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 (A)</p> Signup and view all the answers

    Which factor does NOT influence the shape of the stomach?

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

    In which position is the stomach typically more vertical?

    <p>Standing (D)</p> Signup and view all the answers

    What type of orifice is associated with the stomach?

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

    Which description best fits the J-shaped stomach?

    <p>Vertical long axis (D)</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 (C)</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 (C)</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 (B)</p> Signup and view all the answers

    From which artery does the right gastric artery branch?

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

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

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

    Which artery descends along the lesser curvature of the stomach?

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

    Which artery is a branch of the celiac trunk?

    <p>Left gastric artery (A)</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 (D)</p> Signup and view all the answers

    What is the function of the pyloric sphincter?

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

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

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

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

    <p>Gastric rugae (B)</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 (A)</p> Signup and view all the answers

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

    <p>Peritoneum (A)</p> Signup and view all the answers

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

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

    Which organ is located posteriorly to the stomach?

    <p>Spleen (C)</p> Signup and view all the answers

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

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

    Where does the cardiac orifice lie?

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

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

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

    What structure is found at the pyloric orifice?

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

    What parts form the pyloric part of the stomach?

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

    What anatomical feature assists surgeons in identifying the pylorus?

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

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

    <p>Posterior and anterior surfaces (C)</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 (A)</p> Signup and view all the answers

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

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

    The right gastroepiploic vein primarily drains into which vein?

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

    Where does the lymphatic drainage of the stomach ultimately lead?

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

    Which of the following arteries is noted as potentially absent?

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

    What is the primary function of the left gastroepiploic veins?

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

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

    <p>Left renal vessels (A)</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 (C)</p> Signup and view all the answers

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

    <p>Abdominal aorta (B)</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. (A)</p> Signup and view all the answers

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

    <p>Inferior mesenteric vein (B)</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 (A)</p> Signup and view all the answers

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

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

    Flashcards

    Subcostal and Intertubercular Planes

    Two horizontal planes used to divide the abdomen: the subcostal plane at the level of the third lumbar vertebra (L3) and the intertubercular plane at the level of the fifth lumbar vertebra (L5).

    Right and Left Midclavicular Lines

    Two vertical planes used to divide the abdomen: the right and left midclavicular lines, which run vertically down the body, passing through the midpoints of the clavicles.

    Stomach

    The largest and most dilated portion of the gastrointestinal (GI) tract, responsible for the digestion and breakdown of food.

    Stomach Location

    The stomach's location within the abdomen is in the left hypochondrium (upper left region), epigastric region (central upper region), and umbilical region (central region, around the belly button).

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    Stomach Location: Vertebrae

    The stomach is positioned at the level of the 10th thoracic vertebra (T10) to the 3rd lumbar vertebra (L3).

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    Stomach Capacity

    The typical capacity of an adult stomach is approximately 2 liters.

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    Stomach Shape: J-Shape

    The most common shape of the stomach is J-shaped, with its long axis oriented vertically. This shape can vary depending on factors like distension, body build, respiration, and body position.

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    Stomach Shape: Steer Horn

    An alternative shape of the stomach is Steer horn-shaped, with a more horizontal long axis. This shape is more common in short and obese individuals.

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    Pyloric Canal

    The narrow, distal part of the stomach, connecting the antrum to the pyloric sphincter.

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    Pyloric Sphincter

    The muscular ring at the base of the stomach that controls the flow of food into the small intestine.

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    Gastric Rugae

    The folds or ridges within the lining of the stomach, which increase surface area for digestion.

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    Pyloric Antrum

    The region of the stomach responsible for mixing and churning food before it enters the pyloric canal.

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    Lesser Sac

    The anatomical space behind the stomach, containing organs like the pancreas and spleen.

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    Bare Area of Stomach

    The area of the stomach that lacks peritoneal covering, allowing it to directly contact the diaphragm.

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    Peritonitis

    A serious complication of a perforated ulcer in the stomach, potentially leading to infection of the abdominal cavity.

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    Pancreatitis

    A condition where the pancreas becomes inflamed, often due to a perforated ulcer in the stomach.

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    Gastroesophageal Sphincter

    A physiological sphincter formed by smooth muscle fibers of the right crus of the diaphragm, encircling the lower end of the esophagus. It prevents stomach contents from flowing back into the esophagus.

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    Cardiac Orifice

    The opening through which food passes from the esophagus to the stomach. Located behind the left 6th costal cartilage, 2-4 cm from the median plane at the level of T10 or T11 vertebra.

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    Pyloric Orifice

    The opening between the stomach and the small intestine (duodenum). Lies at the transpyloric plane (L1), 1.25 cm to the right of the median plane.

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    Fundus

    The dome-shaped upper portion of the stomach. It lies to the left of the cardia and above the body of the stomach.

