the
abdominal
cavity.
• It consists of 3
divisions:
• Duodenum
• Jejunum
• Ileum

Dr: Azza Zaki

 Duodenum
It is the shortest and widest
part of the small intestine
(about 25 cm in length).
 It is “C” shaped and
is formed of 4 parts.
It is firmly attached to
the posterior abdominal
wall and not mobile.
The head of pancreas
lies in the “C” shaped concavity. cancer head of
The bile duct and main pancreas leads to:
pancreatic duct unit together and  obstructive jaundice
open in the middle of the 2nd part. intestinal obstruction
Dr: Azza Zaki
Jejunum and Ileum Jejunum Ileum
form the free part of Extent Proximal2/5 Distal 3/5
the small intestine
and are freely
mobile.
mobile Diameter Larger Smaller
They are attached to
the posterior
abdominal wall by Lymphatic Are few & small Are
means of mesentery. follicles numerous
& large
Jejunum extends (Payer’s
from the duodenum. patches
The ileum ends by Mucosa More circular Less
opening into the folds & larger circular
cecum (ileocecal villi folds &
valve) smaller villi
Dr: Azza Zaki
Ileum Dr: Azza Zaki Jejunum
 Large Intestine (Colon)
It is about
1.5 meters
in length.
It extends
from the
end of the
ileum to
the anus.
It is larger
in
diameter
than the
small
intestine.
Dr: Azza Zaki
The large intestine has the following features:
• Appendices epiploicae: are small peritoneal
sacs filled with fat scattered on the wall of large
intestine (except on cecum & appendix & rectum).
• Taenia coli: the outer longitudinal muscle coat
of large intestine is arranged in 3 longitudinal
bands that begin at the base of appendix (they
are absent in the appendix & rectum).
• Sacculations:
the length of taenia coli is
shorter than the true length
of large intestine  puckering
of the wall.
Dr: Azza Zaki
 Small Large
intestine intestine

Dr: Azza Zaki

Difference between small & large intestines

Small intestine Large intestine

Length About 6 meters About 1 ½ meter

Diameter Smaller Larger

Appendices Absent Present
epiploicae
Taenia coli Absent Present

Sacculation Absent Present

Mucosa • Permanent circular • Circular folds disappear by

folds distension
•Villi are present •Villi are absent
•Aggregated lymph •Solitary lymph node
follicles
Dr: Azza Zaki
•The large intestine is divided into the following parts:
–Cecum is a blind
pouch which hangs
down at the junction
of the ileum and the
colon. The Ileocecal
valve lies at its medial aspect
and prevents the return
of the faeces from the
cecum into the small
intestine. The appendix arises from the cecum about 2.5
cm below the ileocecal valve.
–Ascending Colon extends from the cecum to the
under surface of the liver where it turns to the left. This
bend is called right colic (hepatic) flexure.

Dr: Azza Zaki

Transverse Colon crosses the upper part of abdominal
cavity from right to left and then curves sharply downwards
under the lower end of the spleen forming the left colic
(splenic) flexure.
Descending Colon extends from the splenic flexure to the
brim of the pelvis, where it turns towards the midline to
become the sigmoid colon.
Sigmoid Colon extends from the descending colon at the
level of pelvic brim to the rectum. It is “S” shaped.
Rectum extends from the sigmoid colon to the anal canal. It
descends along the sacrum to the tip of coccyx. Its lower part
shows dilatation called "ampulla of rectum".
Anal Canal is the terminal portion of the large intestine. It
extends from the rectum to the anus and is about 4 cm in
length. In the anal canal the circular muscle fibres are
thickened to form internal anal sphincter. The external anal
sphincter is composed of skeletal muscle, therefore under
voluntary control. Dr: Azza Zaki
Dr: Azza Zaki
 Digestive Glands
•Salivary Glands
•Liver
•Pancreas

Dr: Azza Zaki

 Salivary Glands
• There are three
pairs of salivary
glands:
• Parotid
• Submandibular
• Sulingual

