Chapter 24. Stomach and Duodenum Diseases
Sections • Section 1. Anatomy • 1.1 Gross Anatomy • 1.2 Blood Supply ★★★ • 1.3 Nerve Supply ★★ • 1.4 Lymphatic Drainage • Section 2. Physiology • 2.1 Motility • 2.2 Gastric Juice • 2.3 Mucosal Resistance
1.1 GROSS ANATOMY • The Cardia is located at the gastroesophageal junction. • The Fundus is the portion of the stomach that lies cephalad to the gastroesophageal junction. • The Corpus / Body is the capacious central part; division of the corpus from the pyloric antrum is marked approximately by the angular incisure, a crease on the lesser curvature just proximal to the "crow's-foot" terminations of the nerves of Latarjet. • The Pylorus is the boundary between the stomach and the duodenum
1.1 GROSS ANATOMY • The cardiac gland area locates at the gastroesophageal junction. It contains principally mucus-secreting cells, though a few parietal cells are sometimes present. • The oxyntic gland area is the portion containing parietal (oxyntic) cells and chief cells. • The pyloric gland area constitutes the distal 30% of the stomach and contains the G cells that manufacture gastrin. Mucous cells are common in the oxyntic and pyloric gland areas
1.1 GROSS ANATOMY
1.2 Blood Supply ★★★ • The Left Gastric Artery supplies the lesser curvature and connects with the Right Gastric Artery, a branch of the common Hepatic Artery
1.2 Blood Supply ★★★ • In 60% of persons, a Posterior Gastric Artery arises off the middle third of the Splenic Artery and terminates in branches on the posterior surface of the body and the fundus. Posterior gastric artery
1.2 Blood Supply ★★★ • The greater curvature is supplied by the Right Gastroepiploic Artery (a branch of the Gastroduodenal Artery) and the Left Gastroepiploic Artery (a branch of the Splenic Artery). • The mid portion of the greater curvature corresponds to a point at which the gastric branches of this vascular arcade change direction
1.2 Blood Supply ★★★ • The fundus of the stomach along the greater curvature is supplied by the Short Gastric Arteries (vasa brevia), branches of the Splenic and Left Gastroepiploic Arteries
1.2 Blood Supply ★★★ • The blood supply to the duodenum is from the Superior Pancreaticoduodenal Arteries and Inferior Pancreaticoduodenal Arteries, which are branches of the Gastroduodenal Artery (GDA) and the Superior Mesenteric Artery (SMA), respectively