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MBBS 2: Gastrointestinal Tract Anatomy > Anatomy of Esophagus and Stomach > Flashcards

Anatomy of Esophagus and Stomach Flashcards

1
Q

Describe the length of the esophagus?

A

muscular tube 25 cm long and 2 cm in diameter

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2
Q

What is the extent of the esophagus?

A

pharynx to stomach

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3
Q

What are the 4 constrictions of the esophagus?

A
  1. Upper esophageal sphincter - cricopharyngeus muscle
  2. where it is crossed by the aorta
  3. where it is crossed by the left main bronchus
  4. Lower esophageal sphincter where it passes diaphragm
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4
Q

Describe the course of the esophagus?

A
  • follows the curve of vertebral column
  • Passes through esophageal hiatus - T10
  • Turns forward & to the left to enter stomach at cardial orifice
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5
Q

What is the esophagus distally encircled by?

A

esophageal nerve plexus

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6
Q

Where is the esophagus in the abdomen?

A

retroperitoneal

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7
Q

What is peristalsis?

A

food movement

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8
Q

What is the phrenicoesophageal ligament?

A

the ligamet by which the esophagus is attached to the diaphragm

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9
Q

What are the esophageal histological layers?

A
  1. mucosa
  2. submucosa
  3. muscularis externa
  4. adventitia/serosa
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10
Q

What are the layers of the mucosa?

A
  1. surface epithelium
  2. lamina propria
  3. muscularis mucosa - thin smooth muscle
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11
Q

Describe the muscularis externa?

A
  1. inner circular
  2. outer longitudinal
    - Sup 1/3 is skeletal muscle
    - Mid 1/3 - mixed skeletal &
    smooth
    - Inf 1/3 - smooth muscle
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12
Q

Describe the esophageal adventitia and its function?

A

external fibrous layer that covers the esophagus and connects it to neighbouring structures - without or with mesothelium

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13
Q

The right border of the esophagus is continuous with?

A

lesser curvature of stomach

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14
Q

The left border of the esophagus is seperated from fundus by?

A

cardial notch

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15
Q

Describe the esophagogastric junction?

A

at the Z-line there is a change of esophageal (stratified sqaumous) to gastric (simple columnar) mucosa - the esophageal hiatus functions as the lower esophageal sphincter

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16
Q

What is the lower esophageal sphincter?

A

a ring of muscle that forms a valve at the lower end of the esophagus where it joins the stomach

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17
Q

Describe the function of the lower esophageal sphincter?

A

the LES stays closed except during swallowing when it allows food to pass from the esophagus into the stomach

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18
Q

Describe the arterial supply of the esophagus?

A
  1. Left gastric artery branch of celiac trunk

2. left inferior phrenic artery

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19
Q

Describe the venous drainage of the esophagus?

A
  1. portal venous system - left gastric vein

2. systemic venous system - esophageal + azygos veins

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20
Q

Describe the lymphatic drainage of the esophagus?

A

left gastric lymph nodes → celiac lymph nodes

21
Q

Describe the innervation 0f the esophagus?

A
  1. Vagal trunks – anterior and posterior gastric nerves
  2. Thoracic sympathetic trunks
  3. Greater & lesser splanchnic nerves
  4. Esophageal nerve plexus - right + left vagus nerves
22
Q

Describe the anterior relations of the esophagus?

A
  • Trachea
  • aortic arch
  • right pulmonary artery
  • left main bronchus
  • plexus of esophagus
  • pericardium
  • left atrium
  • anterior vagus nerve
23
Q

Describe the posterior relations of esophagus?

A
  • Connected to vertebral column
  • posterior intercostal arteries
  • azygos vein
  • hemiazygos vein
  • anterior wall of aorta
  • posterior vagal nerve
  • pleura
24
Q

Describe the left side relations of the stomach?

A
  • aortic arch
  • left subclavian artery
  • left inferior laryngeal nerve
  • left vagus nerve
  • thoracic ductus
  • thoracic part of aorta
25
Q

Describe the right side relations of the esophagus?

A
  • Azygos vein
  • pleura of mediastinum
  • right main bronchus
  • right vagus nerve
26
Q

What is the location of the stomach?

