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Phase 1 - Anatomy > Anatomy - The Stomach > Flashcards

Anatomy - The Stomach Flashcards

1
Q

Name the 4 main regions of the stomach.

A
  1. Cardia. 2. Fundus. 3. Body. 4. Pylorus.
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2
Q

What vertebral levels does the stomach lie between?

A

T7 to L3.

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3
Q

What are the folds of the internal stomach surface called?

A

Rugae.

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4
Q

Name the 2 sphincters of the stomach.

A
  1. Inferior oesophageal sphincter. 2. Pyloric sphincter.
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5
Q

Which sphincter of the stomach is physiological (containing no sphincteric muscle)?

A

The inferior oesophageal sphincter.

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6
Q

What forces act on the inferior oesophageal sphincter?

A
  • The diaphragm exerts pressure on the hiatus.
  • The lumen is collapsed in the normal state
  • The oesophagus enters the stomach at a right angle; when the stomach is full this is closed off.
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7
Q

What is the function of the pyloric sphincter?

A

Controls the exit of chyme from the stomach.

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8
Q

What vertebral level is the coeliac trunk found?

A

T12.

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9
Q

Where does the foregut begin and end?

A

The mouth to the 2nd part of the duodenum (major duodenal papilla).

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10
Q

What is the blood supply to the greater curvature of the stomach?

A

The short gastrics, and the right and left gastro-epiploic arteries.

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11
Q

What is the blood supply to the lesser curvature of the stomach?

A

The left and right gastric arteries.

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12
Q

What is the right gastric artery a branch of?

A

The proper hepatic artery which arises from the common hepatic artery from the coeliac trunk.

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13
Q

What is the right gastro-epiploic artery a branch of?

A

It is the terminal branch of the gastroduodenal artery, this arises from the common hepatic artery which arises from the coeliac trunk.

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14
Q

What is the left gastro-epiploic artery a branch of?

A

The splenic artery which arises from the coeliac trunk.

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15
Q

What vein does venous blood from the GI tract, liver and spleen drain into?

A

The hepatic portal vein (goes to the liver).

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16
Q

What supplies sympathetic innervation to the stomach (foregut)?

A

The greater splanchnic nerve (T5-T9).

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17
Q

What supplies parasympathetic innervation to the stomach (foregut)?

A

The Vagus nerve Cn 10.

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18
Q

Is contraction of the stomach sphincters a sympathetic or parasympathetic action?

A

Sympathetic. (Parasympathetic = rest and digest).

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19
Q

At what vertebral level does the oesophagus pass through the stomach?

A

T10.

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20
Q

What structures pass through the diaphragm along side the oesophagus?

A

Vagus nerves and the oesophageal arteries and veins.

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21
Q

What does the left gastric artery supply?

A

The superior part of the lesser curvature of the stomach.

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22
Q

What structures lie anterior to the stomach?

A

The anterior abdominal wall and the left lobe of the liver.

23
Q

What nerve lies anterior to the abdominal oesophagus and which posterior?

A

Left vagus - anterior. Right vagus - posterior. (LARP)

24
Q

What are the 3 major branches of the Coeliac trunk?

A

The left gastric, the splenic and the common hepatic.

25
Q

What does the left gastric artery supply?

A

The lesser curvature of the stomach and lower oesophagus.

26
Q

What branches does the splenic artery give off?

A
  • The short gastric arteries. - The pancreatic arteries. - The left gastroepiploic artery. - 5 branches just before it reaches the Spleen.
27
Q

What do the short gastric arteries supply?

A

The greater curvature of the stomach.

28
Q

What does the left gastroepiploic artery supply? What does anastomose with?

A

It supplies the greater curvature of the stomach. It anastomoses with the right gastroepiploic artery.

29
Q

Name the 2 branches of the common hepatic artery.

A
  1. Proper hepatic artery. 2. Gastroduodenal artery.
30
Q

Name the 2 branches of the Gastroduodenal artery.

A
  1. Right gastroepiploic artery (supplies greater curvature of the stomach). 2. Superior pancreaticoduodenal artery (supplies head of pancreas).
31
Q

In which two abdominal regions would you find the stomach?

A

epigastric and umbilical

32
Q

Describe the four main anatomical divisions of the stomach?

A
  • cardia - surrounds a superior opening of the stomach (T11)
  • fundus - the rounded, often gas-filled portion superior to and left of the cardia
  • body - the largest central portion inferior to the fundus
  • pyloras - the area connects the stomach to the duodenum
    • atrium, canal and sphincter
    • Sphincter marks the transpyloric plane at the level of L1
33
Q

Describe the greater curvature?

A
  • Long, convex lateral border of the stomach
  • Arises from the cardiac notch, arches backwards and passes Inferiorly to the left
  • curves to the right and continues medially to reach the pyloric atrium
  • supplied by short gastric arteries and the right and left gastroepiploic arteries
34
Q

Describe the lesser curvature?

