Stomach Flashcards
What is the stomach?
Widest, most distensible part of the digestive tube
Connections of the stomach
Lower end of esophagus
Duodenum
Location of the stomach
Lies obliquely in the upper and left part of the abdomen in the epigastric, umbilical and left hypochondriac regions
Most of it lies under cover of the left costal margin and the ribs
Length of the stomach
25 cm
Capacity of stomach at birth
30 ml
Capacity of stomach at puberty
1L
Capacity of stomach in adults
1.5-2L
What are the four major external features of the stomach?
Two orifices/openings, two curvatures/borders, two surfaces and two parts
What are the orifices of the stomach?
Cardiac orifice
Pyloric orifice
What is the cardiac orifice?
Joined to the lower end of the esophagus
Location of cardiac orifice
Behind the left 7th costal cartilage, 2.5 cm from its junction with the sternum, at the level of T11
What is the pyloric orifice?
Opens into the duodenum
Location of the pyloric orifice
On empty stomach and supine position
1.2 cm to the right of median plane, at the level of lower border of L1 or transpyloric plane
What are the curvatures of the stomach?
Lesser curvature (right border)
Greater curvature (left border)
Attachments of the lesser curvature
Lesser omentum
Most dependent part of the lesser curvature
Angular notch/incisura angularis
Attachments of the greater curvature
Greater omentum, gastrosplenic ligament and gastrophrenic ligament
Surfaces of the stomach
Anterosuperior surface
Posteroinferior surface
What are the parts of the stomach?
Cardiac
Pyloric
Subdivisions of the cardiac part of the stomach
Fundus
Body
Subdivisions of the pyloric part of the stomach
Antrum
Pyloric canal
How are the fundus and body separated?
The fundus is the upper convex dome shaped part situated above a horizontal line drawn at the level of the cardiac orifice
Appearance of the fundus under radiological examination
Distended with gas
Seen under the left dome of diaphragm
What types of secretory cells do the gastric glands of the stomach contain?
NOT NECESSARY FOR EXAM
Mucous cells
Chief, peptic or zymogenic cells (secreting the digestive enzymes)
The parietal or oxyntic cells (secreting HCl)
NOT NECESSARY FOR EXAM
1 The pyloric antrum is separated from the pyloric canal by an inconstant sulcus, sulcus intermedius present on the greater curvature.
It is about 7.5 cm long. The pyloric glands are richest in mucous cells.
2 The pyloric canal is about 2.5 cm long. It is narrow and tubular. At its right end, it terminates at the pylorus.
Visceral relations of the stomach
Anterior relations: Liver, diaphragm, and the anterior abdominal wall
Posterior relations of the stomach
Structures forming the stomach bed
What structures form the stomach bed?
Diaphragm
Left kidney
Left suprarenal gland
Pancreas
Transverse mesocolon
Splenic flexure of the colon
Splenic artery
Structures founds in the interior of the stomach
Mucosa of an empty stomach is folded into gastric rugae
Submucous coat is made of connective tissue, arterioles and nerve plexus
Muscle coat
Serous coat consists of the peritoneal covering
Arrangement of the muscle coat of the stomach
Longitudinal fibres are most superficial, mainly along the curvatures
Inner circular fibres encircle the body and are thickened at pylorus to form pyloric sphincter
The deepest layer consists of oblique fibres which loop over the cardiac notch
Arterial supply of the stomach
Lesser Curvature: Left gastric artery (branch of the coeliac trunk) and the right gastric artery (branch of the proper hepatic artery)
Greater Curvature: Right gastroepiploic artery (branch of the gastroduodenal) and the left gastroepiploic artery (branch of the splenic artery)
Fundus: 5 to 7 short gastric arteries (branches of the splenic artery)
Veins of the stomach
Portal, superior mesenteric and splenic veins
Lymphatic drainage of stomach
Sympathetic nerve supply of stomach
Derived from T6 to T10 of the spinal cord, via the greater splanchnic nerves, coeliac and hepatic plexuses
Parasympathetic nerve supply of stomach
Derived from the vagi, through the oesophageal plexus and gastric nerves
