Basic Anatomy of Nose

The external nose consists of paired nasal bones and upper and lower lateral cartilages. Internally, the
nasal septum divides the nasal cavity into a right and left side. The lateral nasal wall consists of inferior
and middle turbinates and occasionally a superior or supreme turbinate bone.

The nose has two cavities, separated from one another by a wall of cartilage called the septum.
The external openings are known as nares or nostrils. The roof of the mouth and the floor of the
nose are formed by the palatine bone, the mouth part of which is commonly called the hard
palate; a flap of tissue, the soft palate, extends back into the nasopharynx, the nasal portion of the
throat, and during swallowing is pressed upward, thus closing off the nasopharynx so that food is
not lodged in the back of the nose.

The shape of the nasal cavity is complex. The forward section, within and above each nostril, is
called the vestibule. Behind the vestibule and along each outer wall are three elevations, running
generally from front to rear. Each elevation, called a nasal concha or turbinate, hangs over an air
passage. Beside and above the uppermost concha is the olfactory region of the nasal cavity. The
rest of the cavity is the respiratory portion. The respiratory area is lined with a moist mucous
membrane with fine hairlike projections known as cilia, which serve to collect debris. Mucus
from cells in the membrane wall also helps to trap particles of dust, carbon, soot, and bacteria.
Sinus cavities are located in the bony skull on both sides of the nose.

In the olfactory (smelling) portion of the nose, most of the lining is mucous membrane. A small
segment of the lining contains the nerve cells that are the actual sensory organs. Fibres, called
dendrites, which project from the nerve cells into the nasal cavity, are covered only by a thin
layer of moisture. The moisture dissolves microscopic particles that the air has carried into the
nose from odour-emitting substances, and the particles dissolved in the fluid stimulate the
olfactory nerve cells chemically.

Basic Anatomy of Nasal Cavity

The nasal cavity extends from the external opening, the nostrils, to the pharynx (the upper section of
the throat), where it joins the remainder of the respiratory system. It is separated down the middle by
the nasal septum, a piece of cartilage which shapes and separates the nostrils.
The nasal cavity is a hollow space within the nose and skull that is lined with hairs and mucus
membrane. The function of the nasal cavity is to warm, moisturize, and filter air entering the body
before it reaches the lungs.

The floor of the nasal cavities, which also form the roof of the mouth, is made up by the bones of the
hard palate: the horizontal plate of the palatine bone posteriorly and the palatine process of the maxilla
anteriorly. The most anterior part of the nasal cavity is the nasal vestibule.

Nasal cavity can be divided into the vestibule, respiratory and olfactory sections.
 Basic Anatomy of Paranasal Air Sinuses
Paranasal sinuses are air-filled spaces located within the bones of the skull and facial bones.
They are centered on the nasal cavity and have various functions, including lightening the weight
of the head, humidifying and heating inhaled air, increasing the resonance of speech, and serving
as a crumple zone to protect vital structures in the event of facial trauma. Four sets of paired
sinuses are recognized: maxillary, frontal, sphenoid, and ethmoid
 Anatomy of larynx
The larynx (voice box) is an organ located in the anterior neck. It is a component of the
respiratory tract, and has several important functions, including phonation, the cough reflex, and
protection of the lower respiratory tract.

The structure of the larynx is primarily cartilaginous, and is held together by a series of
ligaments and membranes. Internally, the laryngeal muscles move components of the larynx for
phonation and breathing.

In this article, we will discuss the anatomy of the larynx – its location, structure, vasculature
and innervation. We shall also consider its clinical relevance.

The larynx is formed by a cartilaginous skeleton, which is held together by ligaments and
membranes. The laryngeal muscles act to move the components of the larynx for phonation and
breathing. More information about each of these structures can be found in their respective
sections.

Anatomically, the internal cavity of the larynx can be divided into three sections:

 Supraglottis – From the inferior surface of the epiglottis to the vestibular folds (false
vocal cords).
 Glottis – Contains vocal cords and 1cm below them. The opening between the vocal
cords is known as rima glottidis, the size of which is altered by the muscles of phonation.
 Subglottis – From inferior border of the glottis to the inferior border of the cricoid
cartilage.
 Anatomical position of the larynx (yellow) in the neck.

