The document describes the anatomy and physiology of the stomach. It discusses the location, shape, capacity, subdivisions and internal features of the stomach. It describes the blood supply, nerve supply, lymphatic drainage and histology of the stomach. It also discusses some common stomach conditions like gastric ulcers, gastritis, and stomach cancer. Tests used to examine the stomach like endoscopy, CT scans, and pH testing are also mentioned.

1. Stomach
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2. Stomach
( gaster or venter )
Introduction – stomach is muscular bag forming the widest & most
distensible part of digestive tube.
- helps in digestion & reservior of food.
- it connected above- lower end of oesophagus
below- to duodenum
Location-
a -Epigastrium region
b-Umbilical region
C- left hypo chondriac region
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3. stomach
Shape of stomach-
* depends upon degree of distension, physique& position of adjacent
organ.
=empty stomach- J shaped
= partial distende- Pyriform
= Obese person- steer horn
= normal active person – sthenic shape
(j shaped)
=thin ,tall person – hypostenic shaped
( J shaped)
= strong , active person- horizontal
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6. stomach
• Capacity- varies with age
• Birth-30 ml
• Puberty-1000 ml
• Adult-1.5 to 2 l
length –
25 cm long
or
10 inches
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11. stomach
• Curvatures – 2 curvatures
1. lesser curvature-
• cancave & forms Rt. border of stomach
• Attached to lesser omentum
provide attachment ligament -
1. Hepato-gastric ligament.
2. Hepato-duodenal ligament.
2. greater curvature-
convex & form Lt. border of stomach
Attached to greater omentum
Provide attachment ligament –
1.Gastro-splenic ligament.
2.gastro-phrenic ligament.
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13. Surfaces of Stomach
Sufaces of stomach-
a- Anterosuperior surface – faces forwards & upwards
b- Posteroinferior surface- faces backward & downward.
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16. Stomach
Subdivision-
divided into 2 parts by a line extending from Angula Incisura to greater
curvature.(angula incisura – junction of horizontal & vertical part at lesser
curvature)
1. Larger part - cardiac part. 2. smaller part-Pyloric part.
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17. stomach
cardiac part subdivides- Fundus & Body
Fundus- are above the horizontal line extending from cardiac orifice to
greater curvature
Body of stomach- lies b/w fundus & pyloric antrum.
Pyloric antrum – it is 3 inches long.
Pyloric canal – it is 1 inch long & narrow and tubular.
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18. Internal fearture of stomach
• Orifices –
Cardiac orifice- pyloric orifice
-present at lower end of oesophagus. +nt at 1 inch to rt. of Median plane at L1
- it is physiological sphincter. - It is anatomical sphincter
- it cannot demonstrated anatomically. - Can demonstrated anatomcally
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19. relation of stomach
*Peritoneal relation- covered by peritoneum except bare area
( bare area-behind cardiac end of stomach which is in contact of diaphragm)
Visceral relation-
Anterior posterior
-Liver -stomach bed
-Diaphragm
-Anterior abdominal wall
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22. Stomach bed
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24. Blood supply of stomach
Arterial Supply-
1.Lf. Gastric artery –A branch of Coeliac trunk .it is principal artery of stomach & supplies 2/3 of organ.
2.RT Gastric artery- branch of common hepatic artery, it anastomosis with
LT &RT gastric artery in lesser omentum.
3.Short Gastric arteries-branch of splenic artery & supplt to fundus
4.Lt.Epipolic artery-branch of splenic artery & reaches to Greater curvature of S.
5.Rt Epipolic artery-branch of Gastroduodenal artery & anatomosis with
Lt gastro epiolic artery.
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26. Venous drainage of stomach
1.Rt & Lt Gastric vein drain into trunk of portal vein.
2.Short gastric & Lt Epipolic vein drain into Splenic vein
3. Rt. Gastro-epipolic vein drain into Superior mesenteric vein.
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28. Nerve supply of stomach
Sympathetic fibres-
they arise from Coelic plexus . The pre ganglionic motor fibres arise
from T6 to T9 segment of spinal cord & the fibres reaches via. Greater
splanchic nerve
Following function-
1.They are vasomotor in function.
2.Stimulates the pyloric sphincter.
3.They inhibit rest of gastric muscles.
4. Sensory sympathetic fibres convey painful sensation from
stomach.
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29. Nerve supply of stomach
• Parasympathetic –they arise from both vagus nerve in the form of
Anterior & posterior vagal trunk through oesophagus plexus & gastric nerve.
• They consist of anterior & posterior Gastric nerve .
Stimulation of parasympathetic nerve fibres –
1. Increase motility of stomach.
2. Secrection of gastric juice which is rich in pepsin & hcl
3. Inhibit pyloric sphincher.
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32. Lymphatic of stomach
• All lymphatic from stomach ultimately drain in to coeliac group of
lymph nodes.
