Stomach Flashcards
Most of blood supply of stomach supplied by?
celiac artery
4 main arteries that supply the stomach?
right and left gastric arteries along lesser curve
left and right gastro-epiploics along greater curve
What are some collateral arteries that supply the stomach?
inferior phrenic arteries
short gastrics from spleen
Largest artery to stomach?
left gastric
15-20% of the time, left gastric artery gives off aberrant what?
left hepatic artery
Sometimes ligating the proximal left gastric artery can result in left lobe hepatic ischemia, why?
15-20% of time, left gastric can give off left hepatic artery
Origins of left gastro-epiploics and right gastro-epiploic?
L–> from splenic
R–> from gastroduodenal
Venous drainage of the stomach?
L-gastro epiploic–> splenic vein
R- gastro epiploic–> SMV
L+R gastric veins–> portal vein
Innervation fo stomach occurs via?
PSNS: vagus
SNS: celiac plexus
Position of left and right vagus nerves at GE junction?
LARP
left vagus–anterior
right vagus–posterior
Branches off of the left vagus include:
hepatic branch
anterior nerve of Latarjet
Hepatic branches and anterior nerve of Latarjet are branches off what?
left vagus
First branch off of the right vagus?
criminal nerve of Grassi
Criminal nerve of Grassi comes off of what nerve?
right vagus
Criminal nerve of Grassi, off of the right vagus, can cause problems why?
when left undivided, cause of recurrent ulcers
This vagus gives off a celiac branch:
right vagus
Anatomically where do we perform a truncal vagotomy?
above the celiac and hepatic branches of the vagi
Anatomically where do we perform a selective vagotomy?
below the celiac and hepatic branches of the vagi
What;s a highly selective vagotomy?
divide the crow’s feet to proximal stomach
preserve innervation to antum and pyloric parts of stomach
What are the layers of the stomach wall?
mucosa
submucosa
muscularis layer (3 layers of muscle; incomplete inner oblique layer, middle circular, outer longtidunal)
serosa
Where do we find Aurbach’s plexus in stomach wall?
within muscle layer
Strongest layer of gastric wall?
submucosa –> collagen rich
Where do we find Meissner’s plexus?
submucosa
Where do we find Auerbach’s and Meissner’s plexi?
Auerbachs–muscle layer
Meissner’s–submucosa