Anatomy of the Stomach Quiz
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Questions and Answers

Which region of the body is NOT associated with the location of the stomach?

  • Left iliac region (correct)
  • Left hypochondrium
  • Epigastric region
  • Right hypochondrium

    • At which vertebral level does the stomach primarily reside?

  • L2 - L5
  • T10 - L3 (correct)
  • T5 - L1
  • T12 - L4

    • What is the average capacity of an adult stomach?

  • 2 liters (correct)
  • 1 liter
  • 3 liters
  • 1.5 liters

    • Which shape is NOT typically associated with the stomach?

    <p>Triangular</p> Signup and view all the answers

    Which factor does NOT influence the shape of the stomach?

    <p>Dietary habits</p> Signup and view all the answers

    In which position is the stomach typically more vertical?

    <p>Standing</p> Signup and view all the answers

    What type of orifice is associated with the stomach?

    <p>Cardiac orifice</p> Signup and view all the answers

    Which description best fits the J-shaped stomach?

    <p>Vertical long axis</p> Signup and view all the answers

    Which artery supplies the lower third of the esophagus and upper right part of the stomach?

    <p>Left gastric artery</p> Signup and view all the answers

    What artery arises from the splenic artery and supplies the fundus of the stomach?

    <p>Short gastric arteries</p> Signup and view all the answers

    Which artery supplies the stomach along the upper part of the greater curvature?

    <p>Left gastro-omental artery</p> Signup and view all the answers

    From which artery does the right gastric artery branch?

    <p>Hepatic artery</p> Signup and view all the answers

    The right gastro-omental artery is a branch of which artery?

    <p>Gastroduodenal artery</p> Signup and view all the answers

    Which artery descends along the lesser curvature of the stomach?

    <p>Right gastric artery</p> Signup and view all the answers

    Which artery is a branch of the celiac trunk?

    <p>Left gastric artery</p> Signup and view all the answers

    What is the primary function of the esophageal branch of the left gastric artery?

    <p>Supply the lower third of the esophagus</p> Signup and view all the answers

    What is the function of the pyloric sphincter?

    <p>Regulates the flow of chyme into the duodenum</p> Signup and view all the answers

    Which of the following is NOT a relation of the stomach?

    <p>Right kidney</p> Signup and view all the answers

    What anatomical feature is formed by the folds in the lining of the stomach?

    <p>Gastric rugae</p> Signup and view all the answers

    What could be a consequence of a perforating ulcer in the posterior wall of the stomach?

    <p>Erosion of the splenic artery</p> Signup and view all the answers

    What separates the stomach from surrounding structures besides the lesser sac?

    <p>Peritoneum</p> Signup and view all the answers

    The angular notch is located between which two parts of the stomach?

    <p>Cardiac orifice and antrum</p> Signup and view all the answers

    Which organ is located posteriorly to the stomach?

    <p>Spleen</p> Signup and view all the answers

    What is the least likely symptom of a perforating ulcer affecting the pancreas?

    <p>Increased appetite</p> Signup and view all the answers

    Where does the cardiac orifice lie?

    <p>Behind the left 6th costal cartilage</p> Signup and view all the answers

    What type of sphincter is the gastroesophageal sphincter considered to be?

    <p>A physiological sphincter</p> Signup and view all the answers

    What structure is found at the pyloric orifice?

    <p>Circular groove (pyloric constriction)</p> Signup and view all the answers

    What parts form the pyloric part of the stomach?

    <p>Pyloric antrum, pyloric canal, and pylorus</p> Signup and view all the answers

    How far is the pyloric orifice located from the median plane?

    <p>1.25 cm to the right</p> Signup and view all the answers

    What anatomical feature assists surgeons in identifying the pylorus?

    <p>Prepyloric vein of Mayo</p> Signup and view all the answers

    What type of surface does the body of the stomach have?

    <p>Posterior and anterior surfaces</p> Signup and view all the answers

    What is the relationship between the pyloric orifice and the duodenum?

    <p>The pyloric orifice lies at the beginning of the duodenum</p> Signup and view all the answers

    Which of the following veins drains directly into the hepatic portal vein?

    <p>Left gastric vein</p> Signup and view all the answers

    The right gastroepiploic vein primarily drains into which vein?

    <p>Superior mesenteric vein</p> Signup and view all the answers

    Where does the lymphatic drainage of the stomach ultimately lead?

    <p>Celiac lymph nodes</p> Signup and view all the answers

    Which of the following arteries is noted as potentially absent?

    <p>Posterior gastric artery</p> Signup and view all the answers

    What is the primary function of the left gastroepiploic veins?

    <p>Drain into splenic vein</p> Signup and view all the answers

    Which nodes are responsible for draining the anterior and posterior surfaces of the stomach?

    <p>Gastric and gastroomental lymph nodes</p> Signup and view all the answers

    What do the efferent vessels from lymph nodes in the stomach primarily drain into?

    <p>Celiac lymph nodes</p> Signup and view all the answers

    Which of the following structures is located anteriorly to the third part of the duodenum?

