L4 “Stomach”

Question 1

Location of stomach :

Answer 1

• Left hypochondrium , epigastric ,umbilical regions

Question 2

What is the shape of the stomach?

Answer 2

It’s roughly J- shaped

Question 3

Most of the stomach is protected by:

Answer 3

The lower ribs

Question 4

part of stomach:

Answer 4

• Funds

• body

• pylorus

Question 5

Orifices of stomach:

Answer 5

• cardiac

• pyloric

Question 6

What is the 2 borders of stomach:

Answer 6

Greater curvature

Lesser curvature

Question 7

The pylorus is formed of 3 parts:

Answer 7

• Pyloric antrum

• pyloric canal

• pyloric sphincter

Question 8

What is the site of the cardiac orifice?

Answer 8

• Gasto-esophageal sphincter

• NB. Site for mucosal transition from esophagus to stomach (Z- line)

Question 9

The cardiac orifice consists of :

Answer 9

circular layer of smooth muscle (under vagal and hormonal control).

Question 10

What is the function of cardiac orifice?

Answer 10

Prevent (GER) regurgitation (reflux )

Question 11

Fundus of stomach :

Answer 11

• Dome shaped

• Located to the left cardiac orifice.

• usually full of gas

• In X-Ray film it appears black

• The fundus stores gas produced during digestion

• It doesn’t store any food

Question 12

Body of stomach:

Extends from:

Answer 12

The level of the “fundus” to the level of “incisura Angularis” (A constant notch on the lesser curvature)

Question 13

Lesser curvature:

Answer 13

• Form the right border of stomach
•Extends from the cardiac orifice to the pylorus.
• Attached to the liver by the lesser omentum.

Question 14

Greater curvature :

Answer 14

• Forms the left border of the stomach.

• Extends from the cardiac orifice to the pylorus.

• Its upper part is attached to the spleen by gastrosplenic ligament

• Its lower part is attached to the transverse colon by the greater omentum

• The greater omentum((“Policeman of the Abdomen”) This is due to its immunological function(cover areas of infection with immunologically active tissue)

Question 15

The pyloric antrum extends from……. .

Answer 15

Incisura angularis to the pylorus

Question 16

• The pylorus is a ……… part of the stomach

• It lies in the …….

Answer 16

• Tubular
• Transpyloric plane

Question 17

The pylorus has thick-muscular end called :

Answer 17

pyloric sphincter

Question 18

The cavity of the pylorus is the ……

Answer 18

pyloric canal

Question 19

Posterior surface (stomach bed) related to :

Answer 19

1- splenic flexure colon
2- transverse mesocolon
3- spleen artery
4- pancreas
5 - left kidney
6- left suprarenal gland
7- left crus of diphraagm
8- spleen

** All these structures are separated from stomach by the cavity of lesser sac (except spleen )**

Question 20

Artrial Supply of the stomach :

Rt . Lt. , short Gastric artery :

Answer 20

• Left gastric artery : branch of celiac artery , run along lesser curvature.

• Right gastric artery: from hepatic artery of celiac , run along to left lesser curvature .

• short gastric artery : from splenic artery , pass in gastrosplenic ligament , supply fundus of stomach .

Question 21

Artrial Supply of the stomach :

Rt. Lt. gastroepiploic artery

Answer 21

• left gastroepiploic artery: from splenic artery , pass in gastrosplenice ligament along greater curvature.

• Right gastroepiploic artery : from gastroduodenal artery of hepatic , pass to left greater curvature.

Question 22

Veins of stomach-

Answer 22

1 - Rt. and Lt. Gastric veins, drain into Portal vein

2- Rt. gastroepiploic vein , drain into superior mesenteric vein.

3- Lt . gastroepiploic vein, drain into the splenic vein.

4- short gastric vein, drain into the splenic vein.

Question 23

The lymph vessels follow the arteries , They first drain to the:

Answer 23

• Left and right gastric nodes

• Left and right gastroepiploic nodes

• Short gastric nodes

** all the lymph from the stomach is collected at the celiac nodes.**

Question 24

What is the nasogastric tube?

Answer 24

Is flexible tube is passed through the nose and down the throat to reach the stomach

Question 25

The two purposes of nasogastric tube:

Answer 25

1- To drain the stomach if it’s not working , sometimes happen after surgery

2- provide nourishment (tube feeding) directly into stomach if the patient can’t eat because of intubation