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BDS1 > Stomach > Flashcards

Stomach Flashcards

1
Q

Location of abdominal cavity

A

between diaphragm and pelvic inlet (separated from thorax but not from pelvis - digestive function)

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2
Q

Why are the organs in the abdominal cavity not separated, unlike the heart and lungs in the thorax?

A

All organs in abdominal cavity work together for digestion

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3
Q

What components make up the abdominal wall?

A

Multi-layered musculoaponeurotic wall and adipose tissue

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4
Q

Definition of musculoaponeurotic

A

musculo - muscular
aponeurosis - connective tissue

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5
Q

Term used to describe an abnormally swollen abdomen

A

distended abdomen

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6
Q

How is the abdomen divided?

A

9 areas - name related to bones and vertebra . Or into 4 quadrants - UR, UL, LL, LR

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7
Q

Where in the abdomen is the stomach found?

A

epigastric and left hypochondrium region

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8
Q

Side effects of distended abdomen

A

limited mobility, stomach paralysis, bloating, pain

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9
Q

Which structures are found anterior and superior to the stomach?

A

Liver, lower ribs, diaphragm

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10
Q

Which structures are posterior and inferior to the stomach?

A

Diaphragm (extends toward back of stomach), spleen, L kidney, adrenal gland, pancreas

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11
Q

What is the advantage of the lack of separation/boundaries in the abdominal cavity?

A

Organs can move and be displaced e.g. when the stomach expands during ingestion

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12
Q

4 sections of the stomach

A

cardia, fundus, body, pylorus

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13
Q

What structure controls the release of food into the stomach?

A

Lower oesophageal / cardiac sphincter - physiological due to angle

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14
Q

Which structure controls the movement of chyme into the duodenum?

A

Pyloric sphincter - allows maximum absorption of nutrients in small intestine

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15
Q

Which part of the stomach fills with gas and gives a bloating sensation?

A

fundus

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16
Q

Which side of the stomach has the greater curvature?

A

More lateral side (left)

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17
Q

Which side of the stomach has the lesser curvature?

A

More medial side (right)

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18
Q

Omenta definition

A

fused peritoneal folds connecting the stomach and duodenum with other abdominal organs

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19
Q

What is the greater omentum?

A

Largest of the two omenta - apron-like structure that extends from the greater curvature of the stomach to the transverse colon.

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20
Q

What is the name of the outer connective tissue in the stomach?

A

Serosa

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21
Q

Histological layers of the GIT

A

epithelium, lamina propria (mucous glands) and muscularis mucosae make up the mucosa. Submucosa is found beneath containing blood vessels, lymphatics, nerves, CT. Muscularis propria (CILO). Serosa/ Adventitia

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22
Q

Layers of muscle in muscularis propria in the stomach

A

oblique inner layer, circular middle layer, longitudinal outer layer.

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23
Q

Function of 3 layered muscle in muscularis propria in stomach

A

aids mixing and churning of food

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24
Q

Name of the gastric folds lining the inner surface of the stomach

A

Rugae

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25
Q

Function of rugae

A

Allow stomach to expand when bolus enters

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26
Q

Functions of the stomach

A

Retention of food in lumen if tract has slowed down. Mixing of gastric juice into chyme. Chemical (HCl) and mechanical functions. Absorption (limited - alcohol, aspirin)

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27
Q

Why are there regional variations in the composition of cells in the stomach?

A

Different sections (cardia, fundus, body, pylorus) have slightly different functions

28
Q

Which cells are found in the stomach?

A

Mucus secreting cells (surface mucous cells), parietal (oxyntic) cells, gastric/endocrine cells, chief cells

29
Q

Function of mucous secreting / surface mucous cells

A

Secrete an alkaline mucus as surface protection to prevent the stomach digesting itself.

30
Q

Where are mucous secreting cells found?

A

Luminal surface of stomach and in gastric pits

31
Q

Function of parietal (oxyntic) cells

A

Synthesise and secrete HCl and intrinsic factor (B12 absorption)

32
Q

Function of chief cells

A

synthesise and secrete pepsinogen (inactive pepsin. Activated and converted to pepsin by HCl)

33
Q

How is pepsin activated?

A

Pepsinogen is converted by pepsin by the presence of HCl which is released by parietal (oxyntic) cells

34
Q

Function of endocrine/gastric cells

A

synthesise and secrete gastrin which stimulates HCl production by parietal (oxyntic) cells

35
Q

Which cells are found in gastric glands?

