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ESA 3 - GI Anatomy > Functional and Applied Anatomy of the Stomach > Flashcards

Functional and Applied Anatomy of the Stomach Flashcards

1
Q

What is the stomach?

A

The expanded part of the GI tract between the oesophagus and duodenum

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2
Q

What is the stomach specialised for?

A

The accumulation of ingested food

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3
Q

How much food can the adult stomach hold?

A

2 to 3 litres

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4
Q

What does the adult stomach loook like?

A

Resembles the letter J, but the size and position of teh stomach varies1

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5
Q

What does the size and position of the stomach vary depending on?

A
  • Body shape
  • Degree of distention
  • Posture
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6
Q

What are the structural features of the stomach?

A
  • Five recognisable parts
  • Greater and lesser curvature
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7
Q

What are the five recognisable parts of the stomach?

A
  • Cardia
  • Fundus
  • Body
  • Antrum
  • Pylorus
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8
Q

What are the curvatures of the stomach?

A
  • Greater
  • Lesser
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9
Q

Label this diagram

A
  • A - Oesophagus
  • B - Cardiac notch of the stomach
  • C - Cardia
  • D - Fundus
  • E - Body
  • F - Lesser curvature of the stomach
  • G - Greater curvature of the stomach
  • H - Pylorus
  • I - Antrum
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10
Q

Where do sphincters exist in the stomach?

A

At the entry and exit parts of the stomach

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11
Q

Where does the oesophagogastric junction lie?

A

To the left of the T11 vertebra on the horizontal plane that passes through the tip of the xiphoid process

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12
Q

What is meant by the Z-line?

A

The line where the mucosa abruptly changes from oesophageal to gastric

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13
Q

What happens immediately superior to the Z-line?

A

The diaphragmatic musculature forming the oesophageal hiatus functions that contracts and relaxes

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14
Q

What is the purpose of the physiological sphincter formed by the diaphragmatic musculature?

A

Prevents the reflux of stomach contents

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15
Q

What anatomical feature does the diaphragmatic musculature sphincter work with to prevent reflux of the stomach contents?

A

Cardiac notch

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16
Q

How common is reflux of the gastric contents into the oesophagus?

A

Common

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17
Q

When can reflux of the gastic contents into the oesophagus be problematic?

A

If it is frequent and/or clearance of reflux material is deficient

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18
Q

What can happen if reflux of gastric contents is frequent and/or clearance of reflux material is deficient?

A

‘Heartburn’ and/or inflammation with ulceration may result

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19
Q

What may chronic reflux result in?

A

Metaplastic changes in the mucosa (Barrett’s oesophagus)

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20
Q

Label this diagram

A
  • A - Diaphragm
  • B - Endothoracic fascia
  • C - Pleura
  • D - Upper limb of phrenoico-oesophageal ligament
  • E - Endoabdominal fascia
  • F - Cardial notch
  • G - Lower limb of phrenico-oesophageal ligament
  • H - Cardial orifice of stomach
  • I - Oesophagogastric junction (Z-line)
  • J - Peritoneum
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21
Q

Where is the pyloric sphincter located?

A

At the pyloric end of the stomach obviously

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22
Q

What produces the pyloric sphincter?

A

The circular muscle coat is thickened

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23
Q

What does the pyloric sphincter do?

A

Controls the discharge of the stomach contents through the pyloric orifice into the duodenum

