Stomach and Spleen

Question 1

Location and shape of stomach

Answer 1

Upper abdomen, left of liver
Intraperitoneal organ
J shaped
Lesser curvature, in epigastric region
Greater curvature in hyperchondriac

Question 2

Location and shape can vary on muscular contraction

Answer 2

Hypertonic
Hypotonic
Atonic

Question 3

Location and shape can vary on body shape

Answer 3

Ectomorph
Mesomorph
Endomorph (steerhorn)

Question 4

Parts of the stomach

Answer 4

Fundus, storage, filled with gas

Cardia, has columnar epithelial for mucus secretion

Body, storage, mucus, HCL, pepsinogen, intrinsic factor secretion

Pyloric antrum, mixing/grinding, gastrin

Question 5

Functions of the stomach

Answer 5

Temporary chyme store for 4hrs

Secretions, gastrin enhances intestinal motility
Intrinsic factor, precursor for B12
Mucus, protects oesophagus and stomach from acid

Breakdown of food, churning
Pepsin, hydrolyse proteins
HCL, allows pepsin action, bacteria destruction

Absorption of H20, electrolytes, alcohol, aspirin

Question 6

Arrangement of gut wall

Answer 6

Mucosal layer
Submucosal layer
Muscular externa
Adventitia/serosa

Question 7

Function of structures in mucosal layer

Answer 7

Epithelium absorbs
Glands secrete mucus
Ducts come from pancreas, liver
Lymphoid tissue removes pathogens
Muscular mucosa, muscular movement in lumen

Question 8

Function of structures in submucosal layers

Answer 8

Nerve cells, blood vessels, cell bodies here form ENS, function independently in Meissner’s plexus
Control contractions of muscular mucosa, self controlling

Question 9

Function of structure in muscular externa

Answer 9

Outer longitudinal, inner circular muscle for peristalsis
Myenteric (Auerbach) plexus, part of ENS

Stomach has additional inner oblique layer

Question 10

Function of structure of adventitia/serosa

Answer 10

Serosa, peritoneal membrane that wraps around the gut
If retroperitoneal, covered in adventitia
Blood vessels and nerves that come from outside, joint gut wall here
Motility of gut due to vagus nerve stimulation by parasympathetic innervation in proximal part of gut

Question 11

Structure of stomach wall

Answer 11

Longitudinal muscle
Circular muscle
Oblique muscle, mucosa of longitudinal folds (rugae), allows room for expansion

Question 12

Relations of the stomach

Answer 12

R kidney behind duodenum
IVC, A behind pyloric antrum
L kidney and pancreas behind body
DJ flexure behind bottom of greater curvature

Question 13

Function of coeliac trunk

Answer 13

Comes from aorta, supplies liver, spleen, stomach

Branches into L gastric, splenic, common hepatic

Question 14

Vasculature of stomach (veins)

Answer 14

Whole of gut drains into hepatic portal vein into liver
If hepatic systems blocked, blood enters azygos system around oesophagus => SVC

Splenic vein
L and R gastricepiploic (greater curvature)
Gastric vein (lesser curvature)

Question 15

Vasculature of the stomach (arteries)

Answer 15

L and R gastricepiploic (greater curvature)

From the coeliac trunk:
L gastric artery
Splenic
Common hepatic

Gastroduodenal artery
Superior pancreatic duodenal

Question 16

Lymphatics of stomach

Answer 16

Pancreasticolienal
R gastroomental
Pyloric
R and L gastric
Coeliac

All foregut nodes pass into coeliac nodes (preaortic lymph nodes)
Others go to paraaortic nodes (kidney etc)

Question 17

Nerve supply of the stomach

Parasympathetic nerves

Answer 17

Motor and secretomotor
L vagus => anterior vagal trunk
R vagus => posterior vagal trunk

Question 18

Nerve supply of the stomach

Sympathetic nerves

Answer 18

Afferent, epigastric pain
Efferent, vasoconstriction and antperistaltic

Splanchic nerves from coeliac ganglia cells form esophageal plexus

Question 19

Spleen

Answer 19

Largest lymph organ
Highly vascular
Covered by peritoneum, intraperitaneal
At an angle, posterior, rib 10, comes forward to mid auxiliary vein

Question 20

Functions of the spleen

Answer 20

Removes blood borne antigens
Removes and destroys old/damaged blood cells
Stores RBCs and platelets
Haemopoiesis in fetus

Question 21

Structure of a spleen

Answer 21

Upper pole
Diaphragmatic surface
Indentation of anterior border
Lower pole
Visceral surface
Hilium (point of insertion for splenic artery and vein

Has gastric, renal and colic and pancreatic sections

Question 22

Causes of an enlarged spleen

Answer 22

Liver disease
Blood cancers (lymphoma, leukemia, myelofibrosis)
Infection
Abnormal blood flow and congestion
Catcher disease
Blood cell disorders
inflammatory disease