S5) Anatomy for Dissection — Stomach, Duodenum, Pancreas Flashcards
Identify the following on the stomach:
- Greater curvature
- Lesser curvature
Identify the following on the stomach:
- Fundus
- Body
- Antrum
Identify the following on the stomach:
- Lower oesophageal sphincter
- Pyloric sphincter
- Cardia
Identify 3 key features in the surface anatomy of the stomach
- Stratified columnar epithelium
- Rugae
- Gastric pits
Describe the superior and inferior anatomical relations of the stomach
- Superior: oesophagus, diaphragm
- Inferior: head and neck of pancreas
Describe the anterior and posterior anatomical relations of the stomach
- Anterior: greater omentum, abdominal wall, left lobe of liver, gall bladder
- Posterior: lesser sac, left kidney, left adrenal gland, splenic artery, common bile duct, gastroduodenal artery
Where can the arterial supply of the stomach be derived from?
Coeliac trunk and its branches
Describe the blood supply to the lesser and greater curvatures of the stomach
- Lesser curvature: anastomoses by the right and left gastric arteries
- Greater curvature: anastomoses by the right and left gastro-omental arteries
Where do the right and left gastric arteries arise from?
- Right gastric – branch of the common hepatic artery, which arises from the coeliac trunk
- Left gastric – arises directly from the coeliac trunk
Where do the right and left gastro-omental arteries arise from?
- Right gastro-omental – terminal branch of the gastroduodenal artery, which arises from the common hepatic artery
- Left gastro-omental – branch of the splenic artery, which arises from the coeliac trunk
The veins of the stomach run parallel to the arteries.
Describe the venous drainage of the of the stomach
- Lesser curvature: right and left gastric veins
- Greater curvature: right and left gastro-omental veins
- Fundus: short gastric veins
Where do the right and left gastric veins drain?
The right and left gastric veins drain into the hepatic portal vein
Where does the short gastric vein, right and left gastro-omental veins drain into?
The short gastric vein, left and right gastro-omental veins ultimately drain into the superior mesenteric vein
What is the coeliac trunk and what does it do?
- The coeliac trunk is a major artery of the abdomen
- It arises from the abdominal aorta, and supplies many of the gastrointestinal viscera
What are the main branches of the coeliac trunk?
The greater and lesser omenta divide the abdominal cavity into two; the greater and lesser sac.
Describe the entrance into the lesser sac
The greater and lesser sacs communicate via the epiploic foramen, a hole in the lesser omentum
Which 3 structures can be found along the free border of the lesser omentum?
Free border of lesser omentum encloses the portal triad
What is the sigmoid mesocolon and what does it do?
- The sigmoid mesocolon is a mesentery that attaches the sigmoid colon to the posterior pelvic wall
- The long length of the mesentery permits this part of the colon to be particularly mobile
What is the mesentery of the small intestine and what does it do?
The small bowel mesentery is a broad fan-shaped fold of peritoneum connecting the loops of jejunum and ileum to the posterior abdominal wall
What is the duodenum and where is it found?
- The duodenum is the most proximal portion of the small intestine
- It runs from the pylorus of the stomach to the duodenojejunal junction
The duodenum can be divided into 4 parts. Identify them
Describe the anatomical position of the superior region of the duodenum
- It ascends upwards from the pylorus of the stomach
- It is connected to the liver by the hepatoduodenal ligament
Describe the anatomical position of the descending region of the duodenum
- It curves inferiorly around the head of the pancreas
- It lies posteriorly to the transverse colon, and anterior to the right kidney
How is the descending region of the duodenum marked and why is this significant?
- Internally, the descending duodenum is marked by the major duodenal papilla – an opening for bile and pancreatic secretions to enter
- The duct responsible carrying these secretions is known as the ampulla of Vater (hepatopancreatic ampulla)
Describe the anatomical position of the horizontal region of the duodenum
- It travels laterally to the left, crossing over the inferior vena cava and aorta
- It is located inferiorly to the pancreas, and posteriorly to the superior mesenteric artery and vein
Describe the anatomical position of the ascending region of the duodenum
- It ascends and curves anteriorly to join the jejunum at a sharp turn known as the duodenojejunal flexure
- Located at the duodenojejunal junction is a slip of muscle called the suspensory muscle of the duodenum
Where is the pancreas located?
The pancreas is a retroperitoneal structure located deep within the upper abdomen in the epigastrium and left hypochondrium regions
Describe the anatomical relationship of the pancreas and the duodenum
The duodenum is situated anteriorly and medially, curving around the head of the pancreas
The pancreas can be divided into 5 parts.
Identify them
Describe the anatomical position of the head of the pancreas
- Lies within the C-shaped curve created by the duodenum
- Connected to duodenum by connective tissue
Describe the anatomical position of the uncinate process of the pancreas
- Arises from the lower part of the head and extends medially to lie beneath the body of the pancreas
- Lies posterior to the superior mesenteric vessels
Describe the anatomical position of the neck of the pancreas
- Located between the head and the body of the pancreas
- Overlies the superior mesenteric vessels which form a groove in its posterior aspect
Describe the anatomical position of the body of the pancreas
- Centrally located, crosses the midline of the body
- Lies behind the stomach and to the left of the superior mesenteric vessels
Describe the anatomical position of the tail of the pancreas
- Lies within close proximity to the hilum of the spleen
- Contained within the splenorenal ligament with the splenic vessels (intraperitoneal)
Describe the blood supply to the pancreas
Where do the superior and inferior pancreaticoduodenal arteries arise from?
Describe the venous drainage of the pancreas
- Venous drainage of the head of the pancreas is into the superior mesenteric branches of the hepatic portal vein
- Pancreatic veins draining the rest of the pancreas do so into the splenic vein
Describe the anatomical location of the spleen
The spleen is an intraperitoneal organ located in the upper left quadrant of the abdomen, under cover of the diaphragm and ribcage
The spleen is connected to the stomach and kidney by parts of the greater omentum.
Identify and describe these parts
- Gastrosplenic ligament connects the spleen to the greater curvature of the stomach
- Splenorenal ligament connects the hilum of the spleen to the left kidney
Describe the blood supply to the spleen
The spleen receives its arterial supply from the splenic artery which arises from the coeliac trunk and runs laterally along the superior aspect of the pancreas, within the splenorenal ligament
Describe the venous drainage of the spleen
- Venous drainage occurs through the splenic vein
- It combines with the superior mesenteric vein to form the hepatic portal vein
