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University Of SULAIMANI
   College Of Science
  Department: BIOLOGY




        Stomach
Prepared
   by:

                  Peshawa Yasin
Index

   Description
   Functions of Stomach
   Shape
   Histology
   Structural anatomy
   Functional anatomy
   Gross Anatomy
   Stomach size
   Gastric emptying
   Mechanical & Chemical Digestion
   Gastrectomy
Description


   The stomach is an expanded    J-shaped
    organ in the upper left region of the abdominal
    cavity.
   It is continuous with the esophagus superiorly and
    empties into the duodenum of the small intestine
    inferiorly.
   It continues the mechanical and chemical
    digestion of the bolus. After the bolus has been
    completely processed in the stomach, the
    product is called chyme.
Functions of Stomach



   Digestion.
   Produce acid.
   Reservoir for food.
   Slows food entering intestines.
   Help with vitamin absorption (Vitamin B12).
Stomach shape


   Its shape and position are strongly
    associated with organogenesis.
   Any developmental abnormality of the
    organ itself or nearby located viscera and
    peritoneum, as well as their vessels and
    nerves may influence stomach
    morphology.
Stomach Shapes
Histology

   The stomach is lined by a simple columnar
    epithelium.
   This epithelium contains surface mucous cells
    which secrete mucin onto the epithelial lining.
   The muscularis:
       It is composed of three smooth muscle layers instead
        of two:
       Inner oblique layer.
       Middle circular layer, and o
       Outer longitudinal layer.
Structural anatomy

   The cardia connects the esophagus to the upper
    stomach (fundus), which merges with the body
    (corpus) followed by the antrum of the stomach.
   The lower outlet of the stomach (pylorus) merges
    with the duodenum.
   The left-facing arch of the stomach is the greater
    curvature, whereas the right surface forms the
    lesser curvature. The superior rounded portion
    under the left side of the diaphragm is the
    stomach‘s fundus.
Functional anatomy



   The stomach can be divided into a proximal
    and a distal segment.
   The proximal stomach mainly serves as a
    food reservoir. Its tone determines the rate at
    which food passes to the distal stomach.
   In the distal stomach, food is further
    processed (chyme formation), it is also
    responsible for portioning chyme delivery to
    the small intestine.
Gross Anatomy


   The adult stomach varies from 15 to 25 cm
    long, but its diameter and volume depend
    on how much food it contains.
   An empty stomach has a volume of about
    50 ml and a cross-sectional diameter only
    slightly larger than the large intestine, but
    when it is really distended it can hold
    about 1.5 L of food.
Stomach size

   Stomach is the most
    dilated part of the
    digestive tract.


   Stomach size is
    dependent on the
    degree of gastric
    filling, but this distension
    is mainly limited to the
    proximal stomach.
Gastric emptying


   Solid food remains in the stomach until it has
    been broken down into small particles
    (diameter of !1mm) and suspended in chyme.
   The chyme then passes to the duodenum.
   The time required for 50% of the ingested
    volume to leave the stomach varies, for
    instance:
       10—20 min for water and
       1–4 hours for solids (carbohydrates, proteins, fats).
When empty, the
stomach collapses
inward, throwing its
mucosa into
large, longitudinal
folds called rugae
(roo’ge).
Indigestible substances


   Indigestible substances (bone, fiber, foreign bodies) do not
    leave the stomach during the digestive phase.
   Special contraction waves called migrating motor
    complexes (MMC) pass through the stomach and small
    intestine roughly every 1.5 hours during the ensuing
    interdigestive phase, as determined by an intrinsic
    ―biological clock‖.
   These peristaltic waves transport indigestible substances from
    the stomach and bacteria from the small intestine to the
    large intestine.
Mechanical Digestion


   The walls of stomach have several layers of
    smooth muscle. There are three layers of
    muscle, when food is present, these muscles
    work together to churn the content of
    stomach.
   You have probably heard your stomach
    ―growl‖ when it has been empty for some
    times. These sounds are made by the
    contraction of smooth muscles that form the
    walls of stomach.
Chemical Digestion


