 This is going to be a demonstration of the small intestine, in front of us we can see this is the aorta and this is the supramacentric artery and we can see the branches of the supramacentric artery. Just to bring up to speed, this is an aberrant artery which is going to the right lobe of the liver, this is the first branch, this is the inferior pancreatic urinal. Thereafter we can see these multiple branches. These are all the colic and the gingeral and the ilial branches. So the supramacentric artery is the artery of the mid-cut. The next artery I would like to draw your attention to is this one here. This is the inferior miscentric artery, this is the artery of the hind-cut. This supplies branches to the descending colon and after that it continues into the pelvis as the superior rectal artery which we can see here and supplies the rectum. Having mentioned these arteries, now let's demonstrate the small intestine. So this is the small intestine that I am holding up in front of us. We have completely disemboweled it from its attachments. Right away we can see the small intestine is highly coiled and it is incorporated within the abdomen. It is approximately 6 to 7 meters long. The proximal two-fifths is the ginginum and the distal three-fifths is the ilium. Let's take a look at this fatty structure here. This is the miscentry of the intestine and within the layers of the miscentry are ramifying the blood vessels and that is how the blood vessels reach the small intestine. This small intestine is derived from the mid-cut, so therefore all the vascular supply is from the branches of the superior miscentric artery. The surface which is attached to the miscentry is referred to as the miscentric border and the opposite side is referred to as the anti-miscentric border. So the blood vessels enter through the miscentric border and then they ramify and go to the anti-miscentric border. Now let's take a look at some basic differences between the ginginum and the ilium. So we are holding up the ginginum which is very close to the due to the ginginum flexure. We notice that the ginginum is thick, fleshy and more vascular and in life this will be more pink in color. The next thing we notice is the miscentry. The miscentry is laden with fat but it is much less compared to the ilium. We have cut open a section of the ginginum to show the mucosal pattern. We can see that the mucosal folds are transverse and they are very dense and they are very big and this is referred to as pli-case circularus or belbule conventis and this is what gives a feathery appearance when we do a perium male follow-through. This is a perium male follow-through to show the feathery appearance of the mucosal pattern of the ginginum. In this section of the miscentry we have removed the layers of the miscentry to show the blood vessels. To demonstrate the blood vessels I am going to hold it up against the light. We notice that the blood supply follows a particular pattern. We can see this curved vessel here. This is referred to as the vascular arcade. Emerging from the vascular arcade we can see straight vessels going to the intestine itself. These are referred to as the vasarecta. So in the case of ginginum there will be very few vascular arcades mostly only one. Therefore the vasarecta are long. Now let's take a look at the ilium and see how it compares with the ginginum. Now I am holding up a section of the ilium which is very close to the iliocecal junction. Again let's take a look at the intestine itself. We can see that the intestine is much thinner. It is pale. It is less vascular. Now let's take a look at the fat in the miscentry. We can see that the fat in the miscentry is much more dense and not only that it is encroaching on to the intestinal wall itself. Now let's take a look at the interior. We have cut open a section. We notice that the mucosal folds are not as prominent. They are fewer in number and as we go further distally they will even be absent. This is what is referred to as the structuralist appearance as described by Wangenstein in a bearing lead follow-through. In one section of the miscentry we have removed the layers of the miscellaneous baritonium to show the vascular pattern. And again I am going to hold it up to the light and we can see that the vascular pattern is somewhat different from that of the ginginum. We notice that the vascular arcades are severed. We can see one main arcade here and we can see further subarcades more distally. And then extending from the apex of the arcades we can see that the vascular arcades are smaller because the vascular arcades are extending more distally. So therefore vascular arcades are more, vascular arcades are smaller in the area. Not visible in this section but if we want to take a microscopic view of the submucosa we will see erections of lipfoid follicle in the submucosa which are referred to as pairs patches which are more numerous in the area. So these are some basic gingino ideal differences. Finally just for the sake of comparison I am going to hold the two sections close to each other so that we can see them and have a comparative view. This is the ginginum, this is the alium. Fat is encroaching, fat is not encroaching. Single vascular arcade, multiple vascular arcades. Long vassarector, short vassarector. Ginginum is thick, fleshy, alium is thin. More vascular, less vascular. So therefore to summarize, alium is thin, thin with fat, vascular, mis-entry. One or two words of clinical correlation. Interstitial resection and astromosis is a very commonly performed surgery. When we have to resect a particular section of the intestine, small intestine for any reason whether it is gangrene or whatever we first ligate all these blood vessels right from here till here and then we ligate them from here to here and after we have done that we clamp the segment of the small intestine and we remove it. Thereafter we anastomose the two ends together and so this is the basic principle of doing a resection and astromosis of the small intestine. Point to be remembered is because the alium is less vascular we have to make sure that we do not jeopardize the blood supply when we are doing anastomosis because alial jeopardization of the blood supply is more common than that of the ginginum. These are some of the points which I want to mention about the small intestine. Thank you very much for watching Dr. Sanjay Sanyal signing out. Dr. Govthi Chunilal is a camera person. If you have any questions or comments please put them in the comment section below. Have a nice day.