Anatomy Of The Stomach

Question 1

The stomach is also called the —- or —- from which we have the adjective gastric applied to structures related to the organ.

Answer 1

The stomach is also called the gaster or venter from which we have the adjective gastric applied to structures related to the organ.

Question 2

The location of the stomach using the 9 region divisions

Answer 2

Left hypochondriac
Epigastric
Umbilical

Question 3

Shape and Position
The shape depends upon the degree of its distension and that of the surrounding viscera, e.g. the colon.
When empty, the stomach is somewhat —- -shaped (vertical); when partially distended, it becomes —— in shape.
In obese persons, it is more ——. The shape of the stomach can be studied in the living by radiographical examination after giving a —— meal.

Answer 3

Shape and Position
The exact size, shape and position of the stomach can vary from person to person and with position and respiration.
The shape depends upon the degree of its distension and that of the surrounding viscera, e.g. the colon.
When empty, the stomach is somewhat J-shaped (vertical); when partially distended, it becomes piriform in shape.
In obese persons, it is more horizontal. The shape of the stomach can be studied in the living by radiographical examination after giving a barium meal.

Question 4

Size & Capacity
•The stomach is a very distensible organ. It is about —-cm long
• The mean capacity is: one ounce (—ml) at birth, • one liter (——ml) at puberty,
• — to —liters or more in adults.

Answer 4

Size & Capacity
•The stomach is a very distensible organ. It is about 25 cm long
• The mean capacity is: one ounce (30 ml) at birth, • one liter (1000 ml) at puberty,
• 11⁄2 to 2 liters or more in adults.

Question 5

List the External Features

Answer 5

Eternal Features of the stomach can be best remembered by “twos”.
Two openings Cardiac orifice Pyloric orifice
Two curvatures Lesser curvature Greater curvature
Two surfaces Antero superior Postero inferior
•Two omenta Lesser omentum Greater omentum
•Two gastric nerves Anterior (Left vagal trunk) Posterior (Right vagal trunk)

Question 6

List the parts of the stomach

Answer 6

Parts:
Cardiac region
Fundus
Body
Pylorus

Question 7

The pylorus is formed by

Answer 7

Pyloric antrum
Pyloric canal
Pyloric sphincter

Question 8

Openings
• (a) The cardiac orifice: separates the oesophagus from the stomach, lies at the lower border of the body of the —-th thoracic vertebra behind the—-th left costal cartilage and about —- cm to the left of its chondro sternal junction. There is physiological evidence of sphincteric action at this site, but a sphincter cannot be demonstrated anatomically.
• (b) Pyloric orifice:The pyloric orifice opens into the ——-.
In an empty stomach and in the supine position, it lies —-cm to the right of
median plane, at the level of lower border of vertebra L—or —— plane.
• lies at the transpyloric plane (L1) —- cm to the right of the median plane.
• It can be indicated on the surface of the stomach by a ——-, the pyloric constriction produced by the pyloric sphincter and identified by the —- vein which runs vertically across its anterior surface.

Answer 8

Openings
• (a) The cardiac orifice: separates the oesophagus from the stomach, lies at the lower border of the body of the 11th thoracic vertebra behind the 7th left costal cartilage and about 2.5 cm to the left of its chondro sternal junction. There is physiological evidence of sphincteric action at this site, but a sphincter cannot be demonstrated anatomically.
• (b) Pyloric orifice:The pyloric orifice opens into the duodenum.
In an empty stomach and in the supine position, it lies 1.2 cm to the right of
median plane, at the level of lower border of vertebra L1 or transpyloric plane.
• lies at the transpyloric plane (L1) 1.25 cm to the right of the median plane.
• It can be indicated on the surface of the stomach by a circular groove, the pyloric constriction produced by the pyloric sphincter and identified by the prepyloric vein which runs vertically across its anterior surface.

