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ESA 3 - GI Anatomy > Functional and Applied Anatomy of the Stomach > Flashcards

Functional and Applied Anatomy of the Stomach Flashcards

1
Q

What is the stomach?

A

The expanded part of the GI tract between the oesophagus and duodenum

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2
Q

What is the stomach specialised for?

A

The accumulation of ingested food

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3
Q

How much food can the adult stomach hold?

A

2 to 3 litres

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4
Q

What does the adult stomach loook like?

A

Resembles the letter J, but the size and position of teh stomach varies1

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5
Q

What does the size and position of the stomach vary depending on?

A
  • Body shape
  • Degree of distention
  • Posture
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6
Q

What are the structural features of the stomach?

A
  • Five recognisable parts
  • Greater and lesser curvature
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7
Q

What are the five recognisable parts of the stomach?

A
  • Cardia
  • Fundus
  • Body
  • Antrum
  • Pylorus
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8
Q

What are the curvatures of the stomach?

A
  • Greater
  • Lesser
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9
Q

Label this diagram

A
  • A - Oesophagus
  • B - Cardiac notch of the stomach
  • C - Cardia
  • D - Fundus
  • E - Body
  • F - Lesser curvature of the stomach
  • G - Greater curvature of the stomach
  • H - Pylorus
  • I - Antrum
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10
Q

Where do sphincters exist in the stomach?

A

At the entry and exit parts of the stomach

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11
Q

Where does the oesophagogastric junction lie?

A

To the left of the T11 vertebra on the horizontal plane that passes through the tip of the xiphoid process

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12
Q

What is meant by the Z-line?

A

The line where the mucosa abruptly changes from oesophageal to gastric

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13
Q

What happens immediately superior to the Z-line?

A

The diaphragmatic musculature forming the oesophageal hiatus functions that contracts and relaxes

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14
Q

What is the purpose of the physiological sphincter formed by the diaphragmatic musculature?

A

Prevents the reflux of stomach contents

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15
Q

What anatomical feature does the diaphragmatic musculature sphincter work with to prevent reflux of the stomach contents?

A

Cardiac notch

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16
Q

How common is reflux of the gastric contents into the oesophagus?

A

Common

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17
Q

When can reflux of the gastic contents into the oesophagus be problematic?

A

If it is frequent and/or clearance of reflux material is deficient

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18
Q

What can happen if reflux of gastric contents is frequent and/or clearance of reflux material is deficient?

A

‘Heartburn’ and/or inflammation with ulceration may result

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19
Q

What may chronic reflux result in?

A

Metaplastic changes in the mucosa (Barrett’s oesophagus)

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20
Q

Label this diagram

A
  • A - Diaphragm
  • B - Endothoracic fascia
  • C - Pleura
  • D - Upper limb of phrenoico-oesophageal ligament
  • E - Endoabdominal fascia
  • F - Cardial notch
  • G - Lower limb of phrenico-oesophageal ligament
  • H - Cardial orifice of stomach
  • I - Oesophagogastric junction (Z-line)
  • J - Peritoneum
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21
Q

Where is the pyloric sphincter located?

A

At the pyloric end of the stomach obviously

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22
Q

What produces the pyloric sphincter?

A

The circular muscle coat is thickened

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23
Q

What does the pyloric sphincter do?

A

Controls the discharge of the stomach contents through the pyloric orifice into the duodenum

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24
Q

Label this diagram

A
  • A - Pyloric part of stomach
  • B - Pyloric orifice
  • C - Duodenum
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25
Q

What happens to the gastric mucosa when empty?

A

It is thrown into longitudinal folds called rugae, and a gastric canal forms temporarily

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26
Q

Where does the gastric canal form?

A

Between the gastric folds along the lesser curvature

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27
Q

What is the purpose of the gastric canal?

A

Allows saliva and other fluids (and small amounts of chewed food) to pass along to the pylorus

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28
Q

What are the histologically distinct zones of the gastric mucosa?

A
  • Cardia
  • Fundus and body
  • Pyloric
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29
Q

What cells are found in the cardia mucosa?

A

Neck cells

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30
Q

What do neck cells in the cardia produce?

A

Mucus

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31
Q

What cells are found in the fundus and body mucosa?

A
  • Neck cells
  • Parietal
  • Chief
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32
Q

What do neck cells in the fundus and body produce?

A

Mucus

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33
Q

What do parietal cells in the fundus and body produce?

A

Acid

34
Q

What do chief cells in the fundus and body mucosa produce?

A

Pepsinogen

35
Q

What cells are found in the pyloric mucosa?

A
  • Neck cells
  • G-cells
36
Q

What do the neck cells in the pyloric mucosa produce?

A

Mucus

37
Q

What do G-cells in the pyloric mucosa produce?

A

Gastrin

38
Q

Label this diagram

A
  • A - Gastic pit (opening to the gastric gland)
  • B - Mucous epithelium
  • C - Lymphatic vessel
  • D - Lamina propria
  • E - Muscularis mucosae
  • F - Submucosa
  • G - Oblique muscle
  • H - Circular muscle
  • I - Longitudinal muscle
  • J - Serosa
  • K - Myenteric plexus
  • L - Gastric pit
  • M - Gastric gland
  • N - Mucous cells
  • O - Neck
  • P - Parietal cells
  • Q - Chief cells
  • R - Smooth muscle cel
  • S - G cell
39
Q

Where do peptic ulcers commonly occur?

A

In the antrum and along the lesser curvature of the stomach

40
Q

What does perforation of peptic ulcers lead to?

A

Spillage of gastric contents into the peritoneal cavity

41
Q

What may be the result of spillage of gastric contents into the peritoneal cavity?

