. Anatomy, descriptive and applied. Anatomy. THE JEJUNUM AND ILEUM 1287 of the first portion, being at first trivial elevations irregularly placed. They become higher, regular, and more numerous farther on, and near the termination of the duodenum are strongly marked and closely placed transverse or spiral folds (Fig. 1029 and p. 1289). In the descending portion (Fig. 1029), to the side and rear, is a longitudinal fold {plica longitvdinalis duodeni), which is formed by the projection of the bile duct and pancreatic duct beneath the mucous membrane. The caruncula major of Santorini or the bile
. Anatomy, descriptive and applied. Anatomy. THE JEJUNUM AND ILEUM 1287 of the first portion, being at first trivial elevations irregularly placed. They become higher, regular, and more numerous farther on, and near the termination of the duodenum are strongly marked and closely placed transverse or spiral folds (Fig. 1029 and p. 1289). In the descending portion (Fig. 1029), to the side and rear, is a longitudinal fold {plica longitvdinalis duodeni), which is formed by the projection of the bile duct and pancreatic duct beneath the mucous membrane. The caruncula major of Santorini or the bile papilla is a projection in the lower part of the longitudinal fold. At the summit of this papilla the bile duct and pan- creatic duct empty into the duodenum. One inch above and half an inch or more in front of the bile papilla is a much smaller papilla, the caruncula minor of Santorini {papilla duodeni [Santoriai'\), on the summit of which the acces- sory pancreatic duct of Santorini opens when ANASTOMOSIS OF THE TWO PANCREATICO- DUODENAL ARTERIES Fig. 1031.'—The bloodvessels of the duodenum. (Poirier and Charpy.) Structure of the Duodenum.—(See Structure of the Small Intestine, p. 1289.) Vessels and Nerves.—The arteries (Fig. 1031) supplying the duodenum are the pyloric and pancreaticoduodenal branches of the hepatic, and the inferior pancreaticoduodenal branch of the superior mesenteric. The veins (Fig. 1031) correspond to the arteries. The superior duodenal vein passes into the superior mesenteric, and the inferior duodenal vein passes into the portal. The Ijrmphatics pass along with the pancreaticoduodenal arteries, lymph nodes being present here and there, and terminate in the nodes about the coeliac axis. The nerves are derived from the solar plexus. Applied Anatomy.— Ulcer oftlie duodenum is more common than used to be thought. The portion of the duodenum between the pylorus and the bile papilla is about four inches in length, and is called by the Mayo
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanatomy, bookyear1913