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24
Q

Label this diagram

A
  • A - Pyloric part of stomach
  • B - Pyloric orifice
  • C - Duodenum
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25
What happens to the gastric mucosa when empty?
It is thrown into longitudinal folds called rugae, and a gastric canal forms temporarily
26
Where does the gastric canal form?
Between the gastric folds along the lesser curvature
27
What is the purpose of the gastric canal?
Allows saliva and other fluids (and small amounts of chewed food) to pass along to the pylorus
28
What are the histologically distinct zones of the gastric mucosa?
* Cardia * Fundus and body * Pyloric
29
What cells are found in the cardia mucosa?
Neck cells
30
What do neck cells in the cardia produce?
Mucus
31
What cells are found in the fundus and body mucosa?
* Neck cells * Parietal * Chief
32
What do neck cells in the fundus and body produce?
Mucus
33
What do parietal cells in the fundus and body produce?
Acid
34
What do chief cells in the fundus and body mucosa produce?
Pepsinogen
35
What cells are found in the pyloric mucosa?
* Neck cells * G-cells
36
What do the neck cells in the pyloric mucosa produce?
Mucus
37
What do G-cells in the pyloric mucosa produce?
Gastrin
38
Label this diagram
* A - Gastic pit *(opening to the gastric gland)* * B - Mucous epithelium * C - Lymphatic vessel * D - Lamina propria * E - Muscularis mucosae * F - Submucosa * G - Oblique muscle * H - Circular muscle * I - Longitudinal muscle * J - Serosa * K - Myenteric plexus * L - Gastric pit * M - Gastric gland * N - Mucous cells * O - Neck * P - Parietal cells * Q - Chief cells * R - Smooth muscle cel * S - G cell
39
Where do peptic ulcers commonly occur?
In the antrum and along the lesser curvature of the stomach
40
What does perforation of peptic ulcers lead to?
Spillage of gastric contents into the peritoneal cavity
41
What may be the result of spillage of gastric contents into the peritoneal cavity?
Affects abdominal structures
42
What abdominal stuctures may be affected by the spilling of gastric contents into the peritoneal cavity?
Pancreas and associated blood vessels lying in close proximity to the stomach
43
What is the greater omentum?
A prominent, four-layered peritoneal fold that hangs down like an apron from the greater curve of the stomach
44
What happens to the greater omentum after descending?
It folds back and attaches to the anterior surface of the transverse colon and its mesentery
45
What is the lesser omentum?
A much smaller, double-layered peritoneal fold that connects the lesser curvature of the stomach and the proximal part of the duodenum to the liver
46
What does the lesser omentum connect the stomach to?
The portal triad
47
What is the epiploic foramen (omental foramen)?
An opening
48
What is the importance of the epiploic foramen?
The greater and lesser sacs communicate through it
49
Where is the epiploic foramen situated?
Posterior to the free edge of the lesser omentum (hepatoduodenal ligament)
50
How can the omental foramen be located?
By running a finger along the gall bladder to free the edge of the lesser omentum
51
How many fingers does the omental foramen usually admit?
Two fingers
52
Label this diagram
* A - Diaphragm * B - Falciform ligament * C - Liver * D - 7th rib * E - Porta hepatis * F - Lesser omentum * G - Finger is inserted through omental forament into omental bursa * H - Gallbladder * I - Costodiaphragmatic (pleural) recess * J - 10th rib * K - 11th costal cartilage * L - Transversus abdominis muscle * M - Oesophagus * N - Diaphragm * O - Stomach * P - Greater omentum, gastrocolic portion * Q - Anastomosis between right and left gastro-omental arteries * R - Transverse colon appearing in an unusal gap in the greater omentum
53
What does the coeliac trunk originate from?
The abdominal aorta
54
What does the coeliac trunk give rise to?
The left gastric, splenic, and common hepatic arteries
55
Label this diagram
* A - Left gastric artery * B - Celiac trunk * C - Right and left branches * D - Cystic artery * E - Hepatic artery proper * F - Right gastric artery * G - Common hepatic artery * H - Gastroduodenal artery * I - Supraduodenal artery * J - Superior pancreaticoduodenal artery * K - Right gastro-omnetal artery * L - Abdominal aorta * M - Left gastro-omental artery * N - Spleen * O - Splenic branches * P - Short gastric arteries * Q - Splenic artery * R - Posterior gastric artery * S - Aortic hiatus
56
What does the rich arterial blood supply of the stomach arise from?
The celiac trunk and its branches
57
What is the arterial supply to the lesser curvature of the stomach?
* Left gastric artery * Right gastric artery
58
What does the left gastic artery arise from?
Coeliac trunk
59
What does the right gastric artery arise from?
Coeliac trunk -\> Common hepatic
60
What is the arterial supply to the greater curvature?
* Left gastro-omental * Right gastro-omental
61
What does the left gastro-omental artery arise from?
Coeliac trunk -\> Splenic
62
What does the right gastro-omental artery arise from?
Coeliac trunk -\> Common hepatic -\> Gastroduodenal
63
What is the arterial supply to the fundus and body of the stomach?
Posterior gastric/small gastric
64
What is the arterial supply to the fundus and body?
Coeliac trunk -\> Splenic
65
What do the veins of the stomach do?
Parallel the arteries in position and course
66
What does the left gastric vein follow?
The course of the left gastric artery
67
What does the left gastrin vein drain into?
The hepatic portal vein
68
What does the right gastric vein follow?
The course of right gastric artery
69
What does the right gastric vein drain into?
The hepatic portal vein
70
What does the short gastric vein follow?
The course of the short gastric artery
71
What does the short gastric vein drain into?
The splenic vein
72
What does the splenic vein join?
Superior mesenteric vein
73
What is formed from the joining of the splenic vein and SMV??
Hepatic portal vein
74
What does the left gastro-omental vein follow?
The course of the left gastro-omental artery
75
What does the left gastro-omental vein drain into?
The splenic vein
76
What does the right gastro-omental vein follow?
The right gastro-omental artery
77
What does the right gastro-omental vein drain into?
The superior mesenteric vein
78
Label this diagram
* A - Left gastric vein * B - Right gastric vein * C - Portal vein * D - Prepyloric vein * E - Pylorus * F - Pancreaticoduodenal veins * G - Duodenum * H - Superior mesenteric vein * I - Inferior mesenteric vein * J - Right gastro-omental vein * K - Splenic vein * L - Left gastro-omental vein * M - Middle gastric vein * N - Short gastric vein
79
What are the categories of causes of inflammation of the stomach (gastritis)?
* Acute * Chronic
80
What can cause acute gastritis?
* NSAIDS * Alcohol * Exfoliation of the surface epithelial cells and decreased secretion of protective mucus
81
What can cause chronic gastritis?
* Infection with the bacteria H. Pylori * Inflammatory changes in the mucosa result in atrophy and epithelial metaplasia
82
What may gastric epithelial metaplasia develop into?
Carcinoma

ESA 3 - GI Anatomy (3 decks)

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