Stomach and Oesophagus Flashcards
Oesophagus structure
inner mucosa - stratified squamous
submucosa
double muscular layer - longitudinal outer and circular inner (striated muscle proximal 2/3 and smooth lower 1/3)
outer layer areolar tissue
Blood supply oesophagus
inferior thyroid
descending thoracic aorta
left gastric
Venous drainage oesophagus
lower - azygos system via left gastic
upper - inferior thyroid - brachiocephalic
innervation oesophagus
sensory and parasympathetic
vagus and RCLNs
incisura angularis
notch on the lesser curvature of the stomach marking junctin between pylorus and body
Blood supply stomach
left and right gastric
left and rght gastroepiloic
short gastric
All arise from coeliac trunk
Hepatic artery - right gastric
Gastroduodenal artery - right gastroepiploic
Splenic artery - short gastric and left gastroepliploic
venous drainage stomach
portal vein - right and left gastric
splenic vein - short gastric and left gastroepiploic
SMV - right gastroepiploic
Innervation stomach
anterior vagal trunk - left vagus - anterior stomach and pylorus
posteiror vagal trunk - right vagus - posterior surface and coeliac plexus
blood supply to the spleen
splenic artery (coeliac)
splenic vein - SMV - PV
ribs related to the spleen
9,10,11,12
structure to worry about during splenectomy
tail of pancreas (lienorenal ligament)
describe the course of splenic artery
coeliac trunk - goes left, above pancreas - behind the stomach, seperated from it by the lesser sac - lien ligament - terminal breanches in the hilum
branches to the pancreas and stomach
where does the oesophagus begin
lower border of cricoid c6
lymphatic drainage oesophagus
deep cervical
mediastinal
gastric
(1/3s)
Muscularis externa oesophagus
starts striated and becomes smooth distally
cells lining the oesophagus
stratified squamous
Barret’s oesophagus
columnar metaplasia with increased risk of developing adenocarcinoma
achalasia
oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle of the oeophagus and the lower oesophageal sphincter. characterised by incomplete LES relaxation, increased LES tone and lack of peristalsis
microscopic picture of achalasia
hypertrophied musculatrure with absence of myenteric plexus
what akes an indent on the oesophagus?
left bronchus
aortic arch
left atrium
complications of perforated oesophagus
mediastinitis
contrictions of oesophagus and distance from incisiors
cricoid caritlage 15cm
arch aorta 22cm
left bronchus 27cm
Diaphragmatic hiatus 40cm
parts of the stomach
fundus
pylorus
body
antrum
