Stomach and Spleen Flashcards

1
Q

Where is stomach located?

A
  • In left side of upper abdomen
  • top
  • Pyloric region (end) located on transpyloric plane
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2
Q

What is shape of stomach?

A

Inverted J-shape

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3
Q

What is top of stomach connected to and where its it located?

A

oesophagus which comes through left dome of diaphragm through level of T10

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4
Q

What does shape of stomach depend on?

A

Height e.g. tall person have tall stomach

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5
Q

What are features and location of hypertonic stomach and how is it caused?

A
  • smaller
  • higher up in abdomen
  • caused by excessive contraction of smooth muscle
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6
Q

What are features and location of hypotonic stomach?

A
  • Elongated J-shape

– drops down into umbilical region

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7
Q

What are features and location of atonic stomach and how is it caused?

A
  • lost muscular tone
  • Sit within pelvis, hypogastric/supra-pubic region
  • lesion of vagus nerve
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8
Q

What is a sheerhorn stomach?

A

short and stocky shape, flattened

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9
Q

List all 9 features of the stomach

A
  1. Cardial notch
  2. Cardia
  3. Fundus
  4. Lesser curvature
  5. Incisura angularis
  6. Body
  7. Greater curvature
  8. Pyloric antrum
  9. Pylorus
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10
Q

What is the cardial notch?

A

Between cardia and fundus

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11
Q

What is cardio-oesophageal junction?

A

Line which marks change in mucosa of oesophagus (smooth) to mucosa of stomach (rough)

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12
Q

What is stomach lined by and why?

A
  • glandular mucosa
    – mucus-secreting cells
  • help protect walls from acidic contents
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13
Q

What is oesophagus lined by?

A

stratified squamous epi

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14
Q

What is function of fundus and what can occur?

A
  • Storage (of air released from food)

- Trapped air bubbles

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15
Q

What is function of cardia?

A

Mucus secretion

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16
Q

What are functions of body?

A
  • Storage
  • Produces:
  • mucus
  • HCl
  • pepsinogen
  • intrinsic factor
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17
Q

What is function of pyloric antrum?

A
  • Mixing/grinding of chyme = food that’s been mixed into slush,
  • produces gastrin
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18
Q

What is function of sphincter in pyloric canal?

A
  • controls release of chyme from stomach to 1st part of duodenum
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19
Q

What happens when pyloric sphincter open?

A

– allows chyme to pushed through pyloric opening by peristaltic waves of contraction of stomach wall – starts from body and goes down into pylorus

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20
Q

What is rugae and its function?

A
  • Longitudinal folds of body wall

- helps to channel chyme downwards with gravity to pyloric antrum

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21
Q

What are 4 functions of stomach?

A
  1. Temporary storage of chyme
  2. Secretions
  3. Breakdown
  4. Absorption – through stomach walls + mucosa
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22
Q

How much chyme does stomach store?

A

Holds from 75mls (empty) - 2 litres (or more, full)

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23
Q

What does the stomach secrete?

A
  • gastrin
  • IF
  • mucus
  • HCl
  • pepsinogen
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24
Q

What does the stomach absorb?

A
  • H2O
  • electrolytes
  • Alcohol
  • aspirin
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25
Q

How long does food remain in stomach?

A

4 hours

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26
Q

What are 5 features of mucosa (innermost layer) of gut wall?

A
  1. Duct of accessory gland (e.g. pancreas, liver)
  2. Mucosal gland
  3. Sub-mucosal gland
  4. GALT (gut-associated lymphoid tissue)
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27
Q

What are 3 layers of mucosa?

A
  1. Epithelium
  2. Lamina Propria
  3. Muscularis Mucosa
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28
Q

What is Muscularis Mucosa?

A

muscle of mucosa allows contraction and wrinkling – move mucosa wall in contact with chime- effective absorption and secretion

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29
Q

What are features of submucosa (2nd innermost layer) of gut wall?

