hypochondrial region
Stomach
--- Content provided by FirstRanker.com ---
l In adult life, stomach located T10 and
L3 vertebral segment
--- Content provided by FirstRanker.com ---
l Can be divided into anatomic regionsbased on external landmarks
l 4 regions
--- Content provided by FirstRanker.com ---
l Cardia
l Fundus
l Corpus (body)
l Antrum
--- Content provided by FirstRanker.com ---
Anatomy
l Cardia- region
--- Content provided by FirstRanker.com ---
just distal to the
GE junction
--- Content provided by FirstRanker.com ---
l Fundus- portionabove and to the
left of the GE
--- Content provided by FirstRanker.com ---
junction
Anatomy
l Corpus- region
--- Content provided by FirstRanker.com ---
between fundus and
antrum
--- Content provided by FirstRanker.com ---
l Margin not distinctlyexternal, has arbitrary
borders
--- Content provided by FirstRanker.com ---
l Antrum- bounded
distally by the
--- Content provided by FirstRanker.com ---
pylorusl Which can be
appreciated by
--- Content provided by FirstRanker.com ---
palpation of a
thickened ring of
--- Content provided by FirstRanker.com ---
smooth muscleshape
l Depends on degree of distension and
--- Content provided by FirstRanker.com ---
surrounding viscera
l Empty - J shape
l Partly distended - piriform
--- Content provided by FirstRanker.com ---
l Obese - horizontal - steer hornstomach
size
--- Content provided by FirstRanker.com ---
l Distensiblel 10 in. long
Capacity
--- Content provided by FirstRanker.com ---
l 30 ml - birthl 1 l - puberty
l 1 ? l ? 2 l or more - adult
External features
--- Content provided by FirstRanker.com ---
l Cardiac orfice -7th costal cartilage, T 11
vertebra
--- Content provided by FirstRanker.com ---
l Pyloric orifice - lowerborder of L 1Pyloric constriction - circular groove
Pylorus = gate guard
PrePyloric vein in front of constriction
l Lesser curvature, lesser omentum, incisura
--- Content provided by FirstRanker.com ---
angularis
External features...
l Greater curvature, GO,GS,GP.
--- Content provided by FirstRanker.com ---
l cardiac notchAnterior surface - forward upward
Posterior surface -backward downward
--- Content provided by FirstRanker.com ---
Sub divisionsl Cardiac ,Pyloric parts
Cardiac ? fundus , body
--- Content provided by FirstRanker.com ---
Pyloric ? pyloric antrum ( 3 in.), pyloriccanal(1 in.)
Relations
--- Content provided by FirstRanker.com ---
Peritoneall Lesser omentum
l Greater omentum
l Gastrosplenic ligament
l Gastrophrenic ligament
--- Content provided by FirstRanker.com ---
l Bare areaRelations.....
Visceral
--- Content provided by FirstRanker.com ---
l Anterior surfaceLiver, diaphragm, ant. Abd.wall
l Posterior surface
Diaphragm, Lt. kidney, Lt. supra renal
--- Content provided by FirstRanker.com ---
gland, pancreas, transverse mesocolon,splEnic flexure of colon, splenic artery -
stomach bed
--- Content provided by FirstRanker.com ---
Sromach Bed
Interior of stomach
--- Content provided by FirstRanker.com ---
l Gastric rugae
Longitudinal along lesser curvature ?
gastric canal, irregular elsewhere.
--- Content provided by FirstRanker.com ---
l Gastric pits
Gastric glands opens
Vasculature
--- Content provided by FirstRanker.com ---
l Well vascularized organl Arterial flow mainly derived from
Celiac Artery
--- Content provided by FirstRanker.com ---
l 3 BrancheslLeft Gastric Artery
lSupplies the cardia of the
--- Content provided by FirstRanker.com ---
stomach and distal esophagus
lSplenic Artery
--- Content provided by FirstRanker.com ---
lGives rise to 2 branches whichhelp supply the greater
curvature of the stomach
--- Content provided by FirstRanker.com ---
lLeft Gastroepiploic
lShort Gastric Arteries
lCommon Hepatic or Proper Hepatic
--- Content provided by FirstRanker.com ---
Arteryl2 major branches
lRight Gastric- supples a
--- Content provided by FirstRanker.com ---
portion of the lesser curvature
lGastroduodenal artery
--- Content provided by FirstRanker.com ---
-Gives rise to RightGastroepiploic artery
-helps supply greater
--- Content provided by FirstRanker.com ---
curvature in conjunction
--- Content provided by FirstRanker.com ---
with Left Gastroepiploic ArteryBlood supply
l Left gastric artery- br of coeliac trunk
--- Content provided by FirstRanker.com ---
l Right gastric artery- br of commonhepatic artery
l Right gastro epiploic artery- br of
--- Content provided by FirstRanker.com ---
gastrodoudinal artery
l Left gastro epiploic artery- br of
--- Content provided by FirstRanker.com ---
splenic arteyl 5-7 short gastric arteries -br of
splenic artery
--- Content provided by FirstRanker.com ---
Arterial Supply
--- Content provided by FirstRanker.com ---
Vasculature
Blood supply
lVeins
--- Content provided by FirstRanker.com ---
Portal veinSuperior mesenteric vein
Splenic vein
Venous drainage
--- Content provided by FirstRanker.com ---
? Right & left gastric veins -> hepatic
portal vein.
