The Stomach and the Lesser Sac

Question 1

The Stomach is attached to the liver via

Answer 1

the lesser omentum, which carries the hepatic artery, hepatic portal vein and bile duct.

Question 2

What does the lesser omentum carry

Answer 2

the hepatic artery, hepatic portal vein and bile duct.

Question 3

Behind the stomach lies the

Answer 3

lesser sac

Question 4

behind the lesser sac lies the

Answer 4

Pancreas, splenic artery and part of the duodenum, these are collectively referred to as the gastric bed.

Question 5

gastric bed

Answer 5

Pancreas, splenic artery and part of the duodenum

Question 6

The stomach contains a harsh environment with high acidity and this may lead to destruction of the mucosa leading to a

Answer 6

‘peptic ulcer

Question 7

Once the mucosa is breached the ulcer may erode through the gastric wall into adjacent structures, including

Answer 7

blood vessels and the gastric bed

Question 8

Tumours of the stomach are relatively common and may spread via lymphatics to .. and veins to ..

Answer 8

lymphatics to the nodes surrounding the coeliac axis,

veins to the liver.

Question 9

The Coeliac trunk is the artery to the fore gut, it branches off the front of the aorta just below the diaphragm and supplies

Answer 9

from the lower third of the oesophagus to the 2nd part of the duodenum.

Question 10

The liver and part of the pancreas develop from where and are supplied by

Answer 10

develop from the fore gut and are also supplied by branches of the coeliac trunk

Question 11

Venous blood drains into

Answer 11

the portal vein to be taken to the liver.

Question 12

The fore gut receives a sympathetic nerve supply from ..

and a parasympathetic nerve supply from the

Answer 12

the Greater Splanchnic Nerve (T5-T9)
vagal trunks (X cranial nerve).

Question 13

Veins in the lower third of the oesophagus usually drain to the portal vein but they also join with veins in the chest which drain to

Answer 13

the superior vena cava

Question 14

n disease of the liver, eg. Cirrhosis, the portal venous channels in the liver become progressively smaller until there are insufficient for normal blood flow. The venous blood from the bowel will then flow up

Answer 14

the veins of the oesophagus and into the superior vena cava, a porto-systemic shunt

Question 15

The veins in the oesophagus distend to form

Answer 15

oesophageal varices; varicose veins of the oesophagus which bleed easily.

Question 16

Some children, in the first six weeks of life, over develop the pyloric sphincter and the stomach cannot empty into the duodenum what is this called and how is it presented

Answer 16

pyloric stenosis
After feeding, when the stomach contracts, food it forced out of the mouth, projectile vomiting. Because the child is not getting any nutrition they are always hungry and eager to feed.

Question 17

A common site for peptic ulcer is the

Answer 17

posterior wall of the first part of the duodenum

Question 18

if a peptic ulcer erodes through the duodenal wall it may erode into the and cause what

Answer 18

gastroduodenal artery and cause very brisk bleeding.

Question 19

At what vertebral level does the oesophagus pass through the diaphragm?

Answer 19

Thoracic 10.

Question 20

Which structure(s) passes through the diaphragm alongside the oesophagus?

Answer 20

The vagal trunks, inferior oesophageal artery and vein.

Question 21

Draw and name the parts of the stomach.

Answer 21

look up in handbook 

Question 22

From where does the stomach receive its nerve supply?

Answer 22

Parasympathetic from the vagus nerves, cranial nerve X

Sympathetic from the greater splanchnic nerves, Thoracic nerves T5-T9

Question 23

What structure attaches the stomach to the liver?

Answer 23

Lesser omentum

Question 24

Which structures lie in front of the stomach?

Answer 24

Left lobe of the liver, anterior abdominal wall

Question 25

Which structures lie behind the stomach?

Answer 25

The lesser sac, behind the lesser sac is the pancreas and diaphragm.

Question 26

What is a porto-systemic anastomosis?

Answer 26

It is a vein which joins to the hepatic portal system (so can carry blood to the liver) to
the systemic system. It can take blood from the bowel and bypass the liver to return the blood to the heart.