STOMACH/SI/LI

ABDOMEN

STOMACH

OMENTAL BURSA

Esophagus 25cm (10in) 2cm dm pharynx to stomach passes thru elliptical esophageal hiatus in the muscular right crus of diaphragm left of median plane level T10

Esophagogastric junction terminal point -esophagus ingested matter enters cardial orifice left of the midline at the level 7th left costal cartilage T11 vertebra retroperitoneal -abdominal course Z-line abrupt transition esophageal to gastric mucosa

Venous drainage primarily to the portal venous system through the left gastric vein

Inferior esophageal sphincter superior to Zline musculature physiological inferior esophageal sphincter contracts and relaxes px reflux esophageal branches of the left gastric artery, a branch of the celiac trunk, and the left inferior phrenic artery.

Lymphatic drainage into the left gastric lymph nodes, which in turn drain mainly to the celiac lymph nodes proximal thoracic systemic venous system through the esophageal veins entering the azygos vein Innervation from the vagal trunks (becoming anterior and posterior gastric nerves),

thoracic sympathetic trunks via the greater (abdominopelvic) spanchnic

PARTS
Trumpet shaped orifice
parasympathetic from the anterior vagal trunk left vagus n and posterior vagal trunk (mainly right vagus nerve) and their branches, which enter the abdomen through the esophageal hiatus . Superior part superior dome diaphragm 5th ICS

gastric and gastroomental lymph nodes are located. The efferent vessels from these nodes via the pancreaticosplenic, pyloric, and pancreaticoduodenal lymph nodes

sympathetic nerve from the T6T9 the spinal cord, which passes to the celiac plexus via the greater splanchnic nerves and is distributed as

INTERNAL SURFACE

BLOOD SUPPLY

Gastric veins that parallel the arteries in position and course . The left and right gastric veins drain directly into the hepatic portal vein. The short gastric veins and the left gastro-omental veins drain into the splenic vein, which then joins the superior mesenteric vein (SMV) to form the hepatic portal vein. Right gastro-omental SMV

CELIAC ARTERY

small intestine, consisting of the duodenum, jejunum, and ileum, extends from the pylorus of the stomach to the ileocecal junction, where the ileum joins the cecum, the first part of the large

DUODENUM The duodenum, the first and shortest (25 cm) part of the small intestine, is also the widest and most fixed part. The duodenum begins at the pylorus on the right side and ends at the duodenojejunal junction on the left side.

SPLEEN RELATIONSHP

PARTS AND RELATIONSHIP DUODENUM/SPLEEN

Proximally the abdominal part of the alimentary tract is supplied by the celiac trunk, and the first and second parts of the duodenum are supplied via the gastroduodenal artery and its branch, the superior pancreaticoduodenal artery. Distally a major part of the alimentary canal (extending as far as the left colic flexure) is supplied by the SMA, and the third and fourth parts of the duodenum are supplied by its branch, the inferior pancreaticoduodenal artery. The superior and inferior pancreaticoduodenal arteries form an anastomotic loop between the celiac trunk and the SMA; consequently, there is potential for collateral circulation here.

Duodenal veins, which follow the arteries and drain into the hepatic portal vein ; some veins drain directly and others indirectly through the superior mesenteric and splenic veins.

SPLEEN