The interior surface of the larynx is lined by pseudostratified ciliated columnar epithelium. An
important exception to this is the true vocal cords, which are lined by a stratified squamous epithelium.
 Basic Anatomy of Trachea
The trachea, commonly known as the windpipe, is a tube about 4 inches long and less than an
inch in diameter in most people. The trachea begins just under the larynx (voice box) and runs
down behind the breastbone (sternum). The trachea then divides into two smaller tubes called
bronchi: one bronchus for each lung.

The trachea is composed of about 20 rings of tough cartilage. The back part of each ring is made
of muscle and connective tissue. Moist, smooth tissue called mucosa lines the inside of the
trachea. The trachea widens and lengthens slightly with each breath in, returning to its resting
size with each breath out.
 Basic Anatomy of Bronchi

The tracheobronchial tree is the anatomical and functional segment of the respiratory system that
conducts air from the upper airways to the lung parenchyma. It is composed of the trachea and
the intrapulmonary airways, including the bronchi, bronchioles and respiratory bronchioles.
Different histological characteristics are seen at each level and serve specific purposes. [1]

The trachea and bronchi (from the Greek bronkhos, meaning "windpipe") have cartilaginous
walls. Bronchi undergo multiple divisions and eventually give rise to the terminal bronchioles,
which by definition, lack cartilage
Bronchi are plural for bronchus and represent the passageways leading into the lungs. The first
bronchi branch from trachea, and they are the right and left main bronchi. These bronchi are the
widest and they enter the lung. After entering the lungs, the bronchi continue to branch further
into the secondary bronchi, known as lobar bronchi, which then branch into tertiary
(segmental) bronchi.

Segmental bronchi continue their branching until they reach the final, sixt generation of bronchi.
Every generation, starting from primary, is supported by cartilage in its wall. After sixth
generation, the passageways are very narrow to be supported by the cartillage, and thus are
called bronchioles (small bronchi).

A bronchus, which is also known as a main or primary bronchus, represents the airway in the
respiratory tract that conducts air into the lungs. Bronchi will branch into smaller tubes that
become bronchioles.

The trachea (windpipe) is found inferior to the thyroid cartilage and superior to division into the
left and right main bronchus. The trachea divides into the left and right main bronchus, which is
known as the tracheal bifurcation, at the level of the sternal angle and of the fifth thoracic
vertebra (or up to two vertebrae higher or lower, depending on lung volume changes due to
breathing).

It is important to note that the right main bronchus is wider, shorter, and more vertical than the
left main bronchus, and it enters the right lung at roughly the level of the fifth thoracic
vertebra. The right main bronchus has 3 subdivisions, which become secondary bronchi also
known as lobar bronchi, which deliver air to the 3 lobes of the right lung. Anatomically, the
azygos vein arches over the right main bronchus from behind. The right pulmonary artery lies
initially below the right bronchus and then later in front of it.

In contrast, the left main bronchus is smaller in size, but longer in length (~5 cm, as opposed to
2-3 cm long) than the right main bronchus. The left main bronchus enters the root of the left lung
opposite to the sixth thoracic vertebra, passes underneath the aortic arch, and crosses in front of
the esophagus, the thoracic duct, and the descending aorta. The left main bronchus subdivides
into 2 secondary or lobar bronchi that deliver air to the 2 lobes of the left lung. The left
pulmonary artery is found lying initially above the left main bronchus, then later in front of it.
Secondary bronchi will further subdivide into the tertiary bronchi, which are also called the
segmental bronchi, each of which supplies a bronchopulmonary segment.

Bronchopulmonary segment is a division of the lung that is separated from the rest of the lung by a
septum of connective tissue, which is an advantage during surgery since a bronchopulmonary segment
can be removed without affects other nearby segments. There are 10 bronchopulmonary segments in
the right lung (3 in the superior lobe, 2 in the middle lobe, 5 in the inferior lobe), and 8 segments in the
left lung (4 in the upper lobe, 4 in the lower lobe). During development, there are initially 10 segments
per lung, but since the left lung only has 2 lobes, 2 pairs of bronchopulmonary segments fuse to give 8
total segments, with 4 for each lobe. The segmental bronchi divide into many smaller bronchioles that
divide into terminal bronchioles, and then into respiratory bronchioles, which divide into 2 to 11
alveolar ducts. Each alveolar duct has 5 or 6 associated alveolar sacs. The alveolus is the basic anatomic
unit of gas exchange.