CARDIAC ORIFICE
• It is the site of the gast

Question 9

Cardiac orifice

It is the site of the gastro- esophageal sphincter.
• It is a —— rather than an ——, sphincter.
• Consists of a —— layer of smooth muscle (under —- and —- control).
• Function:——
• NB. Notice the abrupt mucosal transition from esophagus to stomach (it is called——)

Answer 9

It is the site of the gastro- esophageal sphincter.
• It is a physiological rather than an anatomical, sphincter.
• Consists of a circular layer of smooth muscle (under vagal and hormonal control).
• Function:
• Prevents (GER) regurgitation (reflux)
• NB. Notice the abrupt mucosal transition from esophagus to stomach (Z- line)

Question 10

Two Curvatures
•The lesser curvature is (concave/convex?)and forms the —— border of the stomach. It provides attachment to the —— omentum. The most dependent part of the curvature is marked by the —- notch or ———.
•The greater curvature is (concave/convex?) and forms the —— border of the stomach..

Answer 10

Two Curvatures
•The lesser curvature is concave and forms the right border of the stomach. It provides attachment to the lesser omentum. The most dependent part of the curvature is marked by the angular notch or incisura angularis.
•The greater curvature is convex and forms the left border of the stomach.

Question 11

• The greater curvature gives attachment to the following dorsal mesenteries starting from above.
1.
2.
3.

Answer 11

• The greater curvature gives attachment to the following dorsal mesenteries starting from above.
1. Gastro phrenic ligament
2. Gastro splenic ligament
3. Greater omentum

Question 12

•
The gastro epiploic vessels lie between the two layers of the —— at its point of attachment to the ——-.
At its upper end, the greater curvature presents the —- notch which separates it from the oesophagus.

Answer 12

•
The gastro epiploic vessels lie between the two layers of the greater omentum at its point of attachment to the greater curvature.
At its upper end, the greater curvature presents the cardiac notch which separates it from the oesophagus.

Question 13

•
The gastro epiploic vessels lie between the two layers of the —— at its point of attachment to the ——-.
At its upper end, the greater curvature presents the —- notch which separates it from the oesophagus.

Answer 13

•
The gastro epiploic vessels lie between the two layers of the greater omentum at its point of attachment to the greater curvature.
At its upper end, the greater curvature presents the cardiac notch which separates it from the oesophagus.

Question 14

Anatomical division of the stomach
• The stomach has four main anatomical divisions; the cardia, fundus, body and pylorus:
• —— – surrounds the superior opening of the stomach at the T11 level.
• ——- – the rounded, often gas filled portion superior to and left of the cardia.
• —— – the large central portion inferior to the fundus.
• —— – This area connects the stomach to the duodenum. It is divided into the pyloric antrum, pyloric canal and pyloric sphincter. The pyloric sphincter demarcates the transpyloric plane at the level of L—.

The pyloric antrum is —- inches long
The pyloric canal is —— inches long

Answer 14

Anatomical division of the stomach
• The stomach has four main anatomical divisions; the cardia, fundus, body and pylorus:
• Cardia – surrounds the superior opening of the stomach at the T11 level.
• Fundus – the rounded, often gas filled portion superior to and left of the cardia.
• Body – the large central portion inferior to the fundus.
• Pylorus – This area connects the stomach to the duodenum. It is divided into the pyloric antrum, pyloric canal and pyloric sphincter. The pyloric sphincter demarcates the transpyloric plane at the level of L1.

3inches
1inch

Question 15

Interior of Stomach
• The stomach has to be opened to see its internal structure.
• The mucosa of an empty stomach is thrown into folds termed as ——-.
• The rugae are longitudinal along the —— curvature and are —— elsewhere. The rugae are —- in a distended stomach.

Answer 15

Interior of Stomach
• The stomach has to be opened to see its internal structure.
• The mucosa of an empty stomach is thrown into folds termed as gastric rugae.
• The rugae are longitudinal along the lesser curvature and are irregular elsewhere. The rugae are flattened in a distended stomach.