A
  • Submucosal (Meissner’s) Plexus
  • Submucosa
    Sub-mucosal gland
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30
Q

What does submucosa contain?

A
  • Loose CT
  • Blood Vessels
  • Lymphatics
  • Nerves
  • Glands
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31
Q

What are features of Muscularis Externa?

A
  1. Outer Longitudinal muscle
  2. Inner Circular muscle
  3. Myenteric (Auerbach’s) Plexus
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32
Q

What is special about stomach’s Muscularis Externa?

A

additional inner oblique layer where rest of gut has 2 layers

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33
Q

Where does Myenteric (Auerbach’s) Plexus get its feed from and what does this mean?

A
  • vagus nerve

– most of gut moves through parasym stim

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34
Q

What are features of Adventitia (CT) or Serosa (serous mem) (final layer) of gut wall?

A

Connective Tissue or Peritoneum
Extrinsic nerves
Blood Vessels

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35
Q

What are 4 layers of gut wall?

A
  1. Mucosa
  2. Submucosa
  3. Muscularis Externa
  4. Adventitia (CT) or Serosa (serous mem)
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36
Q

What are 3 layers of stomach wall?

A
  1. Longitudinal muscle layer
  2. Circ muscle layer
  3. Oblique muscle layer
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37
Q

How is rugae roughened into shape?

A

by muscularis mucosa

38
Q

What are the 9 posterior relations of stomach?

A
  1. Aorta
  2. IVC
  3. R + L Kidney
  4. SMV
  5. SMA
  6. Duodenum
  7. Jejunum (mainly duodenal jejunal flexure)
  8. Uncinate process
  9. Pancreas
  10. L supra-renal gland
39
Q

What is anterior relation of stomach?

A

Liver

40
Q

What are blood vessel relations of stomach?

A
  1. Common hepatic artery (IVC)
  2. Coeliac trunk (aorta)
  3. Splenic artery (aorta)
41
Q

What are veins of stomach?

A
  1. SVC
  2. IVC
  3. Azygos vein
  4. Oesophageal plexus
  5. Hepatic portal vein
  6. Splenic vein
  7. IMV
  8. SMV
42
Q

What is splenic vein and what does it supply?

A
  • branch of SMV

- foregut

43
Q

What is SMV and what does it supply?

A
  • what hepatic portal vein becomes

- Midgut

44
Q

What is IMV and what does it supply?

A
  • branch of SMV

- Hindgut

45
Q

What does hepatic portal vein supply?

A

blood from entire gut

46
Q

What are branches of common hepatic artery?

A
  • becomes proper hepatic artery
  • R + L hepatic artery
  • cystic artery
47
Q

What are branches of proper hepatic artery?

A
  • R gastric artery

- Gastroduodenal artery

48
Q

What is R gastric artery?

A
  • Branch to lesser curvature

– normally branches off proper hepatic artery but could come from anywhere on this artery

49
Q

What is R gastroepipolic artery and where does it go?

A
  • where Gastroduodenal artery becomes this
  • Artery to stomach (greater curvature)
  • Heads down behind 1st part of duodenum
50
Q

What is superior pancreaticoduodenal artery?

A

Branch of juction between Gastroduodenal and R gastroepipolic arteries

51
Q

What is L gastric artery?

A
  • branch of coeliac trunk

- branches to lesser curvature

52
Q

What is ascending oesophageal artery?

A
  • branch of L gastric artery

- branches to oesophagus

53
Q

What is splenic artery?

A
  • branch of coeliac trunk
  • where u get most of blood supply to stomach
  • runs behind stomach
54
Q

What are short gastric arteries?

A
  • branches of splenic artery

- branches to fundus

55
Q

What is L gastroepiploic artery?

A
  • branch of splenic artery
  • joins R gastroepi artery
  • branches to greater curvature of stomach
56
Q

List arteries of stomach

A
  1. Common hepatic
  2. Proper hepatic
  3. R + L hepatic
  4. Cystic
  5. R + L gastric
  6. Gastroduodenal
  7. R + L gastroepiploic
  8. Superior pancreaticoduodenal
  9. Ascending oesophageal
  10. Splenic
  11. Short gastric
57
Q

What are lymphs nodes of stomach?

