Chapter 91 Stomach

Question 1

What are the different parts of the stomach?

Answer 1

Cardia
Fundus
Body
Pylorus (antrum & sphincter)

Question 2

What is the angular notch (incisura angularis)?

Answer 2

Protrusion of tissue midpoint of lesser curvature that seperates the antrum and the body.
Area in which papillary process of liver lies

Important landmark for endoscopy

Question 3

What part of the omentum attaches onto the greater curvature of the stomach? Lesser?

Answer 3

Greater = bursal portion of greater omentum
Lesser = lesser omentum

Question 4

What vessel does the blood supply to the stomach arise from?

Answer 4

Celiac artery

Question 5

What are the 3 main branches of the celiac artery and their further branches?

Answer 5

1. Left gastric
2. Splenic
   → left gastroepiploic
3. Hepatic
   → right gastric
   →gastroduodenal → cranial pancreaticoduodenal and right gastroepiploic

Question 6

What does the left gastric artery supply?

Answer 6

Fundus of stomach
Caudal esophagus

Question 7

What does the splenic artery supply?

Not including left gastroepiploic

Answer 7

Left limb of pancreas and spleen

Question 8

What does the cranial pancreaticoduodenal artery supply?

Answer 8

Portion of the right pancreas

Question 9

Name the vascular supply to the following parts of the stomach:
Fundus
Greater curvature
Lesser curvature
Pylorus & pyloric antrum

Answer 9

Fundus = L gastric a.
Greater curvature = L & R gastroepiploic a.
Lesser curvature = L & R gastric a.
Pylorus and pyloric antrum = R gastric a.

Question 10

What is the parasympathetic innervation of the stomach? Sympathetic?

Answer 10

Parasympathetic = fibers of the vagus nerve
Sympathetic = fibers of the celiac plexus

Question 11

What are the two major sources of venous drainage of the stomach?

Answer 11

Splenic vein on the left
Gastroduodenal vein on the right

Drain to portal vein

Question 12

What are the 4 tissue layers of the stomach?

Answer 12

• Serosa
• Muscle (longitudinal, inner circular, oblique)
• Submucosa
• Mucosa

Question 13

What tissue layer is absent in the fundus?

Answer 13

Inner circular layer of muscle is absent in fundus

Question 14

What are the 3 types of glands and where are they located in the stomach?

Answer 14

1. Cardiac - located around cardia
2. Pyloric - pylorus and gastric body
3. Gastric - fundus and body

Question 15

What do cardiac glands primarily secrete?

Answer 15

Serous secretion

Question 16

What do pyloric glands primary secrete?

Answer 16

Mucous

Question 17

What are the 4 cell types within the gastric glands?

Answer 17

1. Parietal
2. Chief
3. Mucous Neck
4. Endocrine

Question 18

Where are parietal cells located in the stomach and what is their function?

Answer 18

Body
Secrete acids (H+) and intrinsic factor (binds to B12) to permit absorption into distal small itnestine

Question 19

Where are chief cells located in the stomach and what is their function?

Answer 19

Body
Secrete pepsinogen which converts into pepsin and breaks down proteins

Question 20

Where are mucous neck cells located in the stomach and what is their function?

Answer 20

Body and antrum
Secrete mucous to protect other glandular cells

Question 21

Where are endocrine cells located in the stomach and what is their function?

Answer 21

Body
Gastrin, histamine, serotonin production

Question 22

Where are surface epithelium cells located in the stomach and what is their function?

Answer 22

Diffuse throughout stomach
Produce mucous and bicarbonate

Question 23

How is food digested in the stomach?

Answer 23

• Relaxation of fundus (stimulated by swallowing) allows gastric accomodation for digestion
• Food churned and forced into pylorus
• Pylorus allows liquid chyme to pass, gastric contents >2mm forced retrograde for additional churning

Question 24

What size particles are appropriate to pass through the pylorus?

Answer 24

0.1-0.63 mm