stomach

Prepared by\sarbast aziz hussein

Supervised by\Dr.Yuns zandy

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 Table of content
1-Introduction…………………………3
2-Anatomy……………………………..4
*division(part)of stomach………….....4
* Anatomical relation of stomach with other organs…………5
* Greater and Lesser Curvatures…………………...…………6
3- Sphincters of the Stomach…………..………………………7
* Inferior Oesophageal Sphincter……………..………………7
* Pyloric Sphincter……………..………………………………8
4- Neurovascular Supply…………………………………….....9
* Innervation……………………………………...……………10
5-Lymphatic……………………………………………………10
6- Greater and Lesser Omenta…………………………..…11-12
7-Refrences……………………………………………….….13-14

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Introduction
The stomach is a muscular organ located on the left side of the upper
abdomen. The stomach receives food from the esophagus. As food reaches
the end of the esophagus, it enters the stomach through a muscular valve
called the lower esophageal sphincter, The stomach secretes acid and
enzymes that digest food. Ridges of muscle tissue called rugaeline the
stomach. The stomach muscles contract periodically, churning food to
enhance digestion. The pyloric sphincter is a muscular valve that opens to
allow food to pass from the stomach to the small intestine and the stomach is
is a J-shaped organ that digests food. It produces enzymes (substances that
create chemical reactions) and acids (digestive juices). This mix of enzymes
and digestive juices breaks down food so it can pass to your small
intestine.Your stomach is part of the gastrointestinal (GI) tract. The GI tract
is a long tube that starts at your mouth. It runs to your anus, where stool
(poop) leaves your body. The GI tract is a key part of your digestive system
Food in the stomach then passes through to the small intestine where most of
the food's nutrition is absorbed

And most adults have roughly the same size stomach, even though people
can weigh different amounts. Your empty stomach is about 12 inches long
by 6 inches across at its widest point. As an adult, your stomach can expand
to hold about 1 quart of food

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Anatomy
The stomach, is an intraperitoneal digestive organ located between the
oesophagus 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 and it lies within the superior aspect of the
abdomen.It primarily lies in the epigastric and umbilical regions, however,
the exact size, shape and position of the stomach can vary from person to
person and with position and respiration
*Divisions (part) of stomach
The stomach has four main anatomical divisions; the (cardia, fundus, body
and pylorus)
 Cardia – surrounds the superior opening of the stomach at the T11
level
 Fundus – the rounded, often gas filled portion superior to and left of
the cardia
 Body – the large central portion inferior to the fundus.
 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

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Anatomical relation of stomach with other organs:-
Anatomical Relation Structure

Superior Oesophagus and left dome of the

diaphragm

Anterior Diaphragm, greater omentum,

anterior abdominal wall, left lobe of
liver, gall bladder
Posterior Lesser sac, pancreas, left kidney, left
adrenal gland, spleen, splenic artery,
transverse mesocolon

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*Greater and Lesser Curvatures
The medial and lateral borders of the stomach are curved, forming the lesser
and greater curvatures:-
 Greater curvature – forms the long, convex, lateral border of the
stomach
 Arising at the cardiac notch, it arches backwards and passes inferiorly
to the left
 It curves to the right as it continues medially to reach the pyloric
antrum.
 The short gastric arteries and the right and left gastro-omental
arteries supply branches to the greater curvature

 Lesser curvature – forms the shorter, concave, medial surface of

the stomach
 The most inferior part of the lesser curvature, the angular
notch, indicates the junction of the body and pyloric region
 The lesser curvature gives attachment to the hepatogastric
ligament and is supplied by the left gastric artery and right gastric
branch of the hepatic artery