A
  • Forms the shorter, concave, medial surface of the stomach
  • most inferior part, the angular notch, Indicates the junction of the body and the pyloric region
  • gives attachment to the hepatogastric Ligament
  • supplied by the left gastric artery and the right gastric branch of the hepatic artery
35
Q

Describe the inferior oesophageal sphincter?

A
  • the oesophagus passes through the diaphragm through the oesophageal hiatus at the level of T10
  • inferior oesophageal sphincter is at T11
  • allows food to pass through the cardiac orifice into the stomach
  • not under voluntary control
36
Q

Describe the pyloric sphincter?

A
  • between the pylorus and the first part of the duodenum
  • controls the exit of chyme from the stomach
  • Is an anatomical sphincter, so contain smooth muscle that constrict to limit the discharge of stomach contents passing through
  • stomach emptying occurs intermittently when intra-gastric pressure overcomes the resistance of the pylorus
  • The pylorus is normally contracted but gastric peristalsis pushes chyme into the duodenum
37
Q

Describe the greater omentum?

A
  • Double layer of peritoneum
  • Hangs down from the greater curvature of the stomach
  • folds back on itself to attach to the transverse colon
  • contains many lymph nodes as it plays a role in immunity and reducing the spread of intra-peritoneal infections
38
Q

Describe the lesser omentum?

A
  • continuous with the peritoneal layers of the stomach and duodenum
  • arises from the lesser curvature and attaches to the liver
  • main function is to attach the stomach and duodenum to the liver
39
Q

Describe the neurovascular supply of the stomach’s Lesser curvature?

A
  • arterial supply from the coeliac trunk (and branches)
    • left gastric artery
  • right gastric artery (branch from the common hepatic artery)
40
Q

Describe the vascular supply of the stomach’s greater curvature?

A
  • left gastroepiploic artery (Branch of the splenic artery)
  • right gastroepiploic artery (Branch of the gastroduodenal artery)
  • short gastric artery ( branch of the splenic artery)
41
Q

What is the venous drainage from the stomach?

A
  • veins of the stomach run parallel to the arteries
  • left and right gastric veins drain into the hepatic portal vein
  • short gastric vein drains into the superior mesenteric vein
42
Q

How’s the stomach innervated?

A
  • from the autonomic nervous system
  • Parasympathetic nerve supply - anterior and posterior vagal trunks (CN X)
  • sympathetic nervous supply - T5-9, passes to the coeliac plexus via the greater splanchnic nerve
43
Q

How is lymph collected in the stomach?

A
  • the gastric lymphatic vessels travel with the arteries along the greater and lesser curvature of the stomach
  • drains into the gastric and gastro-omental lymph nodes
  • drain into the coeliac lymph nodes located on the posterior abdominal wall
44
Q

What are Rugae?

A
  • Folds of the mucosa allowing for greater surface area for stretching of the stomach to accommodate food
45
Q

What is the gastric bed? where is it found and what does it contain?

A
  • behind the lesser sac is the pancreas, splenic artery, and part of the duodenum
46
Q

What is the clinical relevance of a peptic ulcer?

A
  • damage to the mucosa due to the high acidity of the stomach
  • the ulcer may erode through the gastric wall into adjacent structures
  • including blood vessels and the structures of the gastric bed
  • May spread by the lymphatics to the coeliac axis or veins to the liver
47
Q

Describe the coeliac trunk?

A
  • artery in the foregut, branches in front of the aorta just below the diaphragm
  • supplies from the lower third of the oesophagus the second part of the duodenum
  • also supplies the liver and parts of the pancreas
48
Q

Where do veins in the lower third of the oesophagus usually drain into? What is its clinical relevance?

A
  • hepatic portal vein and veins in the chest that drain into the superior vena cava
  • in cirrhosis, the portal venous channels become progressively smaller so blood flow is redirected to flow up the veins of the oesophagus and into the superior vena cava
    • called porto-systemic shunt via a porto-systemic anastomosis
    • causes varicose veins of the oesophagus that bleed easily
49
Q

Where do peptic ulcers commonly form?

A
  • posterior wall of the first part of the duodenum
  • can a row the duodenal wall into the gastroduodenal artery
  • causing very brisk bleeding
50
Q

At what level does the oesophagus pass through the diaphragm? which structures accompany it?

A
  • T10
  • vagal trunks, inferior oesophageal artery and vein
51
Q

What structure attaches the stomach to the liver?

A
  • the lesser omentum
52
Q

What structures lie in front and behind the stomach?

A
  • left lobe of the liver, anterior abdominal wall
  • the lesser sac, and behind that the pancreas and diaphragm
53
Q

Hypertrophy of the pyloric sphincter can cause what?

A

Vomiting of gastric contents.

54
Q

What is the nerve supply of the stomach?

A

Parasympathetic nerve supply comes from the posterior and anterior vagal trunks, derived from the vagus nerve. Sympathetic from the celiac plexus.

Phase 1 - Anatomy (29 decks)

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