--- Content provided by FirstRanker.com ---
l Left gastroepiploic & short gastricveins -> hepatic portal vein via the
splenic vein.
--- Content provided by FirstRanker.com ---
l Right gastroepiploic vein join superior
mesenteric vein.
--- Content provided by FirstRanker.com ---
Venous Drainage
Lymphatic drainage
--- Content provided by FirstRanker.com ---
l Area A pancreatosplenicl Area B left gastric
l Area C right gastroepiploic sub pyloric
hepatic
--- Content provided by FirstRanker.com ---
l Area D diff directions into pyloric,
hepatic, left gastric
--- Content provided by FirstRanker.com ---
l Coeliac trunk cisterna chyliLymphatic Drainage
--- Content provided by FirstRanker.com ---
Anatomyl Lymphatic drainage
l Lymph from the proximal portion of the
--- Content provided by FirstRanker.com ---
stomach drains along the lesser curvature first
drains into superior gastric lymph nodes
--- Content provided by FirstRanker.com ---
surrounding the Left Gastric Arteryl Distal portion of lesser curvature drains through
the suprapyloric nodes
--- Content provided by FirstRanker.com ---
l Proximal portion of the greater curvature is
supplied by the lymphatic vessels that traverse
--- Content provided by FirstRanker.com ---
the pancreaticosplenic nodesl Antral portion of the greater curvature drains
into the subpyloric and omental nodal groups
--- Content provided by FirstRanker.com ---
Anatomy
l Nerve Supply
--- Content provided by FirstRanker.com ---
l Left and Right Vagus Nerves descend
parallel to the esophagus within the
--- Content provided by FirstRanker.com ---
thorax before forming a peri-esophagealplexus between the tracheal bifurcation
and the diaphragm
--- Content provided by FirstRanker.com ---
l From this plexus, two vagal trunks
coalesce before passing through the
--- Content provided by FirstRanker.com ---
esophageal hiatus of the diaphragmAnatomy
l Left (anterior)
--- Content provided by FirstRanker.com ---
l
Vagus Nerve
--- Content provided by FirstRanker.com ---
l Left of theesophagus
l Branches
--- Content provided by FirstRanker.com ---
l Hepatic Branch
l Supplies liver
--- Content provided by FirstRanker.com ---
and BiliaryTract
l Anterior gastric
--- Content provided by FirstRanker.com ---
or Ant. Nerve of
Latarget
--- Content provided by FirstRanker.com ---
Anatomy
l Right (posterior)
--- Content provided by FirstRanker.com ---
Vagus Nervel Right of the
esophagus
--- Content provided by FirstRanker.com ---
l Branches
l Celiac
l Posterior
--- Content provided by FirstRanker.com ---
Latarget
l Innervates
--- Content provided by FirstRanker.com ---
posteriorgastric wall
Anatomy
--- Content provided by FirstRanker.com ---
l Parasympathetic innervation of
Stomach- Vagus Nerve
--- Content provided by FirstRanker.com ---
l 90% of fiber in vagal trunk is afferent(info transmitting from stomach to CNS)
l Sympathetic innervation of Stomach-
--- Content provided by FirstRanker.com ---
Splanchnic Nerve
l Derived from spinal segement T5-T10
Nerve supply
--- Content provided by FirstRanker.com ---
l Sympathetic T5 - T10
Via splanchenic nerves, coeliac and
hepatic pluxes
--- Content provided by FirstRanker.com ---
? Vasomotor
? Motor to pyloric shincter only
? Pain sensation from stomach
--- Content provided by FirstRanker.com ---
Nerve supplyl Parasympathetic
From vagi through oesophageal pluxes
--- Content provided by FirstRanker.com ---
and gastric nerves? Motor and secretomotor
--- Content provided by FirstRanker.com ---
Innervationfunctions
l Reservoir of food
--- Content provided by FirstRanker.com ---
l Peristaltic movementsl Gastric glands gastric juice, HCL
l Mucous
l absorption
Applied anatomy
--- Content provided by FirstRanker.com ---
l Displacement of stomach
l Hiatus hernia
l Congenital diaphramatic hernia
l Pyloro spasm
--- Content provided by FirstRanker.com ---
l Congenital hypertrophic pyloric stenosisl Gastrectomy ? ca stomach
Applied anatomy
--- Content provided by FirstRanker.com ---
l Ulcers, helico bacter pylori andvagotomy
l Gastric pain felt in epigastium
--- Content provided by FirstRanker.com ---
l Barium meal x ray, gastroscope