Stomach

Question 1

Function of the stomach

Answer 1

Accumulation of ingested food

Question 2

How much food can an adult stomach hold

Answer 2

2-3l

Question 3

What affects the size and position of the stomach

Answer 3

Body shape
Degree of distension
Posture

Question 4

What are the 5 parts of the stomach

Answer 4

Cardia - surrounds superior opening
Fundus - rounded portion superior to and left of the cardia
Body - large central portion inferior to the fundus
Antrum - rounded portion inferior to the body and left of the pylorus
Pylorus - connects to duodenum

Question 5

What is the Z line

Answer 5

Line where the mucosa changes from oesophageal to gastric

Question 6

Where is the oesophagogastric junction

Answer 6

Left of T11 vertebra

Question 7

What is the inferior oesophageal sphincter

Answer 7

Diaphragmatic musculature forming the oesophageal hiatus (hole in diaphragm that oesophagus passes through) immediately superior to the Z line

Question 8

What prevents acid reflux as well as the inferior oesophageal sphincter

Answer 8

Cardiac notch

Question 9

What occurs as a result of frequent acid reflux

Answer 9

Heartburn
Ulceration
Barrett’s oesophagus

Question 10

What is the pyloric sphincter

Answer 10

Thickened coat of circular muscle at the pyloric end of the stomach

Question 11

Function of the pyloric sphincter

Answer 11

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

Question 12

How does the gastric mucosa exist when the stomach is empty

Answer 12

In longitudinal folds called rugae and a gastric canal temporarily forms between the gastric folds along the lesser curvature

Question 13

What does the gastric canal allow

Answer 13

Saliva and other fluids to pass along to the pylorus

Question 14

What cells produce mucus

Answer 14

Neck cells

Question 15

What cells produce acid

Answer 15

Parietal cells

Question 16

What cells produce pepsinogen

Answer 16

Chief cells

Question 17

What cells produce gastrin

Answer 17

G cells

Question 18

What cells are found in the cardia

Answer 18

Neck cells

Question 19

What cells are found in the fundus and body

Answer 19

Neck cells
Parietal cells
Chief cells

Question 20

What cells are found in the pylorus

Answer 20

Neck cells

G cells

Question 21

Where do peptic ulcers commonly occur

Answer 21

Antrum

Lesser curvature

Question 22

What does perforation of peptic ulcers lead to

Answer 22

Spillage of gastric contents into the peritoneal cavity

Question 23

Origin of the coeliac trunk

Answer 23

Abdominal aorta

Question 24

What arises from the coeliac trunk

Answer 24

Left gastric artery
Splenic artery
Common hepatic artery

Question 25

Blood supply of lesser curvature

Answer 25

Coeliac trunk -> left gastric | Coeliac trunk -> common hepatic -> right gastric

Question 26

Blood supply of the greater curvature

Answer 26

Coeliac trunk -> splenic -> left gastro-omental | Coeliac trunk -> common hepatic -> gastroduodenal -> right gastro-omental

Question 27

Blood supply of the fundus and body

Answer 27

Coeliac trunk -> splenic -> posterior gastric | Coeliac trunk -> splenic -> short gastric

Question 28

Venous supply of the stomach

Answer 28

``` Left gastric vein Right gastric vein Short gastric vein Left gastro-omental vein Right gastro-omental vein (All follow course of respective arteries) ```

Question 29

What does the left gastric vein drain into

Answer 29

Hepatic portal vein

Question 30

What does the right gastric vein drain into

Answer 30

Hepatic portal vein

Question 31

What does the short gastric vein drain into

Answer 31

Splenic vein

Question 32

What forms the hepatic portal vein

Answer 32

Formed when the splenic vein and superior mesenteric vein join

Question 33

What does the left gastro-omental vein drain into

Answer 33

Splenic vein

Question 34

What does the right gastro-omental vein drain into

Answer 34

Superior mesenteric vein

Question 35

What causes acute gastritis

Answer 35

NSAIDs | Alcohol

Question 36

What occurs in acute gastritis

Answer 36

Exfoliation of surface epithelial cells and decreased secretion of protective mucus

Question 37

What causes chronic gastritis

Answer 37

Helicobacter pylori

Question 38

What occurs in chronic gastritis

Answer 38

Inflammatory changes in the mucosa result in atrophy and epithelial metaplasia

Question 39

What abdominal regions does the stomach occupy

Answer 39

Epigastric | Umbilical

Question 40

Where does the greater curvature run from and to

Answer 40

From cardiac orifice to pyloric antrum

Question 41

What is the junction between the body and pylorus

Answer 41

Angular incision (most inferior part of the lesser curvature)

Question 42

What extrinsic forces control entry of material into the stomach

Answer 42

At the oesophageal hiatus, the right crus of the diaphragm exerts pressure on the oesophageal wall In the non eating state, the oesophagus is collapsed The oesophagus enters the stomach at an angle so when the stomach is full, entry to the stomach is closed off

Question 43

When does the stomach empty

Answer 43

When intragastric pressure overcomes the resistance of the pylorus (normally contracted)

Question 44

Parasympathetic innervation

Answer 44

Posterior vagal trunks which are derived from the vagus nerve

Question 45

Sympathetic innervation

Answer 45

Coeliac plexus (T6-9)

Question 46

What do the gastric lymphatic vessels drain into

Answer 46

Gastric lymph nodes | Gastro-omental lymph nodes

Question 47

What do the efferent vessels from the gastric and gastro-omental lymph nodes drain into

Answer 47

Coeliac lymph nodes

Question 48

Where are the coeliac lymph nodes

Answer 48

Posterior abdominal wall

Question 49

What is GORD

Answer 49

Gastro-oesophageal reflux disease | A disorder affecting the lower oesophageal sphincter

Question 50

Main causes of GORD

Answer 50

Dysfunction of the lower oesophageal sphincter Delayed gastric emptying Hiatus hernia

Question 51

What is a hiatus hernia

Answer 51

Part of the stomach protrudes into the chest though oesophageal hiatus in the diaphragm

Question 52

Types of hiatus hernia

Answer 52

Sliding | Rolling

Question 53

Describe a sliding hiatus hernia and give the common complication

Answer 53

Lower oesophageal sphincter slides superiorly | Reflux as the diaphragm is no longer reinforcing the sphincter

Question 54

Describe a rolling hiatus hernia

Answer 54

Lower oesophageal sphincter remains in place but a part of the stomach herniates into the chest next to it