   Gastric fluid carries out chemical digestion in
    the stomach.
   Gastric enzymes:
     Pepsin  splits complex protein molecules into
      shorter chains of amino acids.
     Hydrochloric  acid in the stomach not only
      ensure the low pH, but also dissolves minerals
      and kills bacteria that enter the stomach
      along with food.
Gastrectomy


   About half of the patients subjected to total
    gastrectomy experience weight loss.
   Malabsorption, particularly fat malabsorption, is
    a common feature after total gastrectomy. This
    may be due to shortened intestinal transit time
    and small bowel bacterial overgrowth, but is less
    often due to diarrhea or pancreatic exocrine
    insufficiency.
Total and subtotal


   In a total gastrectomy, the intestine is
    joined to the end of the esophagus,
    whilst
   In a partial (or sub-total) gastrectomy the
    intestine is joined to the remaining
    healthy stomach.
sub
Total
Total and subtotal


   Patients who had a total gastrectomy continued
    to suffer from alimentary symptoms, especially
    indigestion and diarrhea, during the entire follow-
    up period.
   However, patients who underwent subtotal
    gastrectomy had a significantly better outcome
    already during the first postoperative yr. Patients
    given a gastric substitute after gastrectomy
    improved with the passage of time and had an
    even better outcome in the long run.
Common After-Effects of Gastrectomy


   Prolonged period of recovery.
   Reduces size of the food reservoir – this can lead to reduced
    food intake and weight loss.
   Vitamin B12 not available from diet – so B12 will be needed by
    injection.
   No stomach acid means that the stomach is more susceptible
    to infections.
   Rapid movement of food to small intestine – this causes
    ‗dumping syndrome‘.
Comparison between different animals
References


   Books
       Elaine N. Marieb, Katja Hoehn. (2013). Human anatomy &
        physiology. 9th ed. Pearson Education, Inc. USA. 1107 pp.
       Fox, Stuart Ira. (2011). Human physiology. 12th ed. McGraw-Hill
        Companies, Inc. USA. 749 pp.
       Freudenrich c.c. and Tortora G. J. (2010). Visualizing Human
        Anatomy and Physiology. John wiley & Sons, Inc. USA 400-415 pp.
       Johnson M.D. (2010). Human Biology Concepts and Currents. 6th
        ed. Pearson Education, Inc. 327-341 pp.
       John H. postlethwait, Janet L. Hopson. (2006). Modern Biology.
        Holt, Rinehart and Winston. USA. 1130.
       Agamemnon Despopoulos, Stefan Silbernagl. (2003). Color Atlas of
        Physiology 5th ed. Georg Thieme Verlag. Germany. 436 pp.
References

   Articles:
       Burdan F. and R.K. Ingrid. (2012). Anatomical classification of
        the shape and topography of the stomach. 34(2): 171–178
        pp.
        Jan Svedlund MD, and Sullivan M. (1999). Long term
        consequences of gastrectomy for patients' quality of life: the
        impact of reconstructive techniques. 94, 438–445.
       Lars Olbe M.D. and Lars Lundell M.D. (1987). Intestinal function
        after total gastrectomy and possible consequences of gastric
        replacement. Volume 11, Issue 6, pp 713-719.



   Website:
       http://www.gics.org.uk/content/3.pdf
“   THANK
     YOU ”

