Diagnostic Ultrasound - Abdomen and Pelvis
Bowel SMALL INTESTINE Anatomy: Abdomen Celiac artery Superior mesenteric artery Ileocolic artery Jejunal straight arteries Jejunal arterial arcades Ileal straight arteries Liver Stomach Pancreas Superior mesenteric artery Duodenum (3rd part) Transverse colon Aorta Greater omentum Inferior vena cava Small bowel loops (Top) Graphic shows the vascular supply of the entire small intestine from the superior mesenteric artery (SMA). The small bowel segments are displaced inferiorly. The SMA arises from the anterior abdominal aorta and gives off the inferior pancreaticoduodenal branch that supplies the duodenum and pancreas. Arising from the left side of the SMA are numerous branches to the jejunum and ileum. Jejunal arteries are generally larger and longer than those of the ileum. After a straight course, the arteries form multiple intercommunicating curvilinear arcades. (Bottom) Graphic shows the sagittal section of the central abdomen, revealing the jejunum and ileum suspended in a radial pattern by the mesentery. Note the overlying greater omentum attached from the inferior portion of the stomach to drape the small bowel segments and transverse colon. 73
Bowel Anatomy: Abdomen COLON AND ANUS Transverse colon Taenia coli Hepatic flexure Splenic flexure Superior mesenteric artery Ascending colon Descending colon Inferior mesenteric artery Cecum Appendix Rectum Sigmoid Urinary bladder Rectum Prostate External anal sphincter Muscularis propria of rectum Internal anal sphincter Anal canal (Top) Graphic shows the colon in situ. The transverse colon has been retracted upward to demonstrate the arterial supply of the colon from the superior and inferior mesenteric arteries. The SMA supplies the colon from the appendix through the splenic flexure, and the inferior mesenteric artery (IMA) supplies the descending colon through the rectum. Note the band of smooth muscle (taenia coli) running along the length of the intestine, which terminates in the vermiform appendix; these result in sacculations/haustrations along the colon, giving it a segmented appearance. (Bottom) Graphic shows the longitudinal section of a male pelvis. The anus is the external opening of the rectum and terminal end of the GI tract. The internal anal sphincter (IAS) is a thin involuntary muscle deep to the submucosa. The external anal sphincter is thicker, encircles the IAS, and is under voluntary control. 74
- Page 44 and 45: Biliary System Left hepatic duct Ri
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Bowel<br />
Anatomy: <strong>Abdomen</strong><br />
COLON AND ANUS<br />
Transverse colon<br />
Taenia coli<br />
Hepatic flexure<br />
Splenic flexure<br />
Superior mesenteric artery<br />
Ascending colon<br />
Descending colon<br />
Inferior mesenteric artery<br />
Cecum<br />
Appendix<br />
Rectum<br />
Sigmoid<br />
Urinary bladder<br />
Rectum<br />
Prostate<br />
External anal sphincter<br />
Muscularis propria of rectum<br />
Internal anal sphincter<br />
Anal canal<br />
(Top) Graphic shows the colon in situ. The transverse colon has been retracted upward to demonstrate the arterial supply of the colon<br />
from the superior <strong>and</strong> inferior mesenteric arteries. The SMA supplies the colon from the appendix through the splenic flexure, <strong>and</strong> the<br />
inferior mesenteric artery (IMA) supplies the descending colon through the rectum. Note the b<strong>and</strong> of smooth muscle (taenia coli)<br />
running along the length of the intestine, which terminates in the vermiform appendix; these result in sacculations/haustrations along<br />
the colon, giving it a segmented appearance. (Bottom) Graphic shows the longitudinal section of a male pelvis. The anus is the external<br />
opening of the rectum <strong>and</strong> terminal end of the GI tract. The internal anal sphincter (IAS) is a thin involuntary muscle deep to the<br />
submucosa. The external anal sphincter is thicker, encircles the IAS, <strong>and</strong> is under voluntary control.<br />
74
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