S5) Anatomy for Dissection — Stomach, Duodenum, Pancreas

Question 1

Identify the following on the stomach:

• Greater curvature
• Lesser curvature

Answer 1

Question 2

Identify the following on the stomach:

• Fundus
• Body
• Antrum

Answer 2

Question 3

Identify the following on the stomach:

• Lower oesophageal sphincter
• Pyloric sphincter
• Cardia

Answer 3

Question 4

Identify 3 key features in the surface anatomy of the stomach

Answer 4

• Stratified columnar epithelium
• Rugae
• Gastric pits

Question 5

Describe the superior and inferior anatomical relations of the stomach

Answer 5

• Superior: oesophagus, diaphragm
• Inferior: head and neck of pancreas

Question 6

Describe the anterior and posterior anatomical relations of the stomach

Answer 6

• Anterior: greater omentum, abdominal wall, left lobe of liver, gall bladder
• Posterior: lesser sac, left kidney, left adrenal gland, splenic artery, common bile duct, gastroduodenal artery

Question 7

Where can the arterial supply of the stomach be derived from?

Answer 7

Coeliac trunk and its branches

Question 8

Describe the blood supply to the lesser and greater curvatures of the stomach

Answer 8

• Lesser curvature: anastomoses by the right and left gastric arteries
• Greater curvature: anastomoses by the right and left gastro-omental arteries

Question 9

Where do the right and left gastric arteries arise from?

Answer 9

• Right gastric – branch of the common hepatic artery, which arises from the coeliac trunk
• Left gastric – arises directly from the coeliac trunk

Question 10

Where do the right and left gastro-omental arteries arise from?

Answer 10

• Right gastro-omental – terminal branch of the gastroduodenal artery, which arises from the common hepatic artery
• Left gastro-omental – branch of the splenic artery, which arises from the coeliac trunk

Question 11

​The veins of the stomach run parallel to the arteries.

Describe the venous drainage of the of the stomach

Answer 11

• Lesser curvature: right and left gastric veins
• Greater curvature: right and left gastro-omental veins
• Fundus: short gastric veins

Question 12

Where do the right and left gastric veins drain?

Answer 12

The right and left gastric veins drain into the hepatic portal vein

Question 13

Where does the short gastric vein, right and left gastro-omental veins drain into?

Answer 13

The short gastric vein, left and right gastro-omental veins ultimately drain into the superior mesenteric vein

Question 14

What is the coeliac trunk and what does it do?

Answer 14

• The coeliac trunk is a major artery of the abdomen
• It arises from the abdominal aorta, and supplies many of the gastrointestinal viscera

Question 15

What are the main branches of the coeliac trunk?

Answer 15

Question 16

The greater and lesser omenta divide the abdominal cavity into two; the greater and lesser sac.

Describe the entrance into the lesser sac

Answer 16

The greater and lesser sacs communicate via the epiploic foramen, a hole in the lesser omentum

Question 17

Which 3 structures can be found along the free border of the lesser omentum?

Answer 17

Free border of lesser omentum encloses the portal triad

Question 18

What is the sigmoid mesocolon and what does it do?

Answer 18

• The sigmoid mesocolon is a mesentery that attaches the sigmoid colon to the posterior pelvic wall
• The long length of the mesentery permits this part of the colon to be particularly mobile

Question 19

What is the mesentery of the small intestine and what does it do?

Answer 19

The small bowel mesentery is a broad fan-shaped fold of peritoneum connecting the loops of jejunum and ileum to the posterior abdominal wall

Question 20

What is the duodenum and where is it found?

