ANATOMY OF

STOMACH
•

• Name :- SAUMYA SINGH

• Roll:- 83
• BDS 1st yr BIDSH
INTRODUCTION

• The stomach is also called gaster or venter .

• The stomach is muscular bag forming the widest and most distensible part of the
digestive tube .
• It is connect above to the lower end of the oesophagus and below to the duodenum .
• It is located at level of T10 and L3 vertebra .
 LOCATION
• The stomach lies obliquely in the
upper left part of the abdomen ,
occupying the epigastric,
umbilical and left hypochondriac
regions.
• Most of it lies under cover of the
left costal margin and ribs.
SHAPE AND POSITION
Shape of stomach depend upon degree of tone of its muscles and tone of muscles of body.
Normal active person (sthenic): J shaped
Tall person (hyposthenic) : J shaped
Strong & very active person : horizontal shape
SIZE AND CAPACITY
• Stomach is Avery distensible organ.
• It is about 25cm long.
• Capacity : at birth – 30 ml (ounce)
at puberty- 1liter / 1000ml
more in adult- 1 to 2 liter
 EXTERNAL FEATURE
• The stomach has two orifices or opening ,two curvatures or border , two
surface and two incisura.
Orifices : 2 Curvature or Surface : 2 Incisura : 2
or opening borders : 2

1. Cardiac orifice 1.Right known 1. Anterior or 1. Cardiac

cotinuous with as lesser antero-superior incisura.
oesophagus. curvature – surface.
concave .
2.Pyloric orifice 2. Left known as 2.Posterior or 2. Pyloric
continuous with greater postero- incisura.
duodenum. curvature- superior surface.
convex.
 PARTS
Anatomical parts : 3 in number Histological parts : 3 in number
1. Fundus- which is dome shaped 1. Fundic part : it include fundus and
filled with gas.. body .
It extend from up to 5th
intercostal space
above a horizontal line from the
cardiac
notch.
2. Body between the fundus and 2. Cardiac parts
pyloric parts.
3. Pyloric part : It divide into : 3. Pyloric parts
a) pyloric antrum
b) pyloric canal
c) pylorus or pyloric spincter, it
can be .
recognized by :
# sphincter
# a constriction
. # prepyloric vein in front of it
.
# at the level of L1 vertebra.
RELATION OF STOMACH
• 1. PERITONIAL RELATIONS
- Stomach is lined by peritoneum on both it’s surface .
- Fold of peritoneum of stomach are :
# Lesser omentum. # Gastrosplenic ligament.
# Greater omentum. # Gastrophernic ligament.
.
2.VISCERAL RELATION
• The anterior surface of the stomach is related to the liver the diaphragm, transverse colon and the
anterior abdominal wall .
• the diaphragm separates the stomach from the left pleura ,the pericardium , and the 6th to 9th ribs
.
• The costal cartilage are separated from the stomach by the transverse abdominal.
• Gastric nerves and vessels ramify deep to the peritoneum.
 BLOOD SUPPLY
• The stomach is supplied along.

1) the lesser curvature by : the left gastric artery, a branch of the download trunk and the
right gastric artery , a

branch of the proper hepatic artery.

2) Along the greater curvature . It is supplied by the right gastroepiploic artery , a branch of
the gastroduodenal

and the left gastroepiploic artery . A branch of the splenic .

3) Fundus is supplied by 5 to 7 short gastric arteries , which are also branch of the splenic
artery .

The vein of the stomach drain into the portal , superior mesenteric and splenic vein .

Right and left gastric vein drain in the portal vein . Right gastroepiploic ends in superior
mesenteric vein ; while

left gastroepiploic and short gastric veins terminate in splenic vein.

 LYMPHATIC DRAINAGE
• The stomach can be decided into few lymphatic territories.
• A) Pancreaticospleenic node I.e upper part of left 1/3 drains
along the splenic artery I.e on the back of the stomach.
• B) Right 2/3 drains into the left gastric nodes lying along the
artery of the same name. These nodes also drain the
abdominal part the oesophagus.
• C) Lower part of the 1/3 drains into the right gastroepiploic
nodes that lie along the artery of the same name.
• D) Pyloric part drain in different direction into the pyloric , hepatic and left
gastric nodes and passes from all these nodes and the download nodes.
 NERVE SUPPLY
The stomach is supplied by sympathetic and parasympathetic nerves
.The sympathetic nerves are derived from thoracic six to ten
segment of the spinal cord via the greater solanki nerve coeliac and
hepatic plexuses .
They travel along the arteries supplying the stomach. These nerves
are :

