[ Up ] [ The skin ] [ Heart ] [ Thorax ] [ Abdominal wall ] [ Gastrointestinal tract ] [ Stomach ] [ Small intestine ] [ Large intestine ] [ Liver and pancreas ] [ Upper renal tract ] [ Lower renal tract ] [ Inguinal canal ] [ Head & neck ] [ Arteries of the head & neck ] [ Thyroid ] [ Salivary glands ] [ Arteries of the upper limb ] [ Nerves of the upper limb ] [ Joints of the upper limb ] [ Muscles of the upper limb ] [ Bones of the upper limb ] [ Lower limb general ] [ Nerves of the lower limb ] [ Arteries of the lower limb ] [ Veins of the lower limb ] [ Joints of the lower limb ] [ Muscles of the lower limb ] [ Pituitary gland ] [ Brachial plexus ]

Stomach

Development

  • The GI tract is divided into 3 sections
  • Foregut
    • Stomach and duodenum as far as Ampulla of Vater
  • Midgut
    • Ampulla of Vater to junction of mid and distal transverse colon
  • Hindgut
    • The distal colon
  • Blood supply of the 3 sections is
    • Foregut – coeliac axis
    • Midgut – superior mesenteric artery
    • Hindgut – inferior mesenteric artery

Anatomy

  • For descriptive purposes the stomach is divided into
    • Lesser curve
    • Greater curve
    • Fundus
    • Incisura angularis
    • Body
    • Pylorus

Histology

  • The mucosa is simple columnar epithelium with millions of invaginations known as gastric pits
  • Gastric pits lead into gastric glands which secrete gastric juice
  • Mucous cells secrete acidic mucus and function as stem cells for surface mucosa
  • Parietal cells secrete hydrochloric acid and intrinsic factor
  • Chief cells secrete pepsinogen, an inactive form of pepsin
  • Neuroendocrine cells secrete multiple hormones into the plasma
  • The most important of these is gastrin

Blood supply

  • Five main arteries supply the stomach
    • Left gastric
    • Right gastric
    • Right gastro-epiploic
    • Left gastro-epiploic
    • Short gastric
  • The left gastric artery arises from the coeliac access
  • The right gastric artery arises from the common hepatic artery
  • The right gastro-epiploic artery arises from the gastroduodenal artery
  • The left gastro-epiploic artery arises from the splenic artery
  • The short gastric arteries are branches of the splenic artery

Lymphatic drainage

  • The stomach drains into four groups of nodes
    • Hepatic group
    • Subpyloric group
    • Gastric group
    • Pancreaticolienal group

The vagus nerve

  • Both vagi enter the abdomen through the oesophageal hiatus
  • The left vagus nerve becomes anterior
  • The right vagus nerve becomes posterior
  • The anterior vagus runs along the lesser curve
  • Nerve of Latarjet supplies the pylorus
  • The posterior vagus supplies the coeliac ganglion
Last modified:

 

 
 

Copyright © 1997- 2012 Surgical-tutor.org.uk