Stomach (Dave's notes)

Question 1

What are the four parts of the stomach?

Answer 1

• cardia
• fundus
• body (lesser and greater curvature)
• pylorus

Question 2

What is the incisura (angularis)?

Answer 2

Acute notch just before the pylorus.

left margin joins greater curvature

( incisura = notch latin)

Question 3

The stomach is the most …….. part of the GI tract, is relatively ……. at both ends, but…. in the middle

Answer 3

Dilated, fixed, mobile

Question 4

What are the boundaries of the body of the stomach?

Answer 4

The body extends from the fundus to the angular notch

Question 5

What are the boundaries of the pyloric part?

Answer 5

The pyloric part extends from the angular notch to the gastroduodenal junction (right of the midline around L1??)

Question 6

What six anatomical features make up the bed of the stomach?

Answer 6

• Left crus
• diaphragmatic dome
• upper part of the left kidney
• triangle of the pancreas transversely
• spleen upper laterally
• suprarenal upper medially

Question 7

What arteries supply the stomach?

Answer 7

Left and right gastric, short gastric, left and right gastroepiploic,

Question 8

What is the blood supply to the lesser curvature?

Answer 8

The left and right gastric which anastomose and may be double

Question 9

What is the blood supply to the fundus?

Answer 9

The short gastric a. from the splenic

Question 10

What is the blood supply to the greater curvature?

Answer 10

The left and right gastroepiploic - which also supply the omentum. Gastric branches come off at right angles (c.f. nerves)

Question 11

Describe the venous drainage of the stomach

Answer 11

Identical to the arterial supply however there is no gastroduodenal vein.

Question 12

Where does lymph drain to?

Answer 12

Lymph drains to the coeliac nodes. A watershed exists between the lesser and greater curves and LUQ

Question 13

What is the nerve supply to the stomach?

Answer 13

Sympathetic fibres for vasomotor and parasympathetic (vagal) which controls motility and secretion

Question 14

What is the course of the nerve supply to the stomach?

Answer 14

Anterior to the lesser omentum and a hepatic branch which gives off a pyloric antrum branch, and posterior giving off a large branch to the coeliac ganglion

Question 15

Describe the structure of the stomach wall

Answer 15

Outer longitudinal, inner circular layers, reinforced by innermost oblique muscle layer

Question 16

What are the cell types of the body and their function?

Answer 16

Parietal cells (acid secreting), which give way to pyloric type G cells (gastrin secreting)