Introduction to the

upper GI tract
DR D MERRICK
2018
Aim

 Help in guiding your preparation for next week’s DR class

Acquisition of anatomical knowledge requires a lot of input from you!

Learning objectives
 Define the upper GI tract and associated viscera

 Describe the regions, blood supply, innervation, lymphatic

drainage of the stomach

 Explain the regions of the duodenum, its blood supply,

innervation and lymphatic drainage

 Discuss the differences between the jejunum and ileum in life

 Upper GI Tract
Clinically (from the point of view of GI bleeding):
o Upper GI (bleed) above the duodenojejunal junction
o Lower GI (bleed) below the duodenojejunal junction

Diagnostically (from the point of view of endoscopic imaging) also the

duodenojejunal junction
o Upper GI tract = oesophagus, stomach, duodenum
o Lower GI tract = jejunum, ileum,  rectum, anus

Conventionally:
o Upper (mouth to ileum)
o Lower (caecum to anus)
 Fundus
Cardia
Stomach

Lesser curvature

Pylorus

Pyloric canal Body

Pyloric antrum
Greater curvature
 Cardial orifice

Lesser
curvature

Greater
Pyloric sphincter curvature

Pyloric canal
Gastric folds
Pyloric antrum
(rugae)

What is the blood supply to the stomach?

Recap…

Coeliac Trunk

Superior Mesenteric

Inferior Mesenteric
If you said…

 No idea - 0 marks

 Derived from the coeliac trunk - 2 marks

 L, R gastric arteries - 3 marks

 L, R, (short) gastric, splenic, L, R gastroduodenal aa

- 5 marks
 Posterior gastric
R & L gastric vv
R & L gastric aa Short gastric aa Short gastric v

Portal
Vein

Splenic v

SMA
R & L gastro-omental aa R & L gastro-omental vv
 Ant and post vagal trunks
Greater
Coeliac splanchnic

Gastric

Gastro-
omental
Small intestines: Duodenum
1st

2nd
pylorus

4th
3rd

Major duodenal
papilla
 Superior
pancreaticoduodenal
artery Gastroduodenal artery

Inferior
pancreaticoduodenal artery
Small intestines: jejunum & ileum
Differences
Mesentery

Vasa recta

Arterial arcades
A B C
A

B
If you said

 No idea – 0 marks

A– ileum, B – jejunum, C – junction between the two – 0 marks

A– jejenum, B – ileum, C – junction between the two – 3 marks

A– proximal jejenum, B – distal ileum, C – proximal ileum – 5

marks
SMA:
Jejunal arteries
Ileal arteries
In the dissection room
Vasculature Viscera

Coeliac trunk & branches Stomach

Superior mesenteric Duodenum

artery & main branches
Jejunum
Inferior mesenteric artery
& main branches Ileum

(Large intestines)

* Small and large intestine will be removed

in this class
In the tasking rooms

 Consolidate knowledge of upper GI (mouth 

oesophagus)

 Look at prosections that will correspond to the region you

will dissect in the dissection room

 Work through your workbooks, make them as complete as

possible – these will be an important revision source.
 Check list of things it
would be advisable to do
before entering the DR next

 Not an exhaustive list

 Consider your learning

style!
Oral cavity

 Boundaries
Task 2

*
What is *?
What am i?

 Back of mouth/throat (0 marks)

 Pharynx (2 mark)
 Oropharynx (4 mark)
 Posterior wall of oropharynx (5 marks)
Tongue

 Whatis the motor innervation of the

tongue?
(task 5)
 Trigeminal nerve (CNV)
0 marks

 Glossopharyngeal nerve (CNIX)

0 marks

 Vagus nerve (CNX)

2 marks

 Hypoglossal nerve (CNXII)

3 marks

 Hypoglossal
nerve (CNXII) and
Vagus (CNX)
5 marks
 What am i?
5 marks  I am enclosed in a tough sheath derived from the
investing layer of deep cervical fascia= PAROTID
GLAND!!!!!!
4 marks  I occupy a bed

3 marks  I have a duct

2 marks  The duct opens into the oral cavity opposite the 2nd
maxillary molar tooth

1 mark  Largest of the three paired salivary glands

Task 4
How did you do?
 20-25 marks – wow! Excellent!

 15-20 marks – great some sound knowledge already!

 10-15 marks – good, some knowledge just ensure you find some
time to look through some resources before next week

 Lessthan 10 – ensure you work through the check list before next
week and carry out all tasks in the work book!