Answer 20

• The duodenum is the most proximal portion of the small intestine
• It runs from the pylorus of the stomach to the duodenojejunal junction

Question 21

The duodenum can be divided into 4 parts. Identify them

Answer 21

Question 22

Describe the anatomical position of the superior region of the duodenum

Answer 22

• It ascends upwards from the pylorus of the stomach
• It is connected to the liver by the hepatoduodenal ligament

Question 23

Describe the anatomical position of the descending region of the duodenum

Answer 23

• It curves inferiorly around the head of the pancreas
• It lies posteriorly to the transverse colon, and anterior to the right kidney

Question 24

How is the descending region of the duodenum marked and why is this significant?

Answer 24

• Internally, the descending duodenum is marked by the major duodenal papilla – an opening for bile and pancreatic secretions to enter
• The duct responsible carrying these secretions is known as the ampulla of Vater (hepatopancreatic ampulla)

Question 25

Describe the anatomical position of the horizontal region of the duodenum

Answer 25

- It travels laterally to the left, crossing over the **inferior vena cava** and **aorta** - It is located inferiorly to the **pancreas**, and posteriorly to the **superior mesenteric artery** and **vein**

Question 26

Describe the anatomical position of the ascending region of the duodenum

Answer 26

- It ascends and curves anteriorly to join the jejunum at a sharp turn known as the **duodenojejunal flexure** - Located at the duodenojejunal junction is a slip of muscle called the **suspensory muscle of the duodenum**

Question 27

Where is the pancreas located?

Answer 27

The pancreas is a **retroperitoneal structure** located deep within the upper abdomen in the **epigastrium** and **left hypochondrium** regions

Question 28

Describe the anatomical relationship of the pancreas and the duodenum

Answer 28

The **duodenum** is situated anteriorly and medially, curving around the head of the **pancreas**

Question 29

The pancreas can be divided into 5 parts. Identify them

Answer 29

Question 30

Describe the anatomical position of the head of the pancreas

Answer 30

- Lies within the C-shaped curve created by the **duodenum** - Connected to duodenum by **connective tissue**

Question 31

Describe the anatomical position of the uncinate process of the pancreas

Answer 31

- Arises from the lower part of the head and extends medially to lie beneath the body of the pancreas - Lies posterior to the **superior mesenteric vessels**

Question 32

Describe the anatomical position of the neck of the pancreas

Answer 32

- Located between the head and the body of the pancreas - Overlies the **superior mesenteric vessels** which form a groove in its posterior aspect

Question 33

Describe the anatomical position of the body of the pancreas

Answer 33

- Centrally located, crosses the midline of the body - Lies behind the **stomach** and to the left of the **superior mesenteric vessels**

Question 34

Describe the anatomical position of the tail of the pancreas

Answer 34

- Lies within close proximity to the hilum of the **spleen** - Contained within the **splenorenal ligament** with the splenic vessels (intraperitoneal)

Question 35

Describe the blood supply to the pancreas

Answer 35

Question 36

Where do the superior and inferior pancreaticoduodenal arteries arise from?

Answer 36

Question 37

Describe the venous drainage of the pancreas

Answer 37

- Venous drainage of the head of the pancreas is into the **superior mesenteric** branches of the hepatic portal vein - Pancreatic veins draining the rest of the pancreas do so into the **splenic vein**

Question 38

Describe the anatomical location of the spleen

Answer 38

The **spleen** is an intraperitoneal organ located in the upper left quadrant of the abdomen, under cover of the diaphragm and ribcage

Question 39

The spleen is connected to the stomach and kidney by parts of the greater omentum. Identify and describe these parts

Answer 39

- **Gastrosplenic ligament** connects the spleen to the greater curvature of the stomach - **Splenorenal ligament** connects the hilum of the spleen to the left kidney

Question 40

Describe the blood supply to the spleen

Answer 40

The spleen receives its arterial supply from the **splenic artery** which arises from the coeliac trunk and runs laterally along the superior aspect of the pancreas, within the **splenorenal ligament**

Question 41

Describe the venous drainage of the spleen

Answer 41

- Venous drainage occurs through the **splenic vein** - It combines with the **superior mesenteric vein** to form the **hepatic portal vein**