Question 16

Interior of Stomach
• On the mucosal surface there are numerous small depressions that can be seen with a hand lens. These are the ——-.
The —————- open into these pits. The parts of the lumen of the stomach that lies along the lesser curvature, and has longitudinal rugae, is called the ——-or ——-. This canal allows rapid passage of swallowed liquids along the lesser curvature directly to the lower part before it spreads to the other parts of stomach.
• Thus the lesser curvature bears maximum insult of the swallowed liquids, which makes it vulnerable to ——-

Answer 16

Interior of Stomach
• On the mucosal surface there are numerous small depressions that can be seen with a hand lens. These are the gastric pits. The gastric glands open into these pits. The parts of the lumen of the stomach that lies along the lesser curvature, and has longitudinal rugae, is called the gastric canal or magenstrasse. This canal allows rapid passage of swallowed liquids along the lesser curvature directly to the lower part before it spreads to the other parts of stomach.
• Thus the lesser curvature bears maximum insult of the swallowed liquids, which makes it vulnerable to peptic ulcer

Question 17

Two Surfaces
•The anterior or —- surface faces —- and ——-.
•The posterior or ——— surface faces ——- and ———.

Answer 17

Two Surfaces
•The anterior or anterosuperior surface faces forwards and upwards.
•The posterior or posteroinferior surface faces backwards and downwards.

Question 18

——— separates the pyloric antrum from the pyloric canal

Answer 18

Intermediate sulcus

Question 19

SURFACES
• (a) The antero superior surface faces upwards and forwards and is related to the ————- on its left part and to the ——————-on the right part.
• (b) The postero inferior surface facing backwards and downwards is related to the structures of the stomach bed which is formed by the following:
.
• All there structures are separated from the stomach by the ——or ——-.

Answer 19

Anterosuperior surface
On the left: diaphragm, transversus abdominis. Spleen
On the right side: left and quadrate love of the liver, AAW, transverse colon

Posteroinferior surface
Dr. SS kills patients cruelly and mercilessly
Diaphragm, left suprarenal gland, left kidney, splenic artery, left colic flexure(splenic flexure), transverse mesocolon,body of pancreas,left crus of diaphragm

All there structures are separated from the stomach by the omental bursa or lesser sac.

Question 20

The structures related to the posteroinferior surface of the stomach are called—-

Answer 20

Stomach bed

Question 21

Blood supply of the stomach

Answer 21

Left gastric
Right gastric
Left gastroepiploic
Right gastroepiploic
Short gastric branches

Question 22

Venous drainage of the stomach
They all drain into the ——-

Answer 22

They all drain into the portal circulation
-Right and left gastric vein drain directly into the portal vein
-short gastric veins and left gastroepiploic vein join the splenic vein
-right gastroepiploic vein drain into the superior mesenteric vein

Question 23

The pyloric sphincter is marked externally( anteriorly) by a vein called

Answer 23

Prepyloric vein of Mayo

Question 24

Innervation
The stomach receives innervation from the autonomic nervous
system:
Parasympathetic nerve supply arises from the anterior and posterior vagal trunks, derived from the —- nerve.
Sympathetic nerve supply arises from the T—to-T—- spinal cord segments and passes to the coeliac plexus via the —— nerve. It also carries some pain transmitting fibres

Answer 24

Innervation
The stomach receives innervation from the autonomic nervous
system:
Parasympathetic nerve supply arises from the anterior and posterior vagal trunks, derived from the vagus nerve.
Sympathetic nerve supply arises from the T6-T9 spinal cord segments and passes to the coeliac plexus via the greater splanchnic nerve. It also carries some pain transmitting fibres

Question 25

Lymphatic drainage of the stomach

• The lymph vessels follow the arteries.
• They first drain to the:
– ———-
• Ultimately, all the lymph from the stomach is collected at the —— nodes.

Answer 25

• The lymph vessels follow the arteries.
• They first drain to the:
– Left and right gastric nodes
– Left and right gastroepiploic nodes and the
– Short gastric nodes
• Ultimately, all the lymph from the stomach is collected at the celiac nodes.

Question 26

Lymphatics

• The gastric lymphatic vessels travel with the arteries along the —- and —— of the stomach.

• Lymph fluid drains into the —- and —- lymph nodes found at the curvatures.

• Efferent lymphatic vessels from these nodes connect to the —- lymph nodes, located on the —— wall.