Dr: Azza Zaki

 The Parotid Gland

Is the largest salivary

gland, which lies below &
in front of the ear, between
the mastoid process & ramus
of the mandible.
It is wedge- shaped with its
base directed upwards &
apex directed downwards.
The parotid duct passes
through the buccinator muscle & opens into the vestibule
of the mouth opposite the upper second molar tooth.
Its secretion is watery.
Dr: Azza Zaki
 The Submandibular Gland
 Lies in contact with the
mandible.
 Its duct opens into the
floor of the mouth.
 Its secretion is watery &
mucous
• The Sublingual gland:
 It is the smallest
salivary gland.
 It lies under the mucous
membrane of the floor of the
mouth (under the tongue) it has
several minute ducts, which
open into the floor of the mouth.
 Its secretion is mucous.
Dr: Azza Zaki
• It is the largest
Liver
organ of the body.
• Location:
• In the right
hypochondrium &
epigastrium.
• Surfaces:
• It is a wedged shaped
which has: smooth
convex anterior,
superior, posterior &
right lateral surfaces. The diaphragm separates the liver
They collectively from the right pleura &lung,
related to the pericardium, left pleura & lung.
diaphragm. Dr: Azza Zaki
•Inferior surface:
which is concave&
shows impressions
of these organs:
•Gastric impression
for the stomach
•Renal impression
for the right kidney
•Fossa of gall bladder
•Colic impression
for the right colic flexure
•Groove for the inferior vena cava.
•Duodenal impression
7. Quadrate lobe.
8. Caudate lobe
9.Porta hepatis. Dr: Azza Zaki
 Porta Hepatis
• It is the hilum of
the liver
• It lies between the
caudate & quadrate
lobes.
• It gives passage
to the following
structures:
• Hepatic ducts:
ducts
anterior in position
• Hepatic artery:
intermediate in
position.
• Portal vein: posterior
in position Dr: Azza Zaki
The liver has:
 Two main lobes, right
and left,
left separated by
the falciform ligament.
 Two small lobes:
quadrate & caudate
lobes. Anatomically
these 2 lobes belong to
the right lobe. While
physiologically, they
are part of the left lobe
as they are supplied by
left branch of the
hepatic artery.
 Liver covered by
peritoneum except
bare area posteriorly. Dr: Azza Zaki
 Blood Supply Of The Liver
• The liver has
double blood
supply:
• Hepatic artery
provides 30%
• Portal vein
provides 70%
 The liver is
drained by 2
hepatic veins
which end in the
inferior vena
cava.

Dr: Azza Zaki

 Biliary System
1-Gall bladder:
• It is a pear- shaped sac.
• It has fundus, body
and neck.
• Its neck is continuous
with the cystic duct.
• It is located in gall
bladder fossa on the
inferior surface of the
liver.

Dr: Azza Zaki

2-Right & left hepatic ducts:
• They are coming from the
right & left lobes of the liver
& unite to form common
hepatic duct.
3-Common hepatic duct:
• It is joined by the cystic
duct to form common bile
duct.
4-Common bile duct:
• It descends behind the
head of pancreas, where it
joins the main pancreatic
duct to open into the 2nd
part of the duodenum
• This opening is guarded by
a valve (sphincter of oddi).
Dr: Azza Zaki
 Pancreas
 It is elongated gland that
lies across the posterior
abdominal wall at the
level of 2nd lumbar
vertebra.
 has both endocrine &
exocrine functions:
 The exocrine portion:
secretes pancreatic juice.
 Endocrine portion: islets
of langerhans( beta cells
secrete insulin & alpha
cells secrete glucagon)
 It is not mobile as it is
retro-peritoneal Dr: Azza Zaki
structure.
 Head:
Parts Of The Pancreas
 It is the broad right end
which is enclosed
within the C shaped
curve of the
duodenum.
 It sends a downward
process called uncinate
process.
 Neck:
 It is the junction
between the head and
body. It is related to the
portal vein (union of
superior mesentric
with splenic veins).
veins) Dr: Azza Zaki
• Body: Is triangular in cross section with:
• Anterior surface: lies behind the lesser sac
• Posterior surface: is related to posterior abdominal wall.
• Inferior surface: is related to small intestine.
• Tail: the left narrow end which reach to the spleen.
Dr: Azza Zaki
 Ducts Of The Pancreas
• Main pancreatic duct:
extends
through the whole length
of the pancreas to unite
with the common bile
duct forming the
hepato-pancreatic
ampulla which opens in
the 2nd part duodenum.

• Accessory pancreatic
duct: starts in the
uncinate process &
ascends in front of the
main duct & opensDr:inAzza
theZaki
2nd part duodenum.
 Blood Supply Of The Gastroinestinal Tract
• Arterial supply:
• By 3 single arteries
which arise from the
front of the abdominal
aorta:
• Coeliac trunk:
supplies the foregut:
 lower part of
oesophagus,
 stomach,
 upper half of the 2nd
part duodenum,
 liver,
 pancreas
Dr: Azza Zaki
 & spleen)
2- Superior
mesentric
artery: supplies
the midgut:
 Lower half of the
2nd part
duodenum
 Jejunum
 Ileum
 Caecum
 Ascending colon
 Right 2/3 of the
transverse colon.

Dr: Azza Zaki

3- Inferior
mesentric
artery:
supplies the
hindgut:
Left 1/3 of
transverse colon
Descending
colon
Pelvic colon
Rectum
Upper half of the
anal canal Dr: Azza Zaki
Venous Drainage of GIT

Dr: Azza Zaki

 Venous Drainage of GIT
 By tributaries corresponding
to the branches of arteries,
which ultimately drained into
the portal vein.
 Where and how the portal
vein is formed?
 The portal vein is formed
behind the neck of
pancreas by the union of
superior mesenteric vein &
the splenic vein.
vein The portal
vein goes to the liver.
 From the liver, the 2 hepatic
veins drain into the inferior
vena cava.
Dr: Azza Zaki
Dr: Azza Zaki
 References
• Clinical anatomy by systems. Snell 2007
• Clinically oriented anatomy 5th ed Moore
• Gray’s anatomy for students. Drake
• Color atlas the human body. Faller 2004
• Netter atlas

Dr: Azza Zaki