Gross and microscopic anatomy of lungs

The anatomy of the respiratory system can be divided into 2 major parts, airway anatomy and
lung anatomy.

A major organ of the respiratory system, each lung houses structures of both the conducting and
respiratory zones. The main function of the lungs is to perform the exchange of oxygen and
carbon dioxide with air from the atmosphere. To this end, the lungs exchange respiratory gases
across a very large epithelial surface area—about 70 square meters—that is highly permeable to
gases.

Gross Anatomy of the Lungs

The lungs are pyramid-shaped, paired organs that are connected to the trachea by the right and
left bronchi; on the inferior surface, the lungs are bordered by the diaphragm. The diaphragm is
the flat, dome-shaped muscle located at the base of the lungs and thoracic cavity. The lungs are
enclosed by the pleurae, which are attached to the mediastinum. The right lung is shorter and
wider than the left lung, and the left lung occupies a smaller volume than the right. The cardiac
notch is an indentation on the surface of the left lung, and it allows space for the heart. The apex
of the lung is the superior region, whereas the base is the opposite region near the diaphragm.
The costal surface of the lung borders the ribs. The mediastinal surface faces the midline.

Each lung is composed of smaller units called lobes. Fissures separate these lobes from each
other. The right lung consists of three lobes: the superior, middle, and inferior lobes. The left
lung consists of two lobes: the superior and inferior lobes. A bronchopulmonary segment is a
division of a lobe, and each lobe houses multiple bronchopulmonary segments. Each segment
receives air from its own tertiary bronchus and is supplied with blood by its own artery. Some
diseases of the lungs typically affect one or more bronchopulmonary segments, and in some
cases, the diseased segments can be surgically removed with little influence on neighboring
segments. A pulmonary lobule is a subdivision formed as the bronchi branch into bronchioles.
Each lobule receives its own large bronchiole that has multiple branches. An interlobular septum
is a wall, composed of connective tissue, which separates lobules from one another.

Blood Supply and Nervous Innervation of the Lungs

The blood supply of the lungs plays an important role in gas exchange and serves as a transport
system for gases throughout the body. In addition, innervation by the both the parasympathetic
and sympathetic nervous systems provides an important level of control through dilation and
constriction of the airway.
Blood Supply

The major function of the lungs is to perform gas exchange, which requires blood from the
pulmonary circulation. This blood supply contains deoxygenated blood and travels to the lungs
where erythrocytes, also known as red blood cells, pick up oxygen to be transported to tissues
throughout the body. The pulmonary artery is an artery that arises from the pulmonary trunk
and carries deoxygenated, arterial blood to the alveoli. The pulmonary artery branches multiple
times as it follows the bronchi, and each branch becomes progressively smaller in diameter. One
arteriole and an accompanying venule supply and drain one pulmonary lobule. As they near the
alveoli, the pulmonary arteries become the pulmonary capillary network. The pulmonary
capillary network consists of tiny vessels with very thin walls that lack smooth muscle fibers.
The capillaries branch and follow the bronchioles and structure of the alveoli. It is at this point
that the capillary wall meets the alveolar wall, creating the respiratory membrane. Once the
blood is oxygenated, it drains from the alveoli by way of multiple pulmonary veins, which exit
the lungs through the hilum.

Nervous Innervation

Dilation and constriction of the airway are achieved through nervous control by the
parasympathetic and sympathetic nervous systems. The parasympathetic system causes
bronchoconstriction, whereas the sympathetic nervous system stimulates bronchodilation.
Reflexes such as coughing, and the ability of the lungs to regulate oxygen and carbon dioxide
levels, also result from this autonomic nervous system control. Sensory nerve fibers arise from
the vagus nerve, and from the second to fifth thoracic ganglia. The pulmonary plexus is a region
on the lung root formed by the entrance of the nerves at the hilum. The nerves then follow the
bronchi in the lungs and branch to innervate muscle fibers, glands, and blood vessels.

Pleura of the Lungs

Each lung is enclosed within a cavity that is surrounded by the pleura. The pleura (plural =
pleurae) is a serous membrane that surrounds the lung. The right and left pleurae, which enclose
the right and left lungs, respectively, are separated by the mediastinum. The pleurae consist of
two layers. The visceral pleura is the layer that is superficial to the lungs, and extends into and
lines the lung fissures. In contrast, the parietal pleura is the outer layer that connects to the
thoracic wall, the mediastinum, and the diaphragm. The visceral and parietal pleurae connect to
each other at the hilum. The pleural cavity is the space between the visceral and parietal layers.