    <p>Root of the mesentery</p> Signup and view all the answers

    What vessels are found posteriorly to the fourth part of the duodenum?

    <p>Left renal vessels</p> Signup and view all the answers

    Which structure is NOT associated with the anterior relations of the fourth part of the duodenum?

    <p>Left psoas major muscle</p> Signup and view all the answers

    Which of the following is located posteriorly to the third part of the duodenum?

    <p>Abdominal aorta</p> Signup and view all the answers

    What is the relation between the right psoas major muscle and the third part of the duodenum?

    <p>It lies posteriorly to it.</p> Signup and view all the answers

    Which vessel is NOT found posteriorly to the fourth part of the duodenum?

    <p>Inferior mesenteric vein</p> Signup and view all the answers

    Which structure forms part of the anterior relationship to the third part of the duodenum?

    <p>Root of the mesentery</p> Signup and view all the answers

    What is a significant structure found posterior to the third part of the duodenum?

    <p>Right ureter</p> Signup and view all the answers

    Study Notes

    Anatomy of the Stomach & Duodenum

    • The stomach is the most dilated part of the gastrointestinal tract (GIT).
    • Located in the left hypochondrium, epigastric, and umbilical regions of the abdomen.
    • Situated at the level of vertebrae T10 to L3.
    • Adult stomach capacity is approximately 2 liters.

    Shape of the Stomach

    • Typically J-shaped, with a vertical long axis.
    • Can be steer-horn shaped, with a horizontal long axis, depending on factors.
    • Factors influencing shape include:
      • Distension (empty stomach is more vertical.)
      • Body build (obese people tend toward horizontal)
      • Respiration phase (more vertical during inspiration).
      • Body position (more vertical in standing).

    External Features of the Stomach

    • Orifices:
      • Cardiac orifice: junction of the esophagus and stomach.
      • Pyloric orifice: junction of the stomach and duodenum.
    • Borders:
      • Greater curvature: along the convex side.
      • Lesser curvature: along the concave side.
    • Surfaces:
      • Anterior surface.
      • Posterior surface.
    • Parts:
      • Cardia (surrounds the cardiac orifice).
      • Fundus (dome-shaped, above the cardiac orifice).
      • Body (extends from fundus to angular notch).
      • Pyloric part:
        • Pyloric antrum (widest part).
        • Pyloric canal (narrow, distal to antrum).
        • Pylorus (distal part, with pyloric sphincter).
    • Notches:
      • Cardiac notch.
      • Angular notch.

    Orifices of the Stomach

    • Cardiac Orifice (more fixed end):
      • Located at the junction of the esophagus and stomach.
      • Located behind the left 6th costal cartilage, 2-4 cm from the median plane at the level of T10 or T11 vertebra.
      • Contains the gastroesophageal sphincter, a physiological sphincter.
      • It's composed of smooth muscles of the right crus of the diaphragm encircling the lower esophagus.
      • Function: prevents gastric reflux.
    • Pyloric Orifice (less fixed end):
      • Located at the junction of the stomach and duodenum.
      • Situated at the transpyloric plane (L1), 1.25 cm to the right of the median plane.
      • Position indicated by:
        • Circular groove (pyloric constriction).
        • Prepyloric vein of Mayo (useful for surgical identification).
      • Has a thick anatomical sphincter.

    Borders of the Stomach

    • Lesser Curvature:
      • Runs from the cardiac orifice to the pylorus.
      • Has an angular notch.
      • Attached to the liver by the lesser omentum.
    • Greater Curvature:
      • Runs from the cardiac notch to the pylorus.
      • Attached to the diaphragm by the gastrophrenic ligament.
      • Attached to the spleen by the gastrosplenic ligament.
      • Attached to the transverse colon by the greater omentum.

    Parts of the Stomach

    • Cardia: Area surrounding the cardiac orifice.
    • Fundus: Dome-shaped, left of cardiac orifice, often filled with gas.
    • Body: Extends from the fundus to the angular notch.
    • Pyloric Part: Divided into antrum, canal, and pylorus, with a thick muscular pyloric sphincter.

    Relations of the Stomach

    • Anterior Relations:
      • Anterior abdominal wall.
      • Left costal margin.
      • Left pleura and lung.
      • Diaphragm.
      • Left lobe of the liver.
    • Posterior Relations:
      • Left crus of the diaphragm.
      • Left suprarenal gland.
      • Upper part of the left kidney.
      • Splenic artery.
      • Pancreas.
      • Transverse mesocolon.
      • Transverse colon.
      • Spleen.
      • Stomach separated from these structures by the lesser sac.

    Clinical Notes

    • Perforating ulcer in the posterior wall of the stomach can result in:
      • Peritonitis .
      • Referred back pain due to pancreatic invasion.
      • Erosion of the splenic artery leading to severe peritoneal hemorrhage.