1) Vasomotor.
2) Motor to the spincter , but inhibitory to the rest of the
gastric musculature.
3) The chief pathway for pain sensation from the stomach.
 INTERIOR OF STOMACH
• The stomach has to be opened to see it’s internal structures
:
a) MUCOSA of on empty stomach is through into fold
termed as gastric rutas.
IT surface contain numerous small depressions called
gastric pits for gastric glands.
b) SUBMUCOUSA COAT is made up of connective tissue,
afternoon and nerve plexus.
c) MUSCLE COAT is arranged as under.
# LONGITUDINAL FIBERS are most superficial ,
mainly Alon the curvature.
# CIRCULAR FIBERS encircle the body and are
thickened a pylorus to from pyloric spincter
# The deepest layer consist of OBLIQUE FIBERS
which loop over the cardiac notch.
# SEROUS COAT consist of peritoneal covering.
FUNCTION OF STOMACH
• The stomach acts primarily as a reservoir of food it also acts as a mixer of food.
• By its peristaltic movement it soften and mixed with the gastric juice .
• The gastric glands produce the gastric juice which contain enzymes that play an important role in
digestion of food.
• The gastric gland also produce HCL which destroy many organism present in food and drink .
• The lining cells of the stomach produce abundant mucus which protect the gastric mucosa against the
corrosive action of HCL.
• Some substance like alcohol , water , salt , and a few drugs and absorbed in the stomach
• Stomach produces the “ intrinsic factor” of castle which help in the absorption of Vitamin B12.
 HISTOLOGY OF STOMACH
• At the cardiac end of stomach ,the stratified epithelium of
oesophagus abruptly change to simple columnar epithelium of
stomach
1 ). CARDIAC END
# MUCOUS MEMBRANE :-
The epithelium is simple columnar with small tubular gland.
# SUBMUCOSA :-
It consist of loose connectivity tissue with meissner’s
plexus.
# MUSCULARIS EXTERNA :-
It is made up of outer longitudinal & inner circular layer
including the myenteric plexus of nerve or Aurbach ‘s plexus.
# SEROSA :-
. It is lined by single layer of squamous cell
2. FUNDUS & BODY OF STOMACH

• MUCOUS MEMBRANE :-
It contain tall simple tubular gastric gland upper 1/3rd is conducting while lower 2/3rd is
secretory .
MUSCULARIES MUCOSAE & SUBMUCOSA are same .
MUSCULARIS EXTERNA:-
It contain an additional inner most oblique additional oblique coat of muscle fibre.
SEROSA :-
It is same as cardic end .
 PYLORIC PART

MUCOUS MEMBRANE:-
There are pyloric gland which consist of badal 1/3rd as mucus secretory component and
upper 2/3rd as conducting part
MUSCULARIS MUCOSAois made of two layer of fiber .
SUBMUCOSA is same as in cardic end .
MUSCULARIS externa comprises thich layer of circular fiber forming the pyloric sphincter
.
 CLINICAL ANATOMY
• GASTRIC PAIN :- It is felt in epigastrium because the stomach is supplied from segment T6 to T9 of the
spinal cord which also supply the upper part of abdominal wall . Pain is produced either by spasm of muscle ,
or by over descension . Ulcer pain is attributed to local spasm due to irritation .
• PEPTIC ULCER :- It can occur in the site of pepsin &hydrochloric acid , namely the stomach ,first part of
duodenum , lower end of esophagus and Meckel’s diverticulum . It is common in blood group “O” .
• DYSPEPSIA :- Another name for stomach upset or indigestion . It may be caused by almost any benign or
serious condition that affect the stomach .
• GASTRITIS :- InInflammation of stomach , often causing nausea or pain . It can be caused by alcohol , certain
medication or other factor .
• STOMACH BLEEDING :- Gastritis , ulcers , or gastric cancers may bleed . Seeing blood or black material in
vomit or stool is usually a medical emergency .
• GASTROESOPHAGEAL REFLUX : - Stomach contents , including acid ,can travel backward up the
esophagus. There may be no symptom ,or reflux may cause heartburn or coughing.
Gastric ulcer