PDA

View Full Version : Anatomy Of The Stomach



Medical Videos
04-21-2008, 03:43 PM
m Gross Anatomy:
It consists of the cardia at oesophageal end, the fundus above the cardia and the body which is separated from the pylorus by depression in the lesser curvature called incisura angularis.
m Histological anatomy of the stomach:
Parietal cells, lies in the crypts between epithelial mucous secreting cells of the stomach, more abundant distally. These cells are responsible for the production of hydrogen ion to form HCl through the hydrogen potassium proton pump.
Chief cells, lies in the crypts of proximal part of the stomach and produce pepsinogen I and pepsinogen II. Pesinogen I produced only in the stomach , So, decrease PI : PII ratio is indicator of high risk individual for cancer stomach. Pepsinogen is activated in the stomach to the active enzyme (pepsin)
Endocrine cells,
1- G cells is present in the gastric antrum and produce gastrin.
The peptides and neuropeptides are produced also in the stomach
2- Enterochromatin like (ECL) cells are abundant throughout the body of the stomach and produce Histamin, important factor in Hcl secretion.
3- Somatostatin producing D cells, presents throughout the stomach and soatostatin has a negative regulatory role.
m Arterial Supply:
Right gastric artery, from hepatic branch of coeliac trunk.
Left gastric artery, from coeliac trunk.
Short gastric vessels, from splenic branch of coeliac trunk.
Left gastroepiploic artery, from splenic branch of coeliac trunk.
Right gastroepiploic artery, from gastroduodenal branch of hepatic artery.
mVenous Drainage:
The right and left gastric veins drain into the portal vein.
The short gastric and left gastroepiploic veins drain into the splenic vein.
The right gastroepiploic vein drains into the superior mesenteric vein.

F N.B. The splenic vein and superior mesenteric are the main two tributaries forming the portal vein behind the neck of Pancreas..








mLymphatic Drainage:4 Zones
. The most commonly involved groups in spread of tumors are zone
I and III.
All groups send lymphatic vessels to end in coeliac group.
From coeliac group Through lymphatics of hepatic artery to porta-hepatis.
Or along lymphatics of thoracic duct to Lt. supraclavicular lymph nodes "Virchow's gland".

mNerve Supply:
Sympathetic: Fibers from sympathetic chain inhibit HCl secretion and cause gastric wall relaxation and pyloric sphincter contraction.
Parasympathetic: Right and left vagi stimulate HCl secretion, gastric wall motility and cause pyloric sphincter relaxation through a branch called "nerve of Laterget". Also, The anterior vagus gives hepatic branches to biliary tree and the posterior vagus gives coeliac branches to the intestine.
SOURCE: DR. AYMAN SALEM'S BOOK
Copyright: Vascular Society of Egypt (www.vsegypt.org (http://www.vsegypt.org/)) &Medical Engineering Forums (www.mediengi.com (http://www.mediengi.com/))
Not to be reproduced without permission of Vascular Society of Egypt