A

upper left quadrant of the abdomen

27
Q

What are the regions of the stomach?

A
  1. cardia
  2. fundus
  3. body
  4. pyloric
28
Q

The lesser curvature is associated with?

A

lesser omentum

29
Q

Describe the function of the lesser omentum?

A

connects lesser curvature & proximal part of duodenum to liver through the hepatogastric & hepatoduodenal ligaments

30
Q

Describe the ligaments of the lesser omentum?

A
  1. hepatogastric
  2. hepatoduodenal
    • the hepatic artery proper
    • common bile duct
    • portal vein
31
Q

The greater curvature is associated with?

A

greater omentum

32
Q

What is the greater omentum?

A

the largest peritoneal fold which arises from stomach and superior duodenum and hangs down over intestines + is filled with fat
- Transverse colon & its mesentery are fused to posterior aspect of omentum

33
Q

Function of the greater omentum?

A

it moves to site of infection and adheres to it - preventing spreading

34
Q

What are the 4 layers of the stomach wall?

A
  1. mucosa 2. submucosa 3. muscularis externa 4. adventitia/serosa
35
Q

Describe the mucosa?

A

has folds - gastric rugae to permit stomach distension

36
Q

Describe the muscularis?

A

has 3 layers - longitudinal, circular & oblique

37
Q

What are the anterior relations of the stomach?

A
  1. diaphragm
  2. liver - left lobe
  3. abdominal wall
38
Q

What are the posterior relations of the stomach?

A
  1. omental bursa 2. pancreas
39
Q

Describe what is on the stomach bed from superior to inferior?

A
  1. left dome of diaphragm
  2. spleen
  3. left kidney and suprarenal gland
  4. splenic artery
  5. pancreas
  6. transverse mesocolon and colon
40
Q

Describe the arterial supply of the stomach?

A
  1. left and right gastric arteries - supply lesser curvature
    2. Right gastro-omental art. (gastroepiploic art) - branch of gastroduodenal art - supply greater curvature
    3. Left gastro-omental art - branch of splenic artery
    4. short gastric arteries
41
Q

Describe the venous drainage of the stomach?

A
  1. right and left gastric veins - drain into hepatic portal vein
  2. Short Gastric vein and Left gastro-omental vein - drain into the Splenic Vein
  3. Splenic Vein + Superior Mesenteric Vein (SMV) → form the Hepatic Portal Vein
  4. The right gastro-omental vein drain into the SVM
  5. Prepyloric vein ascend the pylorus and empties into the right gastric vein
42
Q

Function of the prepyloric vein?

A

the Prepyloric vein is very obvious in the living, so its used by surgeons as a landmark to identify the pylorus

43
Q

Describe the lymphatic drainage of the stomach?

A
  1. gastric lymphatic vessels
    2. gastric & gastro-omental lymph nodes
    3. celiac lymph nodes
    4. Pancreaticosplenic nodes
    5. Pancreaticoduodenal nodes
44
Q

Describe the innervation of the stomach?

A
  1. Parasympathetic nerve supply : Ant & post vagal trunks – ant & post gastric nerves
    2. Sympathetic from T6-T9 passes to celiac plexus through - Greater splanchnic nerves
45
Q

Describe what causes the displacement of the stomach?

A

pancreatic pseudocysts + abscesses in omental bursa may push stomach anterior

46
Q

What is a hiatus hernia?

A

protrusion of part of stomach into mediastinum through esophageal hiatus - sliding hiatus hernia & paraesophageal

47
Q

What is a congenital diaphragmatic hernia?

A

posterolateral defect in diaphragm where the bowel, stomach or even the liver can move into the chest cavity

48
Q

What is the consequence of gastro-oesophageal reflex disease (GORD)?

A
  1. causes epigastric discomfort & regurgitation of acidic stomach content
  2. ulceration of oesophagus may occur
49
Q

What is the consequence of a gastric ulcer?

A
  1. gastric ulcer in the posterior of stomach wall may erode splenic artery causing haemorrhage
  2. it may also erode pancreas, giving pain referred to the back

MBBS 2: Gastrointestinal Tract Anatomy (7 decks)

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