anatomy

Question 1

what supplies the thoracic part of the oesophagus with blood

Answer 1

branches of the thoracic aorta and the inferior thyroid artery

Question 2

what is the venous drainage of the thoracic part of the oesophagus

Answer 2

via branches of the azygous veins and the inferior thyroid vein

Question 3

what supplies the abdominal oesophagus

Answer 3

left gastric artery (branch of the coeliac trunk)

Question 4

the abdominal oesophagus has a mixed venous drainage by what routes

Answer 4

• to the portal circulation via the left gastric vein

- the the systemic circulation via the azygous vein

Question 5

what innervates the oespohagus

Answer 5

oesophageal plexus which is formed by a combination of the parasympathetic vagal trunks and the sympathetic fibres from the cervical and thoracic sympathetic trunks

Question 6

what are the 3 parts of the oesophageal lymphatic drainage

Answer 6

• Superior third – deep cervical lymph nodes.
• Middle third – superior and posterior mediastinal nodes.
• Lower third – left gastric and celiac nodes.

Question 7

what are the 4 sections of the stomach

Answer 7

• Cardia – surrounds the superior opening of the stomach at the T11 level.
• Fundus – the rounded, often gas filled portion superior to and left of the cardia.
• Body – the large central portion inferior to the fundus.
• Pylorus – This area connects the stomach to the duodenum. It is divided into the pyloric antrum, pyloric canal and pyloric sphincter. The pyloric sphincter demarcates the transpyloric plane at the level of L1.

Question 8

what supplies the greater curvature of the stomach

Answer 8

short gastric arteries and the right and left gastro-omental arteries (gastroepiplotic)

Question 9

what supplies the lesser curvature of the stomach

Answer 9

supplied by the left gastric artery and the right branch of the hepatic artery

Question 10

where does the greater omentum lie

Answer 10

hangs down from the greater curvature of the stomach and folds back up itsself where it attached to the transverse colon

Question 11

where does the lesser omentrum lie

Answer 11

arises at the lesser curvature and ascend to attach to the liver.

Question 12

what is the greater sac split into

Answer 12

The greater sac is the larger portion of the peritoneal cavity. It is further divided into two compartments by the mesentery of the transverse colon (known as the transverse mesocolon):

• Supracolic compartment – lies above the transverse mesocolon and contains the stomach, liver and spleen.
• Infracolic compartment – lies below the transverse mesocolon and contains the small intestine, ascending and descending colon. The infracolic compartment is further divided into left and right infracolic spaces by the mesentery of the small intestine.

Question 13

what is the lesser sac

Answer 13

The lesser sac lies posterior to the stomach and lesser omentum. It allows the stomach to move freely against the structures posterior and inferior to it.

Question 14

what is the stomachs arterial supply

Answer 14

celiac trunk and its branches

Anastomoses form along the lesser curvature by the right and left gastric arteries and along the greater curvature by the right and left gastro-omental arteries:

Right gastric – branch of the common hepatic artery, which arises from the coeliac trunk.
Left gastric – arises directly from the coeliac trunk.
Right gastro-omental – terminal branch of the gastroduodenal artery, which arises from the common hepatic artery.
Left gastro-omental – branch of the splenic artery, which arises from the coeliac trunk.
The veins of the stomach run parallel to the arteries. The right and left gastric veins drain into the hepatic portal vein. The short gastric vein, left and right gastro-omental veins ultimately drain into the superior mesenteric vein.

Question 15

what are the veins of the stomach and where do they drain into

Answer 15

• left and right gastric vein drain into the hepatic portal vein
• the short gastric vein, left and right gastro-omental veins ultimately drain into the superior mesenteric vein

Question 16

what innervates the stomach

Answer 16

The stomach receives innervation from the autonomic nervous system:

• Parasympathetic nerve supply arises from the anterior and posterior vagal trunks, derived from the vagus nerve.
• Sympathetic nerve supply arises from the T6-T9 spinal cord segments and passes to the coeliac plexus via the greater splanchnic nerve. It also carries some pain transmitting fibres.