• It is derived into 4 region.
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35. Interior of stomach
• When stomach is opened following sts. Seen
Mucosa-
• Empty stomach has muscosal fold called called gastric rugae.
• Numerous small depression b/w fold called gastric pit.
• Lesser curvature having longitudinal rugae or gastric canal or magenstrase
Sub mucous coat
made of connective tissue. arterioles & nerve plexus
Muscular coat-
1. Longitudinal fibres- most superficial, mainly along curvature
2. Circular fibres- middle fibres encircle the body ,
- are thick at pylorus part pyloric sphincture
- are thickened at cardiac end form cardiac sphincter
or lower oesophageal sphincter
3. Oblique fibres- inner fibres or deep fibres,
- forms gastric canal at lesser curvature.
Serous coat-
consist of peritoneal covering
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38. • pic
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39. Histology of stomach
1. Cardiac part-
1.1 mucous membrane-simple columnar with tubular gland
- lower half of gland is secretory
- upper half of gland is conducting
- muscularis mucosae consist of smooth muscle fibre
1.2 sub mucosa- loose connective tissue with meissner`s plexus
1.3 muscularis externa - outer longitudinal fibres
- inner circular fibres
- also having myenteric plexus or auerbach`s plexus
1.4 serosa – single layer of sqamous cell.
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40. Histology of stomach
2.Fundus & body-
2.1 mucous membrane-
-all tubular glands varoius cells like
- zymogenic,oxygentic or parietal and mucous neck cell
- muscularis mucosae consist of smooth muscle fibre
2.2 sub mucosa- same cardiac
2.3 muscularis externa- contain additional circular layer
2.4 serosa- same as cadiac
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41. Histology of stomach
1. Pyloric part-
3.1 mucous membrane- consist of basal & secretory cell
- muscularis mucosa made up of 2 layer of fibres
3.2 sub mucosa- same as cardiac
3.3 muscularis externa-circular layer forms pyloric sphincture
3.4 serosa-same as cardiac
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44. Applied aspect
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45. Applied aspect
• Gastric pain-
 Gastric ulcer
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46. • Gastroparesis
• This digestive disorder reduces the ability of
the stomach to empty its contents, slowing or
stopping the movement of food from the
stomach to the small intestine. Gastroparesis
typically affects more women than men,
though the reason for this is unknown.
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47. • Gastroesophageal Reflux Disease (GERD)
• GERD results when the lower esophageal sphincter–the
muscle that acts as the valve between the esophagus and
stomach–becomes weak or relaxes when it should not. This
causes stomach contents to travel up the esophagus,
triggering heartburn
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Stomach Tests
Upper endoscopy (esophagogastroduodenoscopy or
EGD): A flexible tube with a camera on its end
(endoscope) is inserted through the mouth. The
endoscope allows examination of the esophagus,
stomach, and duodenum (the first part of the small
intestine).
Computed tomography (CT scan): A CT scanner uses
X-rays and a computer to create images of the
stomach and abdomen.
Magnetic resonance imaging: Using a magnetic field,
a scanner creates high-resolution images of the
stomach and abdomen.
pH testing: Using a tube through the nose into the
esophagus, acid levels in the esophagus can be
monitored. This can help diagnose or change
treatment for GERD.
Barium swallow: After swallowing barium, X-ray films
of the esophagus and stomach are taken. This can
sometimes diagnose ulcers or other problems.
Upper GI series: X-rays are taken of the esophagus,
stomach, and upper part of the small intestine.
Gastric emptying study: A test of how rapidly food
passes through the stomach. The food is labeled with
a chemical and viewed on a scanner.

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almost any benign or serious condition that
affects the stomach.
Gastric ulcer (stomach ulcer): An erosion in the
lining of the stomach, often causing pain
and/or bleeding. Gastric ulcers are most often
caused by NSAIDs or H. pylori infection.
Peptic ulcer disease: Doctors consider ulcers in
either the stomach or the duodenum (the first
part of the small intestine) peptic ulcer
disease.
Gastritis: Inflammation of the stomach, often
causing nausea and/or pain. Gastritis can be
caused by alcohol, certain medications, H.
pylori infection, or other factors.
Stomach cancer: Gastric cancer is an
uncommon form of cancer in the U.S.
Adenocarcinoma and lymphoma make up most
of the cases of stomach cancer.
Zollinger-Ellison syndrome (ZES): One or more
tumors that secrete hormones that lead to
increased acid production. Severe GERD and
peptic ulcer disease result from this rare
disorder.
Gastric varices: In people with severe liver
disease, veins in the stomach may swell and