A
  1. Coeliac
  2. R + L gastric
  3. Pyloric
  4. R Gastro-omental
  5. Pancreaticolienal
58
Q

What is cisterna chyli?

A

lymph nodes join this sack before it goes through diaphragm

59
Q

List nerves supplying stomach

A
  • R vagus (posterior)
  • L vagus (anterior)
  • Pos + ant vagal trunk
  • Coeliac branch
60
Q

What is R vagus nerve?

A

branches pos to oesophagus

61
Q

What is pos vagal trunk?

A

what R vagus nerve becomes

62
Q

What is coeliac branch?

A

branch of pos vagal trunk

63
Q

What is L vagus nerve?

A

branches ant to oesophagus

64
Q

What is ant vagal trunk?

A

what L nerve becomes

65
Q

What is function of vagus nerves?

A
  • Motor (to smooth muscle)

- secretomotor (to mucosal + submucosal glands)

66
Q

What is the location of sympathetic nerves?

A

T6-T9

67
Q

What is function of symp afferents?

A
  • pain (epigastric)
68
Q

What is function of symp efferents?

A
  • vasoconstriction

- antiperistaltic – reduce movement while vagus causes peristalsis

69
Q

Where is spleen located?

A

In left hypochondium

70
Q

What is the spleen protected by?

A

(9th-11th ribs)

71
Q

What are features of spleen?

A
  • Largest lymph organ
  • Anterior border axillary to mid-axillary plane
  • Highly vascular from splenic vein
  • Covered by peritoneum (intra-peri organ)
72
Q

What are functions of spleen?

A
  • removes blood-borne antigens (immunity)
    » removes and destroys old/damaged blood cells
    » stores red blood cells and platelets
    » haemopoiesis = formation of RBCs in fetus
73
Q

Name 5 parts of spleen

A
  1. U + L pole
  2. Diaphragmatic surface
    - Visceral surface:
  3. Gastric surface
  4. Renal surface
  5. Colic surface
  6. Pancreatic surface
  7. Hilium
  8. Ant + inf border
74
Q

Where does upper pole point?

A

Backwards

75
Q

Where does lower pole point?

A

Forwards

76
Q

What is diagrammatic surface?

A

In contact with diaphragm

77
Q

What is gastric surface?

A

Where stomach sits

78
Q

What is renal surface?

A

Where upper kidney sits

79
Q

What is colic surface?

A

Contact with splenic flexure of colon (large bowel)

80
Q

What is hilum?

A

Where blood vessels are

81
Q

How can you tell enlarged spleen?

A

See notches of anterior border

82
Q

What is pancreatic surface?

A

Where bit of pancreas sits

83
Q

What is enlarged spleen due to?

A
  • liver disease
  • blood cancers (lymphoma, leukemia, myelofibrosis)
    infections
  • abnormal blood flow and congestion (e.g portal hypertension, cardiac failure)
  • Gaucher disease (a lipid storage
    disease)
  • blood cell disorders
  • Inflammatory disease
84
Q

What is azygos vein?

A
  • branch of SVC

- branches to oesophagus

85
Q

What is oesophageal plexus?

A

What azygous vein branches to

86
Q

What is R gastric vein?

A
  • branch of hepatic portal vein

- branches to lesser curvature

87
Q

What is L gastric vein?

A
  • branch of hepatic portal vein

- branches to lesser curvature on other side

88
Q

What is R gastro-omental artery?

A
  • branch of SMV
  • joins L gastro-ometal artery
  • branches to greater curvature
89
Q

What is L gastro-omental artery?

A
  • branch of SMV
  • joins R gastro-ometal artery
  • branches to greater curvature
90
Q

What is short gastric vein?

A
  • branch of splenic vein

- branches to spleen