STOMACH

 Muscular bag
 Connected above with oesophagus and below with duodenum
 Reservoir of food
Location
 Upper left part of abdomen
 Occupies epigastric, umbilical and left hypochondriac regions

Shape
 J shaped
External features
 2 Orifices/ openings
 2 Curvatures
 2 Surfaces
 2 Parts
Orifices/ openings
 Cardiac orifice
 Where the stomach joins with the lower end of oesophagus
 Lies behind the 7th costal cartilage at the level of T11 vertebra

 Pyloric orifice
 Opens into the duodenum
 Lies 1.2 cms to the right of median plane
 Lower border of body of 1st lumbar or Transpyloric plane
Curvatures
 Lesser curvature –
 Concave
 Right border
 Provide attachment to lesser omentum
 Most dependent part – angular notch or incisura angularis

 Greater curvature –
 Convex
 Left border
 5 times longer
 Provide attachment to greater omentum, gastro splenic lig. and gastrophrenic
lig.
 Cardiac notch – separates stomach from oesophagus
Surfaces
 Anterior or Antrosuperior surface
 Posterior or Posteroinferior

Parts
 Cardiac Fundus

Body
 Pyloric Antrum

Canal
RELATIONS OF STOMACH
Peritoneal Relations - The stomach is lined by peritoneum on both its surfaces.
 At the lesser curvature, the layers of peritoneum lining the anterior and posterior surfaces meet
and become continuous with the lesser omentum.
 Along the greater part of the greater curvature, the two layers meet to form the greater
omentum.
 Near the fundus, the two layers meet to form the gastrosplenic ligament.
 Near the cardiac end, the peritoneum on the posterior surface is reflected onto the diaphragm
as the gastrophrenic ligament.
 Cranial to this ligament a small part of the posterior surface of the stomach is in direct contact
with the diaphragm (left crus). This is the bare area of the stomach.
Visceral Relations
 The anterior surface of the stomach is related to the liver, the diaphragm, and the anterior abdominal
wall.
(The space between left costal margin and lower edge of left lung on stomach is known as Traube’s space.)
 The posterior surface of the stomach is related to structures forming the stomach bed,

These structures are:

a.Diaphragm
b.Left kidney
c.Left suprarenal gland
d.Pancreas
e.Transverse mesocolon
f.Splenic flexure of the colon
g.Splenic artery
Sometimes the spleen is also included in the stomach bed
Layers /Interior of Stomach
4 layers – Serous, Muscular, Sub mucous and Mucous
 Mucous –
 Folds – Rugae
 Numerous small depressions – gastric pits
 Lessee curvature – longitudinal folds – Gastric canal
2) Submucous coat
 is made of connective tissue, arterioles and nerve plexus.

3) Muscle coat is arranged as:

a. Longitudinal fibres are most superficial, mainly along the
curvatures.
b. Inner circular fibres encircle the body and are thickened at
pylorus to form pyloric sphincter
c. The deepest layer consists of oblique fibres which loop over the
cardiac notch. Some fibres spread in the fundus and body of
stomach.
4) Serous coat consists of the peritoneal covering.
Blood supply

Veins: By right and left gastric veins - drained into portal vein, right gastroepiploic vein and
superior mesenteric vein
Nerve supply
Para sympathetic: Vagus and Gastric nerves (anterior and posterior)

Sympathetic: T6 to T10 spinal nerves

Clinical anatomy
 Gastric ulcer
 Peptic ulcer
 Gastric Ca
 Gastric pain is felt in epigastrium – due to same nerve supply T6 - T9