Chapter 91: Stomach

Question 1

List the secretory cells of the stomach, where they are found, and what each produces:

Answer 1

Parietal cells (Body) - Acids and intrinsic factor(binds B12)
Mucous Neck cells (Body, Antrum) - Mucous
Chief cells (Body) - Pepsinogen
Epithelial cells (everywhere) - Mucous, bicarb
Endocrine cells (Body) - Histamine, Gastrin, Serotonin

Question 2

What is contractile retropulsion?

Answer 2

Pyloric closure and full antrum contraction, allowing liquid chyme to pass through pylorus but solids >2mm are forced retrograde back into the body. Reduces food particles to 0.1-0.63mm

Question 3

By what process do gastric mucosa and submucosa ulcers heal?

Answer 3

Mucosa - Epithelial migration
Submucosa- Fibrotic repair

Question 4

What tissues contribute to collagen formation in the stomach?

Answer 4

Fibroblasts and smooth muscle cells of the GIT

Question 5

What are some negative effects of pre-surgical fasting?
What recommendation may be more appropriate?

Answer 5

• Decreased gastric pH
• Higher incidence of gastroesophageal reflux
• Does not reliably decrease gastric volume

Small amounts of canned food 3hr before surgery may decreased gastric acidity and minimize occurrence and clinical impact of gastroesophageal reflux while having minimal to no impact on gastric content volume

Question 6

What are two functions of Parietal Cells?

Answer 6

1. Pump out hydrogen ions to maintain gastric pH between 2-3
2. Release intrinsic factor (a mucoprotein) to help bind B12 for absorption in distal SI

Question 7

There are three layers of gastric musculature, describe them:

Answer 7

1. Longitudinal fibers along whole stomach (esophagus to duodenum)
2. Inner circular layer begins at cardia and extends to pylorus, where it does the grinding Does NOT cover fundus
3. Oblique fibers on fundus and body

Question 8

What are the four parts of the stomach?

Answer 8

cardia, fundus, body, pylorus

Question 9

There are three parts of the greater omentum, which attaches to the greater curvature of the stomach. What are they?

Answer 9

Bursal
Splenic
Veil

Question 10

The lesser omentum attaches to the lesser curvature and forms what ligament?

Answer 10

Hepatogastric ligament

Question 11

what three vessels come off the celiac artery and supply the stomach?

Answer 11

Splenic a.
Hepatic a.
Left gastric a.

Question 12

What do Chief cells secrete?

Answer 12

Pepsinogen -> acid causes conversion to pepsin -> breaks down protein

Question 13

What are glands in the stomach other than gastric proper glands?

Answer 13

Cardiac glands- serious seretion (cardia and antrum)
Pyloric glands- mucus (pylorus and body)

Question 14

In more detail, what is the blood supply to the stomach?

Answer 14

Celiac divides into splenic, hepatic, and L gastric
* Splenic feeds L pancreas and becomes L gastroepiploic, supplying greater curvature of stomach. Short gastric aa. also arise from splenic to supply fundus
* Hepatic continues as R gastric which supplies pylorus & pyloric antrum. Hepatic a. becomes gastroduodenal (R gastroepiploic branch supplies greater curv)
* L gastric supplies fundus and lesser curvature