Lecture 3 - Stomach and Duodenum

Question 1

Arteries that come out of the the abdominal aorta?

Answer 1

1. Celiac Trunk at T12
2. Superior Mesenteric Artery L1
3. Inferior Mesenteric Artery L3

Question 2

Branches of the Celiac Trunk?

Answer 2

1. ) Common Hepatic Artery
2. ) Splenic Artery
3. ) Left Gastric Artery

Question 3

Branches of the common hepatic artery and where is it?

Answer 3

1. ) Proper hepatic artery
2. ) Gastroduodenal artery

Runs through the hepatoduodenal ligament

Question 4

Branches of the splenic artery and where is it?

Answer 4

1. ) Short Gastric
2. ) Left gastro omental artery

Runs along the sueprior border of the pancreas to the spleen

Question 5

Branches of the left gastric artery and where is it?

Answer 5

1.) esophageal branches

And it descends to the lesser curvature of the stomach

Question 6

What are the branches of the superior mesenteric artery and what does it supply?

Answer 6

1.) (anterior and posterior) inferior pancreaticoduodenal artery

It supplies the duodenum distal to the papilla

Question 7

How is the esophagus attached to the stomach?

Answer 7

It is attached to the stomach by the phrenico-esophageal ligament.

Question 8

Where does the stomach terminate and what is there?

Answer 8

It terminates at the cardial orifice of the stomach and there is an inferior esophageal sphincter (physiological)

Question 9

Where does the esophagus travel through to go to the abdominal and at what level?

Answer 9

It travels through the esophageal hiatus at the diaphragm at the level of T10.

Question 10

What is the arterial supply to the esophagus?

Answer 10

Esophageal branches from the left gastric artery

Question 11

What is the venous drainage of the esophagus?

Answer 11

1. ) left gastric vein that is in the portal venous system

2. ) esophageal veins that are in the systemic venous system

Question 12

What are the lymphatics at the esophagus?

Answer 12

Left gastric lymph nodes that drain into the celiac lymph nodes

Question 13

innervation of the esophagus?

Answer 13

Parasympathetic - vagus

Sympathetic - greater splanchnic nerve

Question 14

What happens in the stomach or what is its function?

Answer 14

Stomach is an extended part of the GI tract where food accumulates and prepares for mechanical breakdown and chemical digestion.

Question 15

What are the parts of the stomach?

Answer 15

1. ) Cardia (at the level of T11)
2. ) Fundus - gas goes into it
3. ) Body - two curvatures
4. ) Pylorus

Question 16

Function of the pylorus and its different parts?

Answer 16

It controls the outflow of chime

It has a pyloric antrum (chamber) and a pyloric canal (outflow region)

Question 17

What are the gastric rugae?

Answer 17

Longitudinal folds of mucosa inside the stomach. They increase the surface area of teh stomach and can be either temporary (diminish as stomach distends) or permanant (form the gastric canal).

Question 18

What is the gastric canal?

Answer 18

It is the groove that is along the lesser curvature (in the stomach), it can be seen in medical imaging.

Question 19

What is the pyloric sphincter?

Answer 19

It is a circular band of smooth muscle and is a junction between the stomach and the small intestine.

Question 20

What is the arterial supply to the lesser curvature?

Answer 20

1. ) Left gastric artery that is a direct branch of the celiac trunk
2. ) Right gastric artery that comes from the proper hepatic artery

Question 21

What is the arterial supply to the greater curvature?

Answer 21

1. ) Left gastro omental artery that comes from the splenic artery
2. ) Right gastro omental artery that comes from the gastroduodenal artery

Question 22

What is the arterial supply to the fundus?

Answer 22

Short gastric arteries that are branches of the splenic artery

Question 23

What is the venous drainage of the stomach?

Answer 23

1. ) Right gastric veins that drain into the hepatic portal vein
2. ) Left gastric veins that drain directly into the hepatic portal vein
3. ) Right gastro omental veins that drain into the superior mesenteric vein
4. ) Left gastro omental veiins that drain into the splenic vein
5. ) Short gastric veins that drain into the splenic vein
6. ) Prepyloric vein that drains into the right gastric vein

Question 24

Parts of the small intestine?

Answer 24

1. ) duodenum
2. ) jejunum
3. ) Ileum

Question 25

Parts of the colon?

Answer 25

1. ) ascending colon 2. ) transverse colon 3. ) descending colon 4. ) sigmoid colon

Question 26

What connect the small intestine to the colon and what does it have?

Answer 26

Cecum which has the appendix

Question 27

Parts of the duodenum?

Answer 27

1. ) Superior part 2. ) Descending part 3. ) Transverse Part 4. ) Ascending part

Question 28

What is in the superior part of the duodenum and everything else about it?

Answer 28

1. ) It is intraperitoneal (mobile) 2. ) Duodenal cap or ampulla is continuos with the pylorus of the stomach 3. ) At the level of L1 4. ) Superiorly attached by the hepatoduodenal ligament 5. ) Inferiorly attached by the greater omentum 6. ) Supplied by the celiac trunk

Question 29

What is in the descending part of the duodenum and everything else about it?

Answer 29

1. ) It is secondarily retroperitoneal (immobile and covered by transverse mesocolon) 2. ) It lies at the midline and is anterior to the hilium of the right kidney. 3. ) At the level L2 4. ) Supplied by the celiac trunk and the superior mesenteric artery 5. ) Has the major and minor papilla

Question 30

What is the major papilla?

Answer 30

It is in the descending part of the duodenum and is an opening for the common bile duct and the main pancreatic duct. It releases pancreatic juice and bile and is larger because of the hepatopancreatic ampulla and sphincter internally.

Question 31

What is the minor papilla?

Answer 31

It is in the descending part of the duodenum and is an opening for the acessory pancreatic duct. Releases pancreatic juices only and is about 2 cm superior to the major papilla.

Question 32

What is in the transverse part of the duodenum?

Answer 32

1. ) It is secondarily retroperitoneal 2. ) Crosses posteriorly under the sueprior mesenteric artery and anteriorly it is over the IVC 3. ) It is at teh level of L3 4. ) Longest section of the duodenum 5. ) It is supplied by the superior mesenteric artery

Question 33

What is in the ascending part of the duodenum?

Answer 33

1. ) It is mostly retroperitoneal 2. ) It terminates at the duodenojejunal flexure 3. ) At the level of L2 4. ) Supplied by the superior mesenteric artery 5. ) Supported by the suspensory ligament

Question 34

What is the suspensory ligament and why is it clincally significant?

Answer 34

It conencts the duodenum to the diaphragm and the posterior abdominal wall.. It also facilitates movement of the intestinal content and marks the point of the duodenojejunal flexure. It divides the GI tract into upper and lower. If upper GI tract bleeding then it is proximal and blood would appear in vomit and stool would be dark. If in lower than it is distal and red blood appear in stool.

Question 35

Specifically what is the arterial supply of the duodenum? (the specific branches from the main arteries)

Answer 35

1. ) Celiac trunk - Anterior and posterior superior pancreaticoduodenal arteries 2. ) Gastroduodenal artery - supraduodenal artery 3. ) Superior mesenteric artery - Anterior and posterior inferior pancreatico duodenal arteries