Answer 26

• The gastric lymphatic vessels travel with the arteries along the greater and lesser curvatures of the stomach.
• Lymph fluid drains into the gastric and gastro-omental lymph nodes found at the curvatures.
• Efferent lymphatic vessels from these nodes connect to the coeliac lymph nodes, located on the posterior abdominal wall.

Question 27

APPLIED ANATOMY
• 1. ———- is found at birth from hypertrophy of the circular muscle fibres of the pyloric sphincter.
• 2. Blood vessels and lymphatics of stomach are continuous with the —— but not ——-. Therefore carcinoma of stomach tends to spread to —- but not ——.
• 3. The interior of the stomach can be visualised — by —— meal or with the use of a —— passed through the mouth and oesophagus into the stomach.

Answer 27

APPLIED ANATOMY
• 1. Congenital hypertrophic pyloric stenosis is found at birth from hypertrophy of the circular muscle fibres of the pyloric sphincter.
• 2. Blood vessels and lymphatics of stomach are continuous with the oesophagus but not duodenum. Therefore carcinoma of stomach tends to spread to oesophagus but not duodenum.
• 3. The interior of the stomach can be visualised — by barium meal or with the use of a gastroscope passed through the mouth and oesophagus into the stomach.

Question 28

APPLIED ANATOMY
• 4. Gastric pain can be felt in the epigastrium because the epigastrium and the stomach are both supplied from segments T— to T— of the spinal cord.
• 5. ——- — a part of the anterosuperior surface of the stomach is in contact with the anterior abdominal wall. This area is bounded by the Inferior border of the liver to the right the left costal margin to the left and the transverse colon below and it is through this area that a gastrotomy is done.

Answer 28

APPLIED ANATOMY
• 4. Gastric pain can be felt in the epigastrium because the epigastrium and the stomach are both supplied from segments T6 to T1O of the spinal cord.
• 5. Gastric Triangle — a part of the anterosuperior surface of the stomach is in contact with the anterior abdominal wall. This area is bounded by the Inferior border of the liver to the right the left costal margin to the left and the transverse colon below and it is through this area that a gastrotomy is done.

Question 29

APPLIED ANATOMY
• 4. Gastric pain can be felt in the —- because it and the stomach are both supplied from segments T6 to T1O of the spinal cord.
• 5. Gastric Triangle — a part of the anterosuperior surface of the stomach is in contact with the anterior abdominal wall. This area is bounded by the Inferior border of the liver to the right the left costal margin to the left and the transverse colon below and it is through this area that a ——- is done.

Answer 29

APPLIED ANATOMY
• 4. Gastric pain can be felt in the epigastrium because the epigastrium and the stomach are both supplied from segments T6 to T1O of the spinal cord.
• 5. Gastric Triangle — a part of the anterosuperior surface of the stomach is in contact with the anterior abdominal wall. This area is bounded by the Inferior border of the liver to the right the left costal margin to the left and the transverse colon below and it is through this area that a gastrotomy is done.

Question 30

Anterosuperior surface
• The left half of this surface is in contact with the ——, which separates it from the ———, the——, and the how manyth to how manyth ribs, and ———of the left side.
• The right half is in relation with the —— and —— lobes of the liver and with the ——

Answer 30

The left half of this surface is in contact with the diaphragm, which separates it from the base of the left lung, the pericardium, and the seventh, eighth, and ninth ribs, and intercostal spaces of the left side.
• The right half is in relation with the left and quadrate lobes of the liver and with the anterior abdominal wall

Question 31

Relations of the Stomach
The posteroinferior surface is in relation with the:
1.
2.
3.
4.
5.
6.
7.
• These structures form a shallow bed, the stomach bed, on which the viscus rest

Answer 31

Relations of the Stomach
The posteroinferior surface and a in relation with the diaphragm, the spleen, the left suprarenal gland, the upper part of the front of the left kidney, the anterior surface of the pancreas, the left colic flexure, and the upper layer of the transverse mesocolon.
is in relation with the diaphragm, the
• These structures form a shallow bed, the stomach bed, on which the viscus rest