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Stomach

  • 1. University Of SULAIMANI College Of Science Department: BIOLOGY Stomach Prepared by: Peshawa Yasin
  • 2. Index  Description  Functions of Stomach  Shape  Histology  Structural anatomy  Functional anatomy  Gross Anatomy  Stomach size  Gastric emptying  Mechanical & Chemical Digestion  Gastrectomy
  • 3. Description  The stomach is an expanded J-shaped organ in the upper left region of the abdominal cavity.  It is continuous with the esophagus superiorly and empties into the duodenum of the small intestine inferiorly.  It continues the mechanical and chemical digestion of the bolus. After the bolus has been completely processed in the stomach, the product is called chyme.
  • 4.
  • 5. Functions of Stomach  Digestion.  Produce acid.  Reservoir for food.  Slows food entering intestines.  Help with vitamin absorption (Vitamin B12).
  • 6. Stomach shape  Its shape and position are strongly associated with organogenesis.  Any developmental abnormality of the organ itself or nearby located viscera and peritoneum, as well as their vessels and nerves may influence stomach morphology.
  • 8. Histology  The stomach is lined by a simple columnar epithelium.  This epithelium contains surface mucous cells which secrete mucin onto the epithelial lining.  The muscularis:  It is composed of three smooth muscle layers instead of two:  Inner oblique layer.  Middle circular layer, and o  Outer longitudinal layer.
  • 9.
  • 10. Structural anatomy  The cardia connects the esophagus to the upper stomach (fundus), which merges with the body (corpus) followed by the antrum of the stomach.  The lower outlet of the stomach (pylorus) merges with the duodenum.  The left-facing arch of the stomach is the greater curvature, whereas the right surface forms the lesser curvature. The superior rounded portion under the left side of the diaphragm is the stomach‘s fundus.
  • 11.
  • 12.
  • 13. Functional anatomy  The stomach can be divided into a proximal and a distal segment.  The proximal stomach mainly serves as a food reservoir. Its tone determines the rate at which food passes to the distal stomach.  In the distal stomach, food is further processed (chyme formation), it is also responsible for portioning chyme delivery to the small intestine.
  • 14.
  • 15. Gross Anatomy  The adult stomach varies from 15 to 25 cm long, but its diameter and volume depend on how much food it contains.  An empty stomach has a volume of about 50 ml and a cross-sectional diameter only slightly larger than the large intestine, but when it is really distended it can hold about 1.5 L of food.
  • 16. Stomach size  Stomach is the most dilated part of the digestive tract.  Stomach size is dependent on the degree of gastric filling, but this distension is mainly limited to the proximal stomach.
  • 17. Gastric emptying  Solid food remains in the stomach until it has been broken down into small particles (diameter of !1mm) and suspended in chyme.  The chyme then passes to the duodenum.  The time required for 50% of the ingested volume to leave the stomach varies, for instance:  10—20 min for water and  1–4 hours for solids (carbohydrates, proteins, fats).
  • 18. When empty, the stomach collapses inward, throwing its mucosa into large, longitudinal folds called rugae (roo’ge).
  • 19. Indigestible substances  Indigestible substances (bone, fiber, foreign bodies) do not leave the stomach during the digestive phase.  Special contraction waves called migrating motor complexes (MMC) pass through the stomach and small intestine roughly every 1.5 hours during the ensuing interdigestive phase, as determined by an intrinsic ―biological clock‖.  These peristaltic waves transport indigestible substances from the stomach and bacteria from the small intestine to the large intestine.
  • 20. Mechanical Digestion  The walls of stomach have several layers of smooth muscle. There are three layers of muscle, when food is present, these muscles work together to churn the content of stomach.  You have probably heard your stomach ―growl‖ when it has been empty for some times. These sounds are made by the contraction of smooth muscles that form the walls of stomach.
  • 21. Chemical Digestion  Gastric fluid carries out chemical digestion in the stomach.  Gastric enzymes:  Pepsin splits complex protein molecules into shorter chains of amino acids.  Hydrochloric acid in the stomach not only ensure the low pH, but also dissolves minerals and kills bacteria that enter the stomach along with food.
  • 22. Gastrectomy  About half of the patients subjected to total gastrectomy experience weight loss.  Malabsorption, particularly fat malabsorption, is a common feature after total gastrectomy. This may be due to shortened intestinal transit time and small bowel bacterial overgrowth, but is less often due to diarrhea or pancreatic exocrine insufficiency.
  • 23.
  • 24. Total and subtotal  In a total gastrectomy, the intestine is joined to the end of the esophagus, whilst  In a partial (or sub-total) gastrectomy the intestine is joined to the remaining healthy stomach.
  • 25. sub
  • 26. Total
  • 27. Total and subtotal  Patients who had a total gastrectomy continued to suffer from alimentary symptoms, especially indigestion and diarrhea, during the entire follow- up period.  However, patients who underwent subtotal gastrectomy had a significantly better outcome already during the first postoperative yr. Patients given a gastric substitute after gastrectomy improved with the passage of time and had an even better outcome in the long run.
  • 28. Common After-Effects of Gastrectomy  Prolonged period of recovery.  Reduces size of the food reservoir – this can lead to reduced food intake and weight loss.  Vitamin B12 not available from diet – so B12 will be needed by injection.  No stomach acid means that the stomach is more susceptible to infections.  Rapid movement of food to small intestine – this causes ‗dumping syndrome‘.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 35. References  Books  Elaine N. Marieb, Katja Hoehn. (2013). Human anatomy & physiology. 9th ed. Pearson Education, Inc. USA. 1107 pp.  Fox, Stuart Ira. (2011). Human physiology. 12th ed. McGraw-Hill Companies, Inc. USA. 749 pp.  Freudenrich c.c. and Tortora G. J. (2010). Visualizing Human Anatomy and Physiology. John wiley & Sons, Inc. USA 400-415 pp.  Johnson M.D. (2010). Human Biology Concepts and Currents. 6th ed. Pearson Education, Inc. 327-341 pp.  John H. postlethwait, Janet L. Hopson. (2006). Modern Biology. Holt, Rinehart and Winston. USA. 1130.  Agamemnon Despopoulos, Stefan Silbernagl. (2003). Color Atlas of Physiology 5th ed. Georg Thieme Verlag. Germany. 436 pp.
  • 36. References  Articles:  Burdan F. and R.K. Ingrid. (2012). Anatomical classification of the shape and topography of the stomach. 34(2): 171–178 pp.  Jan Svedlund MD, and Sullivan M. (1999). Long term consequences of gastrectomy for patients' quality of life: the impact of reconstructive techniques. 94, 438–445.  Lars Olbe M.D. and Lars Lundell M.D. (1987). Intestinal function after total gastrectomy and possible consequences of gastric replacement. Volume 11, Issue 6, pp 713-719.  Website:  http://www.gics.org.uk/content/3.pdf
  • 37. THANK YOU ”

