The
lesser curvature forms the right border of the
stomach and extends from the cardiac orifice to the pylorus . It is suspended
from the liver by the lesser omentum.
The
greater curvature is much longer
than the lesser curvature and extends from the left of the cardiac orifice,
over the dome of the fundus, and along the left border of the stomach to the
pylorus.
The
gastrosplenic omentum (ligament)
extends from the upper part of the greater
curvature to the spleen,
Relations
of the stomach:-
1.The
anterior abdominal wall. 1.The
lesser sac.
2.The
left costal margin. 2.The
diaphragm.
3.The
left pleura and lung. 3.The
spleen.
4.The
diaphragm. 4.The
left suprarenal gland.
5.The
left lobe of the liver. 5.The
upper part of the left kidney.
6.The splenic artery.
7.The
pancreas.
8.The
transverse mesocolon
9.The
transverse colon.
Blood
Supply
Arteries
The arteries are derived from the
branches of the celiac artery.
1-The
left gastric artery arises from the celiac artery. It passes upward and to
the left to reach the esophagus and then descends along the lesser curvature of
the stomach.
It
supplies the lower third of the esophagus and the upper right part of the
stomach.
2-The
right gastric artery arises from the hepatic artery at the upper
border of the pylorus and runs to the left along the lesser curvature. It
supplies the lower right part of the stomach.
3-The
short gastric arteries arise from the splenic artery at the hilum of
the spleen and pass forward in the gastrosplenic omentum (ligament) to supply
the fundus.
4-The
left gastroepiploic artery arises from the splenic artery at the hilum of
the spleen and passes forward in the gastrosplenic omentum (ligament) to supply
the stomach along the upper part of the greater curvature.
5-The
right gastroepiploic artery arises from the gastroduodenal branch of the
hepatic artery. It passes to the left and supplies the stomach along the lower
part of the greater curvature.
Veins
The veins drain into the portal circulation
.
1-Left
gastric vein
2-Right
gastric veins. drain directly into the portal vein.
3-Short
gastric veins.
4-Left
gastroepiploic veins. join the splenic vein.
5-Right
gastroepiploic vein. joins the superior mesenteric vein.
Lymph
Drainage
The lymph vessels follow the arteries
into the
1-Left
and right gastric nodes.
2-The
left and right gastroepiploic nodes.
3-And
the short gastric nodes.
All lymph from the stomach eventually passes to the celiac nodes,which
are located
around the root of the celiac artery on the
posterior abdominal wall.
Nerve
Supply
The
nerve supply includes:
1-Sympathetic
fibers derived from the celiac plexus.
2-Parasympathetic
fibers from the right and left vagus nerves.
The
anterior vagal trunk,which is
formed in the thorax from the left vagus nerve, enters the abdomen on the
anterior surface of the esophagus.
The trunk, which may be single or multiple,
then divides into branches that supply the anterior surface of the stomach.
A
large hepatic branch passes up to the liver, and from this a pyloric
branch passes down to the pylorus.
The
posterior vagal trunk,which is formed
in the thorax from the right vagus nerve, enters the abdomen on the posterior
surface of the esophagus.
The
trunk then divides into branches that supply mainly the posterior surface of
the stomach.
A
large branch passes to the celiac and superior mesenteric plexuses
and is distributed to the intestine as far as the splenic flexure and to the
pancreas.
The
sympathetic innervation of the stomach
carries a proportion of pain-transmitting nerve fibers.
Whereas
the parasympathetic vagal fibers are secretomotor to the gastric glands
and motor to the muscular wall of the stomach.
The
pyloric sphincter receives motor
fibers from the sympathetic system and inhibitory fibers from the vagi.