    Arterial Supply of the Stomach

    • Branches from the celiac trunk (branch of abdominal aorta at T12 level).
    • Left Gastric Artery:
      • Branches from the celiac trunk.
      • Passes upward to reach the esophagus then descends along the lesser curvature.
      • Supplies the lower third of the esophagus and the upper right part of the stomach.
    • Right Gastric Artery:
      • Branch of hepatic artery.
      • Runs to the left along the lesser curvature.
      • Supplies the lower right part of the stomach.
    • Short Gastric Arteries:
      • Branches from splenic artery.
      • Supplies fundus of stomach.
    • Left Gastro-omental Artery:
      • Branch of the splenic artery at hilum of spleen.
      • Supplies stomach along the upper part of the greater curvature.
    • Right Gastro-omental Artery:
      • Branches from the gastroduodenal artery
      • Supplies the stomach along the lower portion of the greater curvature.

    Venous Drainage of the Stomach

    • Left and right Gastric Veins: drain directly into the hepatic portal vein.
    • Short Gastric Veins and Left Gastroepiploic Veins: drain into the splenic vein.
    • Right Gastroepiploic Vein: drains into superior mesenteric vein.

    Lymphatic Drainage of the Stomach

    • Anterior & posterior surface drain into gastric and gastro-omental lymph nodes (LNs).
    • Efferent vessels drain into pancreaticosplenic, pyloric, and pancreaticoduodenal LNs.
    • All lymph drains into celiac LNs.

    Nerve Supply of the Stomach

    • Parasympathetic:
      • Anterior vagal trunk (from left vagus nerve) supplies anterior surface.
      • Posterior vagal trunk (from right vagus nerve) supplies posterior surface.
    • Sympathetic: from greater splanchnic nerves (T6-T9) via celiac plexus to pyloric sphincter and pain fibers.

    Anatomy of the Duodenum

    • The duodenum is the first part of the small intestine.
    • It's the shortest, most fixed, and dilated part of the small intestine
    • It's shaped like a "C" and runs around the head of the pancreas.

    Position of the Small Intestine

    • Small intestine is the longest part of the GIT
    • Occupies central and lower part of the abdomen.
    • Surrounded by large intestine and covered anteriorly by greater omentum.
    • Extends from pyloroduodenal junction to ileocecal junction.
    • Divided into 3 parts: duodenum, jejunum, ileum.

    Parts of the Duodenum

    • 25 cm long with 4 parts:
      • 1st (superior) part: 5 cm long, opposite L1 vertebra.
      • 2nd (descending) part: 7-10 cm, from L2-L3 vertebrae.
      • 3rd (horizontal) part: 6-8 cm, at L3 vertebra.
      • 4th (ascending) part: 5 cm, from L3 to L2 vertebrae.

    Peritoneal Coverings of the Duodenum

    • Mostly retroperitoneal, except:
      • First 2 cm is suspended by lesser and greater omentum.
      • Distal end is attached to the right crus of the diaphragm by suspensory ligament of Treitz (surgical landmark).

    Relations of the First Part of the Duodenum

    • Anteriorly:
      • Quadrate lobe of the liver.
      • Gall bladder.
    • Posteriorly:
      • Bile duct.
      • Gastroduodenal artery.
      • Portal vein.

    Relations of the Second Part of the Duodenum

    • Anteriorly:
      • Right lobe of the liver.
      • Transverse colon.
      • Loops of jejunum.
    • Posteriorly:
      • Right kidney.
      • Right renal vessels.
      • Right ureteric pelvis.
      • Right psoas major muscle.

    Relations of the Third Part of the Duodenum

    • Anteriorly:
      • Root of the mesentery.
      • Superior mesenteric vessels.
    • Posteriorly:
      • Right ureter.
      • Right psoas major muscle.
      • Right gonadal vessels.
      • Inferior vena cava.
      • Abdominal aorta and origin of inferior mesenteric artery.

    Relations of the Fourth Part of the Duodenum

    • Anteriorly:
      • Coils of jejunum.
    • Posteriorly:
      • Left psoas major muscle.
      • Left sympathetic trunk.
      • Left renal vessels.
      • Left gonadal vessels.
      • Inferior mesenteric vein.

    Structures Opening in the 2nd Part of the Duodenum

    • Bile duct: joins with the main pancreatic duct to form the hepatopancreatic ampulla (ampulla of Vater) surrounded by the sphincter of Oddi.
    • Accessory pancreatic duct: opens 1" above the major duodenal papilla, in the minor duodenal papilla.

    Blood Supply of the Duodenum

    • Arterial Supply:
      • Upper 1/2: supraduodenal and superior pancreaticoduodenal arteries from gastroduodenal.
    • Lower 1/2: inferior pancreaticoduodenal artery from superior mesenteric.
    • Venous Drainage:
      • Superior pancreaticoduodenal vein drains into portal vein.
    • Inferior pancreaticoduodenal vein drains into superior mesenteric.

    Lymphatic Drainage of the Duodenum

    • Drains to pancreatico-duodenal lymph nodes, then drains into celiac and superior mesenteric LNs, some drain to pyloric and hepatic LNs.

    Nerve Supply of the Duodenum

    • Sympathetic (greater and lesser splanchnic nerves), and parasympathetic (vagus nerve) nerves supplying from celiac superior mesenteric plexuses.

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