The pleurae perform two major functions: They produce pleural fluid and create cavities that
separate the major organs. Pleural fluid is secreted by mesothelial cells from both pleural layers
and acts to lubricate their surfaces. This lubrication reduces friction between the two layers to
prevent trauma during breathing, and creates surface tension that helps maintain the position of
the lungs against the thoracic wall. This adhesive characteristic of the pleural fluid causes the
lungs to enlarge when the thoracic wall expands during ventilation, allowing the lungs to fill with
air. The pleurae also create a division between major organs that prevents interference due to the
movement of the organs, while preventing the spread of infection.

Lung Transverse Section

 Gross and Microscopic Strucute of Pleura
The pulmonary pleurae (sing. pleura) are the two layers of the invaginated sac surrounding each
lung and attaching to the thoracic cavity. The visceral pleura is the delicate membrane that
covers the surface of each lung, and dips into the fissures between the lobes of the lung.The
parietal pleura is the outer membrane which is attached to the inner surface of the thoracic
cavity. It also separates the pleural cavity from the mediastinum. The parietal pleura is
innervated by the intercostal nerves and the phrenic nerve.

Between the membranes is a fluid-filled space called the pleural space.

Function: The contraction of the diaphragm creates a negative pressure within the pleural cavity which
forces the lungs to expand resulting in passive exhalation and active inhalation. This breathing process
can be made forceful through the contraction of the external intercostal muscles which forces the rib
cage to expand and add to the negative pressure in the pleural cavity causing the lungs to fill with air.
The fluid in the cavity provides lubrication and cushioning.

Structure: Each lung is covered by a double membrane, called the pleurae; each membrane is a pleura –
the visceral pleura adheres to the surface of the lung and the parietal pleura attaches to the thoracic
cavity. The pleurae of each lung are not connected in any way.

Visceral pleura : The visceral pleura is the delicate membrane that closely covers the surfaces of the
lungs and dips into the fissures that separate the lobes.

Parietal pleura :

The parietal pleura is the outer membrane that attaches to and lines the inner surface of the thoracic
cavity, covers the upper surface of the diaphragm and is reflected over structures within the middle of the
thorax. It separates the pleural cavity from the mediastinum.
The parietal pleura is differentiated into regions in line with the location in the thorax. The "cervical
pleura" (or "cupula of pleura") is in the region of the cervical vertebrae extending beyond the apex of the
lung and into the neck. The "costal pleura" lines the inner surfaces of the ribs and the intercostal muscles
and are separated from them by endothoracic fascia. An extension of the endothoracic fascia known as the
suprapleural membrane covers the apex of each lung in a thickened layer of connective tissue. The
"diaphragmatic pleura" lines the convex surface of the diaphragm. The "mediastinal pleura" attaches to
the other organs in the mediastinum and forms the separating lateral wall.

Between the two membranes is a space called the pleural cavity or interpleural space, which contains a
lubricating fluid.

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 Digestive system:
Basic Anatomy of Oesophagus
Esophagus is a muscular tube-like organ that originates from endodermal primitive gut, 25–28 cm long,
approximately 2 cm in diameter, located between lower border of laryngeal part of pharynx and cardia
of stomach. Start and end points of esophagus correspond to 6th cervical vertebra and 11th thoracic
vertebra topographically, and the gastroesophageal junction corresponds to xiphoid process of sternum.
Five cm of esophagus is in the neck, and it descends over superior mediastinum and posterior
mediastinum approximately 17–18 cm, continues for 1–1.5 cm in diaphragm, ending with 2–3 cm of
esophagus in abdomen. Sex, age, physical condition, and gender affect the length of esophagus. A
newborn’s esophagus is 18 cm long, and it begins and ends one or two vertebra higher than in adult.
Esophagus lengthens to 22 cm long by age 3 years and to 27 cm by age 10 years

The esophagus is a muscular tube connecting the throat (pharynx) with the stomach. The
esophagus is about 8 inches long, and is lined by moist pink tissue called mucosa. The esophagus
runs behind the windpipe (trachea) and heart, and in front of the spine. Just before entering the
stomach, the esophagus passes through the diaphragm.

