Stomach Anatomy Flashcards
What does the area where the fundus meets the left
side of the Gastroesophageal junction called?
The angle of His.
What are the boundaries of the stomach?
- Superior: Diaphragm + esophagus
- Anterior: Left lobe of liver
- Inferior: Transverse colon + greater omentum
- Left lateral: Spleen
- Posterior: Pancreas and duodenum surrounding it + kidneys + lesser peritoneal sac + the lesser omental bursa.
- The stomach lies on: pancreas, spleen, transverse colon, and a portion of the kidney and suprarenal glands.
The stomach is attached to the
transverse colon by what ?
Gastrocolic omentum
The lesser curvature of the stomach is tethered to the liver by what ?
hepatogastric ligament (the lesser omentum or pars flaccida).
What is the consistently largest artery to the stomach?
The left gastric artery
From the gastrohepatic ligament (lesser omentum) to the left side of the liver are usually supplied by which artery?
Left gastric artery
What is the second largest artery to the stomach ?
Right gastroepiploic artery
What is the blood supply of the stomach?
Mainly: 1- Left gastric artery. 2- right gastric artery. 3- Right gastroepiploic artery. 4- Left gastroepiploic artery. 5- Short gastric artery.
From where does the left gastric artery arises ?
Celiac trunk
From where does the right gastric artery arises ?
Hepatic artery
From where does the right gastroepiploic (gastro-omental)
artery arises ?
Gastroduodenal artery
From where does the left gastroepiploic (gastro-omental)
artery arises ?
splenic artery
What are the veins draining the stomach and where does each one drains ?
- Right gastric vein: Portal
- Left gastric vein: Portal
- Right gastroepiploic vein : Superior mesenteric
- Left gastroepiploic vein: Splenic
- Short: Splenic
To what nodes does the cardia of the stomach and the medial half of the corpus commonly drains into?
drain to nodes along the left gastric and celiac axis.
To what nodes does the lesser curvature side of the antrum commonly drains into?
drains to the right gastric and pyloric nodes.
To what nodes does the greater curvature half
of the distal stomach commonly drains into?
drains to the nodes along the right gastroepiploic
chain.
To what nodes does the proximal greater curvature side of the stomach commonly drains into?
drains into nodes along the left gastroepiploic
or splenic hilum.
To what nodes does the nodes along both the greater and lesser curvature commonly drains into?
drain into the celiac nodal basin.
What are the layers of the gastric wall ?
from inside towards outside:
- Mucosa
- Submucosa
- Muscularis propria (muscularis externa).
- Serosa (visceral peritoneum).
What does the splenic artery supplies?
Spleen
What does the hepatic artery supplies?
Liver
What does the gastroduodenal artery supplies?
Duodenum
Stomach
Liver
What does the right gastric artery supplies?
lesser curvature
What does the left gastric artery supplies?
lesser curvature
What does the right gastroepiploic artery supplies?
greater curvature and stomach corpus
What does the left gastroepiploic artery supplies?
Stomach corpus /body
What is the lesser omentum?
It is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach (hepatogastric ligament) and the first part of the duodenum (hepatoduodenal ligament).
How does the vagus nerve enters the mediastinum?
From the vagal nucleus in the floor of the fourth
cerebral ventricle, the vagus traverses the neck in the carotid
sheath and enters the mediastinum
The vagus nerve has branches that come together again above the esophageal hiatus and form what nerves?
The left (anterior) and right (posterior) vagal trunks (mnemonic LARP).
What is the innervation of the liver in the gastrohepatic ligament, and the lesser curvature of the stomach ?
The anterior nerve of Latarjet, which is a branch of the anterior vagus nerve.
What is the branch that the posterior vagus sends to the posterior fundus ?
The criminal nerve of Grassi.
What is the esophageal hiatus?
It is an opening in the diaphragm through which the esophagus and the vagus nerve pass (At T10).
Which nerve that is easily missed during
truncal or highly selective vagotomy (HSV) ?
The criminal nerve of Grassi.
What is the role of vagus nerve in the stomach?
- Affect secretion (including acid).
- Motor function.
- Mucosal blood flow and cytoprotection.
- Play a role in appetite control.
- Mucosal immunity and inflammation.
What is the lining of the gastric mucosa ?
lined with columnar epithelial cells of various types.
What composes the mucosa of the stomach?
The epithelium, lamina propria, and muscularis
mucosa.
What is the function of the mucus-secreting surface epithelial cells (SECs)?
Secrete bicarbonate and play an important role in
protecting the stomach from injury due to acid, pepsin, and/or ingested irritants.
What are the content of the submucosa?
- Branching blood vessels.
- Lymphatics.
- Collagen.
- Various inflammatory cells.
- Nerve fibers.
- Ganglion cells of Meissner’s autonomic submucosal plexus.