A

Mucous neck cells, chief cells, parietal (oxyntic) cells, endocrine/G cells

36
Q

What is the name of the membrane that wraps around organs?

A

Visceral peritoneum

37
Q

How to differentiate between parietal (oxyntic) cells and chief cells using H&E stain

A

Parietal cells are more pink whereas chief cells are darker and blue in colour (pepsinogen production). Parietal cells have a round nucleus and are arranged in irregular layers.

38
Q

Location of chief cells

A

in lower regions of the gastric glands in the stomach

39
Q

Where are endocrine/gastric cells found?

A

At the bottom of the gastric glands

40
Q

Mechanism for the release of HCl into the stomach lumen from parietal cells

A
  1. CO2 diffuses from the capillaries into parietal cells
  2. CO2 reacts with H2O to produce H2CO3 (catalysed by carbonic anhydrase).
  3. Carbonic acid dissociated to produce H+ ions and HCO3- ions
  4. The H+ moves into the stomach lumen via a H+/K+ pump which requires ATP
  5. HCO3- diffuses from the parietal cell into capillaries
  6. To balance the ions, Cl- diffuses from the capillaries into the parietal cell and then into the stomach lumen. (chloride shift)
41
Q

Which artery contains the celiac trunk?

A

Abdominal aorta

42
Q

Which arteries branch from the abdominal aorta at the celiac trunk?

A

Splenic artery, left gastric artery, hepatic artery

43
Q

Which artery does the right gastric artery branch off?

A

Hepatic artery

44
Q

Which arteries supply the lesser curvature of the stomach?

A

Left and right gastric artery (anastomose)

45
Q

Which arteries supply the greater curvature of the stomach?

A

Short gastric arteries (upper part and fundus), left gastroepiploic artery, right gastroepiploic artery (L+R anastomose)

46
Q

Which arteries branch from the splenic artery?

A

Short gastric arteries and left gastroepiploic artery

47
Q

Which arteries branch from the hepatic artery?

A

Right gastric artery and gastroduodenal artery

48
Q

What structures are supplied by the splenic artery?

A

Fundus and spleen

49
Q

Which veins drain the lesser curvature?

A

Left and right gastric veins

50
Q

Which veins drain the greater curvature?

A

Left and right gastroepiploic veins, short gastric veins

51
Q

Where does the portal vein travel to from the stomach?

A

Liver

52
Q

Which veins merge to form the splenic vein?

A

Short gastric veins and left gastroepiploic vein

53
Q

Which veins join the superior mesenteric vein?

A

Splenic vein and right gastroepiploic vein

54
Q

At what point does the superior mesenteric vein become the portal vein?

A

When the superior mesenteric vein combines with the splenic vein

55
Q

Which veins join the portal vein?

A

Right gastric vein and left gastric vein.

56
Q

How is the upper 2/3 of the oesophagus drained?

A

Into oesophageal veins which drain into the azygos vein and then into the superior vena cava

57
Q

How is the lower 1/3 of the oesophagus drained?

A

Into the left gastric vein which drains into the portal vein to the liver, exiting into the inferior vena cava

58
Q

What are oesophageal varices?

A

Abnormally dilated veins in the oesophagus

59
Q

Cause of oesophageal varices

A

Cirrhosis in the liver or thrombosis in the portal vein can increase portal pressure. Portal hypertension means that portal pressure is greater than inferior vena cava pressure. Blood is redirected to bypass this high pressure system which creates a collateral circulation around the stomach, oesophagus and rectum.

60
Q

Danger of oesophageal varices

A

Bulbus veins are susceptible to rupture which could be fatal.

61
Q

Different forms of stomach surgery for weight loss

A

gastric band, sleeve gastrectomy, gastric by-pass

62
Q

What does a laparoscopic adjustable gastric band surgery involve?

A

Flexible band placed around upper stomach near LOS to create a small pouch

63
Q

What does a gastric by-pass involve?

A

A pouch is created in the upper stomach which is connected directly to the small intestine (usually jejunum) to bypass the body of the stomach. This reduces stomach capacity

64
Q

Why is the duodenum reconnected to the jejunum in gastric by-pass?

A

Duodenum contains bile from the liver and pancreatic enzymes which are needed to aid digestion.

65
Q

What is a sleeve gastrectomy?

A

~80% of the stomach along the greater curvature is removed to leave a sleeve-shaped stomach

BDS1 (24 decks)

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