The upper esophageal sphincter (UES) is a bundle of muscles at the top of the esophagus. The
muscles of the UES are under conscious control, used when breathing, eating, belching, and
vomiting. They keep food and secretions from going down the windpipe.

The lower esophageal sphincter (LES) is a bundle of muscles at the low end of the esophagus,
where it meets the stomach. When the LES is closed, it prevents acid and stomach contents from
traveling backwards from the stomach. The LES muscles are not under voluntary control.

The esophagus is split into the following 3 parts:

 Cervical part (4 cm in length).

 Thoracic part (20 cm in length).
 Abdominal part (12 cm in length).
The cervical part extends from the lower border of cricoid cartilage to the superior border of
manubrium sterni.

The thoracic part extends from superior border of manubrium sterni to the esophageal opening in
the diaphragm.

The narrowest part of esophagus is its commencement at the cricopharyngeal sphincter.

The abdominal part extends create esophageal opening in the diaphragm to the cardiac end of the
stomach.
Basic anatomy of Stomach
The stomach is a muscular organ located on the left side of the upper abdomen. The stomach
receives food from the esophagus. As food reaches the end of the esophagus, it enters the
stomach through a muscular valve called the lower esophageal sphincter.

The stomach secretes acid and enzymes that digest food. Ridges of muscle tissue called rugae
line the stomach. The stomach muscles contract periodically, churning food to enhance
digestion. The pyloric sphincter is a muscular valve that opens to allow food to pass from the
stomach to the small intestine.

The stomach is the most dilated part of the digestive system, lying between the esophagus and
duodenum. More precisely, the stomach spans the region between the cardiac and pyloric
orifices of the gastrointestinal tract. It is covered and connected to other organs by peritoneum.
The lesser omentum connects the stomach to the liver and then extends around the stomach. The
greater omentum then continues inferiorly from the stomach, hanging from it like a curtain.

The stomach is located inside the abdominal cavity in a small area called the bed of the
stomach, onto which the stomach lies when the body is in a supine position, or lying face up. It
spans several regions of the abdomen, including the epigastric, umbilical, left hypochondriac,
and left flank regions. The stomach also has some precise anatomical relations and comes in
contact with several neighboring structures.
 The small intestine
The small intestine is about 6 meters (m) long and consists of three parts: the duodenum, the
jejunum, and the ileum. The duodenum (doo-od′̆e-n̆ um, doo-̄o-d̆ e′n̆ um) is about 25 cm long(the
term duodenum means 12, suggesting that it is 12 in. long). The jejunum (jĕ -joo′ n̆ u m) is about
2.5 m long and makes up two-fifths of the total length of the small intestine. The ileum (il′ ̄e -̆u
m) is about 3.5 m long and makes up three-fifths of the small intestine.
Duodenum nearly completes a 180-degree arc as it curves within the abdominal cavity. Part of
the pancreas lies within this arc. The common bile duct from the liver and the pancreatic
duct from the pancreas join and empty into the duo-denum.

The small intestine is the major site of digestion and absorp-tion of food, which are
accomplished due to the presence of a large surface area. The small intestine has three
modifications that increase its surface area about 600-fold: circular folds, villi, and microvilli.
The mucosa and submucosa form a series of circularfolds that run perpendicular to the long axis
of the digestive tract(figure 16.14a). Tiny, fingerlike projections of the mucosa form
numerous villi (vil′ i; sing. villus), which are 0.5–1.5 mm long.

Each villus is covered by simple columnar epithelium. Within the lMost of the cells composing
the surface of the villi have numerous cytoplasmic extensions, called microvilli oose connective
tissue core of each villus are a blood capillary network and a lymphatic capil-lary called
a lacteal (lak′ tē-ăl; resembling milk). The blood capillary network and the lacteal are very
important in transporting absorbed nutrients.

The mucosa of the small intestine is simple columnar epi-thelium with four major cell types:
(1) absorptive cells, which have microvilli, produce digestive enzymes, and absorb digest-ed
food; (2) goblet cells, which produce a protective mucus;(3) granular cells, which may help
protect the intestinal epi-thelium from bacteria; and (4) endocrine cells, which produce
regulatory hormones.
 Above Figure : Anatomy of Duodenum

The epithelial cells are located within tubular glands of the mucosa, called intestinal
glands or crypts of Lieberkühn, at the base of the villi. Granular and endocrine cells are located
in the bottom of the glands. The submucosa of the duodenum contains mucous glands,
called duodenal glands, which open into the base of the intestinal glands.