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Sphincters of the Stomach
There are two sphincters of the stomach, located at each orifice. They
control the passage of material entering and exiting the stomach
*Inferior Oesophageal Sphincter;-
The oesophagus passes through the diaphragm through the oesophageal
hiatus at the level of T10. It descends a short distance to the inferior
oesophageal sphincter at the T11 level which marks the transition point
between the oesophagus and stomach (in contrast to the superior
oesophageal sphincter, located in the pharynx). It allows food to pass
through the cardiac orifice and into the stomach and is not under voluntary
control

endoscopy photo of Inferior

Oesophageal Sphincter

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* Pyloric Sphincter:-
The pyloric sphincter lies between the pylorus and the first part of
the duodenum. It controls of the exit of chyme (food and gastric acid
mixture) from the stomach.In contrast to the inferior oesophageal sphincter,
this is an anatomical sphincter. It contains smooth muscle, which
constricts to limit the discharge of stomach contents through the
orifice.Emptying of the stomach occurs intermittently when intragastric
pressure overcomes the resistance of the pylorus. The pylorus is normally
contracted so that the orifice is small and food can stay in the stomach for a
suitable period. Gastric peristalsis pushes the chyme through the pyloric
canal into the duodenum for further digestion

a endoscopy photo of Pyloric Sphincter

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Neurovascular Supply:-
The arterial supply to the stomach comes from the celiac trunk and its
branches. Anastomoses form along the lesser curvature by the right and
left gastric arteries and along the greater curvature by the right and
left gastro-omental arteries
 Right gastric:- branch of the common hepatic artery, which arises
from the coeliac trunk.
 Lift gastric:- arises directly from the coeliac trunk.
 Right gastro-omental :- terminal branch of the gastroduodenal artery,
which arises from the common hepatic artery.
 Left gastro-omental:- branch of the splenic artery, which arises from
the coeliac trunk.
The veins of the stomach run parallel to the arteries. The right and left
gastric veins drain into the hepatic portal vein. The short gastric
vein, left and right gastro-omental veins ultimately drain into the
superior mesenteric vein.

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* Innervation: -
The stomach receives innervation from the autonomic nervous system:
 Parasympathetic nerve supply arises from the anterior and posterior
vagal trunks, derived from the vagus nerve.
 Sympathetic nerve supply arises from the T6-T9 spinal cord
segments and passes to the coeliac plexus via the greater splanchnic
nerve. It also carries some pain transmitting fibres.

Lymphatics:-
The gastric lymphatic vessels travel with the arteries along the greater and
lesser curvatures of the stomach. Lymph fluid drains into the gastric and
gastro-omental lymph nodes found at the curvatures. Efferent lymphatic
vessels from these nodes connect to the coeliac lymph nodes, located on the
posterior abdominal wall

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Greater and Lesser Omenta:-
Within the abdominal cavity, a double layered membrane called
the peritoneum. supports most of the abdominal viscera and assists with
their attachment to the abdominal wall. The greater and lesser omenta are
two structures that consist of peritoneum folded over itself (two layers of
peritoneum – four membrane layers). Both omenta attach to the stomach,
and are useful anatomical landmarks:
* Greater omentum – hangs down from the greater curvature of the
stomach and folds back upon itself where it attaches to the transverse colon
It contains many lymph nodes and may adhere to inflamed areas , therefore
playing a key role in gastrointestinal immunity and minimising the spread of
intraperitoneal infections.
* Lesser omentum– continuous with peritoneal layers of the stomach and
duodenum, this smaller peritoneal fold arises at the lesser curvature and
ascend to attach to the liver. The main function of the lesser omentum is to
attach the stomach and duodenum to the liver
Together, the greater and lesser omenta divide the abdominal cavity into
two; the greater and lesser sac. The stomach lies immediately anterior to the
lesser sac. The greater and lesser sacs communicate via the epiploic
foramen, a hole in the lesser omentum.

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Omenta Double fold of peritoneum
Greater and lesser omenta

Greater omentum Largest of the omenta

Attached to the greater curvature of
the stomach and the transverse colon
Policeman of the abdomen - protects
other organs from inflamed or
diseased organs
Lesser omentum Smaller of the omenta
Attached to the lesser curvature of the
stomach and the liver
Divided into hepatogastric and
hepatoduodenal ligaments
Forms anterior border of the epiploic
foramen

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Refrences:-
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stomach
2- https://my.clevelandclinic.org/health/body/21758-stomach
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