Stomach Flashcards
(25 cards)
Location of stomach:
- Epigastrium, left hypochondrium, umbilical region
Size & capacity:
’ Size: 25 cm song
- capacity: at birth - 30 ml
At puberty: 1000 ml
Adult: > 1500 - 2000 ml
Explanation about cardiac orifice
- physiological sphincter due to high pressure area
Explanation of pyloric orifice
Indication of pylorus from duodenum- pyloric constriction ring & prepyloric vein in front of constriction
Lesser curvature
- Concave
- pyloric orifice to cardiac orifice
- attachment to lesser omentum → attaches liver to stomach
- incisora angularis/ angular notch
Greater curvature
- convex
- attachment to:
1) greater omentum → gastrosplenic ligament
2)gastrosplenic ligament( stomach and spleen)
3) gastrophrenic ligament(stomach and diaphragm) - cardiac notch( separates esophagus, and greater curvature)
- 5time longer than lesser curvature
Greater momentum attaches greater curvature to posterior wall,
Fundus
Concave dome shaped
Distended with gas(shown in x-ray on the left diagram)
Body
Extend from fundus to incisura angularis
Fundus and body both have gastric glands. They have the secretory cells.
1) goblet cell/mucus cell
2) chief/peptic
3) parietal/oxyntic
Pyloric antrum
Extension from body to pyloric Canal
Separated from pyloric Canal by sulcus intermedius
It is richest in mucous cells
Pyloric Canal
Narrow and tubular
End at pyloric sphincter
Bare area of stomach
Lesser & greater curvature
Area of gastrophrenic ligament
Visceral relations of anterior surface of stomach
1) diaphragm : separates from - 1) left lung 2) pericardium 3) left 7th to 9th ribs 4) costal cartilages
2) trans versus abdomens: separates from costal cartilages
3) left lobe of liver (superiorly)
4) anterior abdominal wall (inferiorly)
5) transverse colon
Visceral relation of posterior surface of stomach
(I) diaphragm
3,left kidney
4) left supra renal gland
5) transverse mesocolon
6) splenic flexure of colon
7)splenic artery
(All these are separated from lesser sac)
8) spleen(separated by greater sac)
Arterial supply of stomach
Lesser curvature - (I) R gastric artery 2) L gastric artery → supplies cardia & distal oesophagus
Greater curvature - (I) L gastroepiploic artery 2) R gastroepiploic artery
Fundus - short gastric arteries
Venous drainage
Lymphatic drainage
Mucosa
Longitudinal rugae along lesser curvature
Maybe irregular otherside
Gastric pits - gastric glands open up into pits
Longitudinal rugae is also called gastric canal/magenstrasse that allows liquids to pass to lower stomach without spreading to other parts of stomach
Lesser curvature bears the insult of swallowed liquids - peptic ulcers
Pyloric sphincter is made by:
Inner circular layer → thickened at pylorus to make pyloric sphincter
Oblique layer
Forms rugae on lesser curvature → gastric canal
Distribution of smooth muscles of stomach
Oblique→ body & fundus
Longitudinal → curvatures (mainly on lesser)
Circular→ body
Gastric pain felt in:
Epigastrium.
Because of same nerve supply to stomach & upper abdominal wall that is T6 to T9 of spinal cord
Peptic ulcer:
Occurs where pepsin & HCL is present.
(I) stomach
② 1st part of duodenum
(3) lower End of oesophagus
(4) Meckel’s diverticulum
→ common in ‘o’ blood group
Gastric ulcers:
Along lesser curvature because:
(I) mucosa is next freely movable over muscularis coat
(2) epithelium is thin
(3) less blood supply, fewer anastomoses
(4) abundant nerve supply -sensitive
(5) gastric canal→ insults of irritating beverages
(6) H. Pyloric infection
For healing → antacids / partial gastrectomy(vagotomy)
Gastric carcinoma
Around greater curvature
Importance of lymphatic drainage
Common in A blood group
Metastasis → through thoracic duct to left supraclavicular lymph node(troissers sign)
