L19 The Stomach PDF

L19 The stomach Planes and abdominal regions; Horizontal Planes: 1- Transpyloric Plane ( subcostal plane)( R9 - L1 ) 2- Intertubercular Plane ( L5 ) Vertical Planes: 2 Mid Clavicular Lines 9 regions right hypochondriac region Left hypochondriac region Right lumbar region left lumbar region Right ili...

L19 The stomach Planes and abdominal regions; Horizontal Planes: 1- Transpyloric Plane ( subcostal plane)( R9 - L1 ) 2- Intertubercular Plane ( L5 ) Vertical Planes: 2 Mid Clavicular Lines 9 regions right hypochondriac region Left hypochondriac region Right lumbar region left lumbar region Right iliac region Left iliac region Epigastric region Umbilical Region Hypogastric region The stomach is mainly in the epigastric region It is an intraperitoneal digestive organ located between between the esophagus and the duodenum. It has a ‘J’ shape, and features a lesser and greater curvature. The anterior and posterior surfaces are smoothly rounded with a peritoneal covering. Parts of the Stomach 1- Cardia : – Surrounds the superior opening of the stomach at the T11 level. 2- Fundus: – The rounded, often gas filled portion superior to and left of the cardia. 3-Body – The large central portion inferior to the fundus. 4- Pylorus – This area connects the stomach to the duodenum. It is divided into the pyloric antrum, pyloric canal and pyloric sphincter. The pyloric sphincter demarcates the transpyloric plane at the level of L1. Greater and Lesser Curvatures Greater curvature – forms the long, convex, lateral border of the stomach. Arising at the cardiac notch, to reach the pyloric antrum. Lesser curvature – forms the shorter, concave, medial surface of the stomach. The layers of peritoneum attached to the stomach are the lesser omentum and the Greater omentum. Lesser omentum attaches the liver to the lesser curvature Greater momentum attaches the greater curvature to the posterior body wall Surfaces Of The Stomach Anterosuperior Anterior Relations 1. Left lobe of the liver 2. Diaphragm 3. Ant. Abdominal wall 4. 7, 8, 9 ribs Posteroinferior Posterior Surface ( Stomach bed) 1- Spleen 2- Lt Kidney 3- Lt. Suprarenal gland 4- Pancreas 5- Left colic Flexure 6- Splenic artery 7- Diaphragm Separated from the stomach by lesser Sac The celiac trunk has left gastric artery Splenic artery And common hepatic artery The common hepatic artery branches to Gastroduodenal artery and proper hepatic artery The gastroduodenal artery gives the branches to right gastroepiploic artery and superior pancreaticoduodenal artery The proper hepatic artery gives branch to right gastric artery , right branch of hepatic artery , and left hepatic artery Hepatic artery gives branch to the cystic artery BLOOD SUPPLY The lesser curvature is supplied by the left gastric artery, which is a branch of celiac trunk and right gastric artery which is a branch of the proper hepatic artery The greater curvature: It is supplied by the right gastroepiploic artery, a branch of the gastroduodenal Fundus is supplied by 5 to 7 short gastric arteries NERVE SUPPLY ▪ The sympathetic nerves are derived from of the spinal cord, via the greater splanchnic nerves, coeliac and hepatic plexuses. ▪ The parasympathetic nerves are derived from the vagi through gastric nerves