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Block 1: Anatomy > The stomach > Flashcards

The stomach Flashcards

1
Q

What are the four main anatomical divisions of the stomach?

A

Cardia
Fundus
Body
Pylorus

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2
Q

Where is the Cardia of the stomach?

A

Surrounds superior opening of stomach

Vertebral level T11

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3
Q

Where is the Fundus of the stomach?

A

Rounded portion at superior aspect of stomach - usually gas filled

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4
Q

Where is the Body of the stomach?

A

Large central portion, inferior to fundus

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5
Q

Where is the Pylorus of the stomach?

A

Connects stomach to the duodenum
Divided into antrum, canal and sphincter
Pyloric sphincter at transpyloric plane (L1)

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6
Q

What is the blood supply to the greater curvature of the stomach?

A

Short gastric arteries

Right and Left gastro-omental arteries

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7
Q

What is the blood supply to the lesser curvature of the stomach?

A

Left gastric artery

Right gastric branch of Hepatic artery

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8
Q

What are the anatomical relations of the stomach?

A

Superior - oesophagus and diaphragm
Anterior - diaphragm, abdominal wall, left lobe of liver, gallbladder
Posterior - pancreas, left kidney, left adrenal gland, spleen, transverse mesocolon, splenic artery

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9
Q

What vertebral level is the inferior oesophageal sphincter?

A

T11

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10
Q

At what vertebral level does the oesophagus pass through the diaphragm?

A

T10

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11
Q

What is the inferior oesophageal sphincter?

A

Physiological sphincter

Under involuntary control

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12
Q

What is the pyloric sphincter?

A

Anatomical sphincter

Limits exit of chyme from stomach into duodenum through smooth muscle contractions

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13
Q

What is the blood supply to the stomach?

A

Branches of coeliac trunk:
L gastric
Common Hepatic Artery (branches into R gastric and R gastro-omental)
Splenic Artery (branches into L gastro-omental)

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14
Q

What is the venous drainage of the stomach?

A

R and L gastric veins drain into the hepatic portal vein.

Short gastric vein and L + R gastro-omental veins drain into the SMV

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15
Q

What is the parasympathetic nerve supply to the stomach?

A

Vagus (CN X)

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16
Q

What is the sympathetic nerve supply to the stomach?

A

T6-T9

Passes to coeliac plexus via greater splanchnic nerve

17
Q

What is the lymphatic drainage of the stomach?

A

Travel with arteries along greater and lesser curvatures
Drain into gastric and gastro-omental lymph nodes found at curvatures
Lymphatic vessels connect to Coeliac lymph nodes located on posterior abdmoinal wall.

18
Q

What are rugae?

A

Large temporary folds of the stomach mucosa

19
Q

What epithelium lines the stomach mucosa?

A

Non-ciliated simple columnar epithelium

20
Q

What cells are found in the gastric glands?

A 
Simple columnar epithelium + 3 types of exocrine gland cells that secrete into lumen: 
Mucus neck cells (secrete mucus) 
Parietal cells (secrete HCl and IF) 
Chief cells (secrete Pepsinogen)

+ G-Cells that secrete Gastrin directly into blood stream!

21
Q

What are the layers of the muscularis layer of the stomach from inside out?

A 
Inner = oblique layer
Middle = circular layer
Outer = longitudinal layer
22
Q

What is the epiploic foramen?

A

A hole in the lesser omentum allowing for communication between the greater and lesser sacs

23
Q

What does the lesser omentum attach to?

A

Lesser curvature of stomach and duodenum and the posterior aspect of the liver (hepatoduodenal and hepatogastric ligaments)

24
Q

What does the greater omentum attach to?

A

The greater curvature of the stomach and the transverse colon (+ a free border anteriorly)
Gastrocolic ligament

25
Q

What are the subdivisions of the peritoneal cavity?

A 
Greater sac (which is further divided into the supracolic and infracolic compartments by the transverse mesocolon) 
Lesser sac (omental bursa)
26
Q

Why is the peritoneal cavity referred to as ‘potential space’?

A

Normally only filled with a thin layer of peritoneal fluid (function is lubrication, enabling free movement of viscera, and antibody movement to fight infection) - fluid in space can build up causing ascites (most commonly caused by portal hypertension but can also be due to infection, peritonitis, malignancy etc.)

27
Q

What is the clinical relevance of the paracolic gutters?

A

Infection spread between infracolic and supracolic compartments
E.g. right subphrenic abscesses can be caused by appendicitis due to pus travelling up through paracolic gutter

28
Q

What separates the right and left subphrenic recesses?

A

Falciform ligament

29
Q

What organ and artery would be at risk of a gastric ulcer eroded posteriorly?

A 
Pancreas
Splenic artery (runs superiorly to pancreas)

Block 1: Anatomy (11 decks)

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