The duodenum, jejunum, and ileum are similar in structure. However, progressing from the
duodenum through the ileum, there are gradual decreases in the diameter of the small intestine,
in the thickness of the intestinal wall, in the number of circular folds, and in the number of villi.
Lymphatic nodules are common along the entire length of the digestive tract, and clusters of
lym-phatic nodules, called Peyer patches, are numerous in the ileum. These lymphatic tissues
help protect the intestinal tract from harmful pathogens.
Basic Anatomy of Large Intestine
The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and
of the digestive system in vertebrates. Water is absorbed here and the remaining waste material is
stored as feces before being removed by defecation.
The site where the ileum connects to the large intestine is called the ileocecal (il′ ē-ō-sē′
kăl) junction. It has a ring of smooth muscle, the ileocecal sphincter, and an ileocecal
valve ,which allow the intestinal contents to move from the ileum to the large intestine, but not
in the opposite direction.

Function and Form of the Large Intestine

The function of the large intestine (or large bowel) is to absorb water from the remaining
indigestible food matter, and then to pass the useless waste material from the body. The large
intestine consists of the cecum and colon.

It starts in the right iliac region of the pelvis, just at or below the right waist, where it is joined to the
bottom end of the small intestine (cecum). From here it continues up the abdomen (ascending colon),
then across the width of the abdominal cavity (transverse colon), and then it turns down (descending
colon), continuing to its endpoint at the anus (sigmoid colon to rectum to anus). The large intestine is
about 4.9 feet (1.5 m) long—about one-fifth of the whole length of the intestinal canal.

Differences Between Large and Small Intestine

The large intestine differs in physical form from the small intestine in several ways. The large
intestine is much wider, and the longitudinal layers of the muscularis are reduced to three, strap-
like structures known as the taeniae coli.

The wall of the large intestine is lined with simple columnar epithelium. Instead of having the
evaginations of the small intestine (villi), the large intestine has invaginations (the intestinal
glands).

While both the small intestine and the large intestine have goblet cells, they are more abundant in
the large intestine.

Additional Structures

The appendix is attached to its inferior surface of the cecum. It contains the least lymphoid
tissue, and it is a part of mucosa-associated lymphoid tissue, which gives it an important role in
immunity.

Appendicitis is the result of a blockage that traps infectious material in the lumen. The appendix
can be removed with no apparent damage or consequence to the patient.

On the surface of the large intestine, bands of longitudinal muscle fibers called taeniae coli, each
about 0.2 inches wide, can be identified. There are three bands, starting at the base of the
appendix and extending from the cecum to the rectum.
Along the sides of the taeniae, tags of peritoneum filled with fat, called epiploic appendages (or
appendices epiploicae) are found. The sacculations, called haustra, are characteristic features of
the large intestine, and distinguish it from the small intestine.

Basic Anatomy of Liver

The liver is located in the upper right-hand portion of the abdominal cavity, beneath the
diaphragm, and on top of the stomach, right kidney, and intestines.

Shaped like a cone, the liver is a dark reddish-brown organ that weighs about 3 pounds.

There are 2 distinct sources that supply blood to the liver, including the following:

 Oxygenated blood flows in from the hepatic artery

 Nutrient-rich blood flows in from the hepatic portal vein
The liver holds about one pint (13%) of the body's blood supply at any given moment. The liver
consists of 2 main lobes. Both are made up of 8 segments that consist of 1,000 lobules (small
lobes). These lobules are connected to small ducts (tubes) that connect with larger ducts to form
the common hepatic duct. The common hepatic duct transports the bile made by the liver cells to
the gallbladder and duodenum (the first part of the small intestine) via the common bile duct.

