The Stomach- Anatomy.

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 It has both digestive and not digestive functions.

It’s development is in the foregut. It is situated in the upper abdomen, left

hypochondriac, epigastric and umbilical regions.

It is normally J shaped.

Capacity

New born 30 ml

At puberty-1000 ml

Adult 1500 ml

Shape

When empty the stomach is somewhat J shaped. When partially it

becomes piriform in shape. In obese persons it is more horizontal.

Size

It is about 10 inches long and the mean capacity is one Ounce

(30 ml) at birth, one litre at puberty and 1.5 – 2 litres or more in adults.

External Features

The stomach has

1. 2 openings or ends.(orifices)

2. 2 borders.

3. 2 surfaces

4. 2 peritoneal sacs are related.

5. 2 Omenta are attached to it.

Openings of the Stomach

Cardiac end

This is the upper opening of the stomach. This is not an anatomical

sphincter. The Oesophagus opens in to the stomach at the level of

T11 vertebra.

Pyloric end

This is the lower opening of the stomach. It is situated 1.25 cm to the

right of the midline at the transpylorie line. It opens into the duodenum. It

has a well defined anatomical pyloric sphincter. Pyloric groove separates it

from the duodenum. The pyloric end is greenish as it is stained by the bile.

Borders of the stomach

It has 2 borders

1. Lesser Curvature.

2. Greater Curvature.

Lesser Curvature

It is the right upper border. It is the direct continuation of the right

border of angularis. Lesser curvature gives attachment to the lesser

Omentum. A peptic ulcer commonly occurs along or nearer to the lesser

curvature.

Greater Curvature

It is the lower and left border of the stomach. It is 5 times longer than

the lesser Curvature. Between the Oesophagus and greater curvature the

cadiac notch is situated.

To the greater curvature the following peritoneal folds are attached,

1. Gastrophrenic ligament.

2. Gastro Splenic ligament.

3. Greater Omentum

Surface of the Stomach

It has two surfaces,

1. The antero superior surface.

2. The postero inferior surface.

Structures forming the stomach bed

1. The diaphragm (left crus)

2. Left kidney.

3. Left supra renal gland.

4. Splenic artery and spleen.

5. Body of the Pancreas.

6. Transverse Mesocolen.

7. Left colic flexure.

Parts of the Stomach (Fig.1)

1. Fundus

2. Body

3. Pyloric Antrum

4. Pyloric canal.

Fundus

It is the highest part of the stomach. Usually it is filled with gas.

Body

It is situated below the fundus.

Pylorus

It is situated along the right side of the body of the stomach.

BLOOD SUPPLY

ARTERIAL SUPPLY (Fig. 2)

Along the lesser Curvature

1. Left gastric artery from coeliac artery.

2. Right gastric artery from hepatic artery.

Along the greater Curvature

1. Right gastroepiploic artery from the gastroduodentral artery.

2. Left gastroepiploic artery from the splenic artery.

Fundus of the stomach

5-6 short gastric arteriers from splenic artery.

Venous Drainage

Among the lesser Curvature

1. Left gastric vein.

2. Right gastric vein – into portal vein.

Among the greater Curvature

1. Left gastroepiploic vein into splenic vein.

2. Right gastroepiploic vein into superior mesentric vein.

Fundus of the Stomach

5-6 short gastric veins into splenic vein.

Nerve supply

Parasympathetic supply

1. Right and left vagus nerves via anterior and posterior gastric

nerves.

2. Oesphageal plexus.

Sympathetic Supply

The greater splanchnic nerve (T5 – T9) joins the coeliac ganglion.

From the ganglion post – ganglionic fibres continues to form the coeliac

flexus.

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