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    Body of the Stomach

    The main part of the stomach, located below the fundus. It is the largest part of the stomach and serves as the primary storage area for food.

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    Pyloric Part of the Stomach

    The narrowed, terminal portion of the stomach that connects to the duodenum. It consists of the pyloric antrum, pyloric canal, and pylorus.

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    Lesser Curvature of the Stomach

    The curved edge of the stomach on the right side. It is shorter and curves along the upper border of the organ.

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    Greater Curvature of the Stomach

    The curved edge of the stomach on the left side. It is longer and curves along the lower border of the organ.

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    Left Gastric Artery

    The main artery supplying the stomach, arising from the celiac trunk, which is a branch of the abdominal aorta.

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    Right Gastric Artery

    A branch of the hepatic artery, this artery runs to the left along the lesser curvature, supplying the lower right part of the stomach.

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    Short Gastric Arteries

    Arising from the splenic artery, these arteries supply the fundus (upper curved part) of the stomach.

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    Left Gastro-omental Artery

    A branch of the splenic artery, this artery supplies the stomach along the upper part of the greater curvature.

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    Right Gastro-omental Artery

    A branch of the gastroduodenal artery, this artery supplies the stomach along the lower part of the greater curvature.

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    Celiac Trunk

    The main artery supplying the stomach and its surrounding structures, branching from the abdominal aorta at the level of T12.

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    Common Hepatic Artery

    The artery supplying the liver, gallbladder, and duodenum, branching from the celiac trunk.

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    Splenic Artery

    The artery supplying the spleen and its surrounding structures, including the pancreas, branching from the celiac trunk.

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    Right Gastroepiploic Artery

    The artery that supplies blood to the lower part of the stomach's greater curvature, also known as the right gastroepiploic artery.

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    Posterior Gastric Artery

    This artery provides blood to the back of the stomach's fundus and the upper part of its body. It's a branch of the splenic artery, though it might not always be present.

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    Venous Drainage of the Stomach

    The veins in the stomach drain into the portal circulation, a system of blood vessels that carry blood from the digestive system to the liver. This system is responsible for filtering nutrients and toxins.

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    Left and Right Gastric Veins

    These veins drain directly into the hepatic portal vein, which carries blood from the digestive tract to the liver.

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    Short Gastric Veins & Left Gastroepiploic Veins

    These veins drain into the splenic vein, which carries blood from the spleen and pancreas to the liver.

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    Right Gastroepiploic Vein

    This vein drains into the superior mesenteric vein, which carries blood from the small intestine to the liver.

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    Lymphatic Drainage of the Stomach

    The lymphatic system is a network of vessels that carry lymph fluid, which helps remove waste products and fight infections. The stomach's lymphatic drainage is important for maintaining its health.

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    Gastric and Gastro-Omental Lymph Nodes

    These lymph nodes filter lymph fluid from the stomach's anterior and posterior surfaces, helping to remove waste and fight infections.

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    Location: Second Part of Duodenum

    The second part of the duodenum is situated on the right side of the abdominal cavity. It is a curved structure that lies in close proximity to the head of the pancreas and the right kidney.

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    Second Part of Duodenum: Enclosed by Jejunum

    The second part of the duodenum is enclosed by a loop of the jejunum, the first part of the small intestine, creating a distinct anatomical feature.

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    Location: Third Part of Duodenum

    The third part of the duodenum is located horizontally across the abdomen. It lies posterior to the superior mesenteric vessels and the root of the mesentery, which suspends the small intestine from the posterior abdominal wall.

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    Third Part of Duodenum: Anterior Relations

    The anterior relations of the third part of the duodenum include the root of the mesentery and the superior mesenteric vessels. These structures are crucial in providing support and vascular supply to the small intestine.

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    Third Part of Duodenum: Posterior Relations

    The posterior relations of the third part of the duodenum include the right ureter, right psoas major muscle, right gonadal vessels, inferior vena cava, and the abdominal aorta. These structures are vital for urinary drainage, muscle movement, and blood circulation.

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    Location: Fourth Part of Duodenum

    The fourth part of the duodenum ascends vertically on the left side of the abdominal cavity. It is positioned anterior to the left psoas major muscle, left sympathetic trunk, and the left renal vessels.

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    Fourth Part of Duodenum: Anterior Relations

    The fourth part's anterior relations include the coils of jejunum, which intertwine with the duodenum before heading towards the small intestine.

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    Fourth Part of Duodenum: Posterior Relations

    The posterior relations of the fourth part of the duodenum include the left psoas major muscle, left sympathetic trunk, left renal vessels, left gonadal vessels, and inferior mesenteric vein. These structures provide vital support for the digestive system.

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    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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