Functions of the liver

The liver regulates most chemical levels in the blood and excretes a product called bile. This
helps carry away waste products from the liver. All the blood leaving the stomach and intestines
passes through the liver. The liver processes this blood and breaks down, balances, and creates
the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the
body or that are nontoxic. More than 500 vital functions have been identified with the liver.
Some of the more well-known functions include the following:

 Production of bile, which helps carry away waste and break down fats in the small
intestine during digestion
 Production of certain proteins for blood plasma
 Production of cholesterol and special proteins to help carry fats through the body
 Conversion of excess glucose into glycogen for storage (glycogen can later be converted
back to glucose for energy) and to balance and make glucose as needed
 Regulation of blood levels of amino acids, which form the building blocks of proteins
  Processing of hemoglobin for use of its iron content (the liver stores iron)
 Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism
and is excreted in the urine)
 Clearing the blood of drugs and other poisonous substances
 Regulating blood clotting
 Resisting infections by making immune factors and removing bacteria from the
bloodstream
 Clearance of bilirubin, also from red blood cells. If there is an accumulation of bilirubin,
the skin and eyes turn yellow.

When the liver has broken down harmful substances, its by-products are excreted into the bile or
blood. Bile by-products enter the intestine and leave the body in the form of feces. Blood by-
products are filtered out by the kidneys, and leave the body in the form of urine.
 Basic Anatomy of Pancreas
The pancreas (meaning all flesh) lies in the upper abdomen behind the stomach. The pancreas is part of
the gastrointestinal system that makes and secretes digestive enzymes into the intestine, and also an
endocrine organ that makes and secretes hormones into the blood to control energy metabolism and
storage throughout the body.

The pancreas is an elongated, tapered organ located across the back of the belly, behind the stomach.
The right side of the organ—called the head—is the widest part of the organ and lies in the curve of the
duodenum, the first division of the small intestine. The tapered left side extends slightly upward—called
the body of the pancreas—and ends near the spleen—called the tail.

Exocrine pancreas, the portion of the pancreas that makes and secretes digestive enzymes into
the duodenum. This includes acinar and duct cells with associated connective tissue, vessels, and
nerves. The exocrine components comprise more than 95% of the pancreatic mass.

Endocrine pancreas, the portions of the pancreas (the islets) that make and secrete insulin,
glucagon, somatostatin and pancreatic polypeptide into the blood. Islets comprise 1-2% of
pancreatic mass.

Gross anatomy of the pancreas and its relationship to surrounding organs in adults. It is
customary to refer to various portions of the pancreas as head, body, and tail. The head lies near
the duodenum and the tail extends to the hilum of the spleen.

The pancreas is viewed from the front and a portion of the parenchyma has been dissected away to
reveal (1) the main (principal) pancreatic duct (Wirsung’s duct) with multiple branches, (2) the accessory
duct (Santorini’s duct), and (3) the distal common bile duct. Although the regions are not labeled we see
the head of the pancreas at image left, and tail of the pancreas, image right.

Anatomic relationships of the pancreas with surrounding organs and structures.

• The head of the pancreas lies in the loop of the duodenum as it exits the stomach.

• The tail of the pancreas lies near the hilum of the spleen.

• The body of the pancreas lies posterior to the distal portion of the stomach between the tail and
the neck and is unlabeled in this drawing.

• The portion of the pancreas that lies anterior to the aorta is somewhat thinner than the adjacent
portions of the head and body of the pancreas. This region is sometimes designated as the neck
of the pancreas and marks the junction of the head and body.

• The close proximity of the neck of the pancreas to major blood vessels posteriorly including the
superior mesenteric artery, superior mesenteric-portal vein, inferior vena cava, and aorta limits
the option for a wide surgical margin when pancreatectomy (surgical removal of the pancreas) is
done.
• The common bile duct passes through the head of the pancreas to join the main duct of the
pancreas near the duodenum. The portion nearest the liver lies in a groove on the dorsal aspect of
the head.

•The minor papilla where the accessory pancreatic duct drains into the duodenum and the major
papilla (ampulla of Vater) where the main pancreatic duct enters the duodenum are depicted.

Functions of the pancreas

The pancreas has digestive and hormonal functions:

 The enzymes secreted by the exocrine gland in the pancreas help break down
carbohydrates, fats, proteins, and acids in the duodenum. These enzymes travel down the
pancreatic duct into the bile duct in an inactive form. When they enter the duodenum,
they are activated. The exocrine tissue also secretes a bicarbonate to neutralize stomach
acid in the duodenum. This is the first section of the small intestine.
 The main hormones secreted by the endocrine gland in the pancreas are insulin and
glucagon, which regulate the level of glucose in the blood, and somatostatin, which
prevents the release of insulin and glucagon.