A

Affects abdominal structures

42
Q

What abdominal stuctures may be affected by the spilling of gastric contents into the peritoneal cavity?

A

Pancreas and associated blood vessels lying in close proximity to the stomach

43
Q

What is the greater omentum?

A

A prominent, four-layered peritoneal fold that hangs down like an apron from the greater curve of the stomach

44
Q

What happens to the greater omentum after descending?

A

It folds back and attaches to the anterior surface of the transverse colon and its mesentery

45
Q

What is the lesser omentum?

A

A much smaller, double-layered peritoneal fold that connects the lesser curvature of the stomach and the proximal part of the duodenum to the liver

46
Q

What does the lesser omentum connect the stomach to?

A

The portal triad

47
Q

What is the epiploic foramen (omental foramen)?

A

An opening

48
Q

What is the importance of the epiploic foramen?

A

The greater and lesser sacs communicate through it

49
Q

Where is the epiploic foramen situated?

A

Posterior to the free edge of the lesser omentum (hepatoduodenal ligament)

50
Q

How can the omental foramen be located?

A

By running a finger along the gall bladder to free the edge of the lesser omentum

51
Q

How many fingers does the omental foramen usually admit?

A

Two fingers

52
Q

Label this diagram

A
  • A - Diaphragm
  • B - Falciform ligament
  • C - Liver
  • D - 7th rib
  • E - Porta hepatis
  • F - Lesser omentum
  • G - Finger is inserted through omental forament into omental bursa
  • H - Gallbladder
  • I - Costodiaphragmatic (pleural) recess
  • J - 10th rib
  • K - 11th costal cartilage
  • L - Transversus abdominis muscle
  • M - Oesophagus
  • N - Diaphragm
  • O - Stomach
  • P - Greater omentum, gastrocolic portion
  • Q - Anastomosis between right and left gastro-omental arteries
  • R - Transverse colon appearing in an unusal gap in the greater omentum
53
Q

What does the coeliac trunk originate from?

A

The abdominal aorta

54
Q

What does the coeliac trunk give rise to?

A

The left gastric, splenic, and common hepatic arteries

55
Q

Label this diagram

A
  • A - Left gastric artery
  • B - Celiac trunk
  • C - Right and left branches
  • D - Cystic artery
  • E - Hepatic artery proper
  • F - Right gastric artery
  • G - Common hepatic artery
  • H - Gastroduodenal artery
  • I - Supraduodenal artery
  • J - Superior pancreaticoduodenal artery
  • K - Right gastro-omnetal artery
  • L - Abdominal aorta
  • M - Left gastro-omental artery
  • N - Spleen
  • O - Splenic branches
  • P - Short gastric arteries
  • Q - Splenic artery
  • R - Posterior gastric artery
  • S - Aortic hiatus
56
Q

What does the rich arterial blood supply of the stomach arise from?

A

The celiac trunk and its branches

57
Q

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

A
  • Left gastric artery
  • Right gastric artery
58
Q

What does the left gastic artery arise from?

A

Coeliac trunk

59
Q

What does the right gastric artery arise from?

A

Coeliac trunk -> Common hepatic

60
Q

What is the arterial supply to the greater curvature?

A
  • Left gastro-omental
  • Right gastro-omental
61
Q

What does the left gastro-omental artery arise from?

A

Coeliac trunk -> Splenic

62
Q

What does the right gastro-omental artery arise from?

A

Coeliac trunk -> Common hepatic -> Gastroduodenal

63
Q

What is the arterial supply to the fundus and body of the stomach?

A

Posterior gastric/small gastric

64
Q

What is the arterial supply to the fundus and body?

A

Coeliac trunk -> Splenic

65
Q

What do the veins of the stomach do?

A

Parallel the arteries in position and course

66
Q

What does the left gastric vein follow?

A

The course of the left gastric artery

67
Q

What does the left gastrin vein drain into?

A

The hepatic portal vein

68
Q

What does the right gastric vein follow?

A

The course of right gastric artery

69
Q

What does the right gastric vein drain into?

A

The hepatic portal vein

70
Q

What does the short gastric vein follow?

A

The course of the short gastric artery

71
Q

What does the short gastric vein drain into?

A

The splenic vein

72
Q

What does the splenic vein join?

A

Superior mesenteric vein

73
Q

What is formed from the joining of the splenic vein and SMV??

A

Hepatic portal vein

74
Q

What does the left gastro-omental vein follow?

A

The course of the left gastro-omental artery

75
Q

What does the left gastro-omental vein drain into?

A

The splenic vein

76
Q

What does the right gastro-omental vein follow?

A

The right gastro-omental artery

77
Q

What does the right gastro-omental vein drain into?

A

The superior mesenteric vein

78
Q

Label this diagram

A
  • A - Left gastric vein
  • B - Right gastric vein
  • C - Portal vein
  • D - Prepyloric vein
  • E - Pylorus
  • F - Pancreaticoduodenal veins
  • G - Duodenum
  • H - Superior mesenteric vein
  • I - Inferior mesenteric vein
  • J - Right gastro-omental vein
  • K - Splenic vein
  • L - Left gastro-omental vein
  • M - Middle gastric vein
  • N - Short gastric vein
79
Q

What are the categories of causes of inflammation of the stomach (gastritis)?

A
  • Acute
  • Chronic
80
Q

What can cause acute gastritis?

A
  • NSAIDS
  • Alcohol
  • Exfoliation of the surface epithelial cells and decreased secretion of protective mucus
81
Q

What can cause chronic gastritis?

A
  • Infection with the bacteria H. Pylori
  • Inflammatory changes in the mucosa result in atrophy and epithelial metaplasia
82
Q

What may gastric epithelial metaplasia develop into?

A

Carcinoma

ESA 3 - GI Anatomy (3 decks)

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