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STOMACH

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STOMACH

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    1. STOMACH PRESENTED BY DR.BHARATH PRAVEEN.VS

    2. stomach Also called gaster. Muscular bag. Most widest . Most distensible part. Connection. Reservoir of food. Helps in digestion of proteins and fats

    3. Location Upper and left part of abdomen Epigastric, umbilical and left hypochondrial region

    4. shape Depends on degree of distension and surrounding viscera Empty - J shape Partly distended - piriform Obese - horizontal - steer horn stomach

    5. size Distensible 10 in. long Capacity 30 ml - birth 1 l - puberty 1 ½ l – 2 l or more - adult

    6. External features Cardiac orfice -7th costal cartilage, T 11 vertebra Pyloric orifice - lowerborder of L 1 Pyloric constriction - circular groove Pylorus = gate guard PrePyloric vein in front of constriction Lesser curvature, lesser omentum, incisura angularis

    7. External features… Greater curvature, GO, cardiac notch Anterior surface - forward upward Posterior surface -backward downward

    8. Sub divisions Cardiac ,Pyloric parts Cardiac – fundus , body Pyloric – pyloric antrum ( 3 in.), pyloric canal(1 in.)

    9. Relations Peritoneal Lesser omentum Greater omentum Gastrosplenic ligament Gastrophrenic ligament Bare area

    10. Relations….. Visceral Anterior surface Liver, diaphram, ant. Abd.wall Posterior surface Diapham, lt kidney, lt supra renal gland,pancreas, transverse mesocolon, splinic flexure of colon, splenic artery - stomach bed

    11. Interior of stomach Gastric rugae Longitudinal along lesser curvature – gastric canal, irregular elsewhere. Gastric pits Gastric glands opens

    12. Blood supply Left gastric artery- br of coeliac trunk Right gastric artery- br of common hepatic artery Right gastro epiploic artery- br of gastrodoudinal artery Left gastro epiploic artery- br of splenic artey 5-7 short gastric arteries -br of splenic artery

    13. Blood supply Veins Portal Superior mesentric splenic

    14. Lymphatic drainage Area A pancreatosplenic Area B left gastric Area C right gastroepiploic sub pyloric hepatic Area D diff directions into pyloric, hepatic, left gastric Coeliac trunk cisterna chyli

    15. Nerve supply Sympathetic t6 t10 Via splanchenic nerves, coeliac and hepatic pluxes Vasomotor Motor to pyloric shincter only Pain sensation from stomach

    16. Nerve supply Parasympathetic From vagi through oesophageal pluxes and gastric nerves Motor and secretomotor

    17. functions Reservoir of food Peristaltic movements Gastric glands gastric juice, HCL Mucous absorption

    18. Applied anatomy Displacement of stomach Hiatus hernia Congenital diaphramatic hernia Pyloro spasm Congenital hypertrophic pyloric stenosis Gastrectomy – ca stomach

    19. Applied anatomy Ulcers, helico bacter pylori and vagotomy Gastric pain felt in epigastium Barium meal x ray, gastroscope

    20. THANK YOU

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