Editor's Notes

  1. http://www.gics.org.uk/content/3.pdf
  2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284679/
  3. Fig. 1Diagrams with the most common, anatomical variances of the stomach: typical shape of the stomach (a), malrotation (b), sliding hiatal hernia (c), paraesophagealhiatal hernia (d), mixed-form hiatal hernia (e), upside-down hernia (f), congenital short esophagus (g), cascade (h), lack of the whole organ (i), lack of the fundus (j), short body (k), advanced enlargement (l), congenital gastroduodenal (m) and gastroileal (n) fistula
  4. Digest-HumanAnatomyС-2
  5. Color Atlas of Physiology 5th Ed. - A. Despopoulos
  6. Color Atlas of Physiology 5th Ed. - A. Despopoulos
  7. Color Atlas of Physiology 5th Ed. - A. Despopoulos
  8. Human anatomy physiology
  9. Color Atlas of Physiology 5th Ed. - A. Despopoulos
  10. Color Atlas of Physiology 5th Ed. - A. Despopoulos
  11. Color Atlas of Physiology 5th Ed. - A. Despopoulos
  12. Modern Biology - Postlethwait , Hopson
  13. Modern Biology - Postlethwait , Hopson
  14. http://link.springer.com/article/10.1007%2FBF01656593?LI=true
  15. Life after Gastrectomy and Oesophagectomy
  16. http://www.nature.com/ajg/journal/v94/n2/abs/ajg199984a.html
  17. Dumping SyndromeIt is caused by rapid movement of food into the intestine. This process creates insulinwhich then makes the blood sugar level too low, causing some or all of:• sweatiness• dizziness• light-headedness• nausea• weakness and fatigue• fast heart rateRefined sugar can cause worse symptoms - to prevent dumping, try to take somefibre with refined sugar. If symptoms of dumping occur, a little sugary foodimproves symptoms quickly.