hello everyone this is dr glenn fox let's talk about the esophagus stomach and spleen
this is a fairly typical superficial view of the contents of the abdominal cavity so the anterior
wall has been removed and one of the most striking features that that we can see here is the liver
occupying space in the uh the right hypochondriac and epigastric regions it's being retracted here
ever so slightly and that's giving us room to see the abdominal part of the esophagus
the abdominal esophagus is leading itself into the stomach
the stomach has two very visible features here the first is the greater curvature and that starts
here at the cardiac notch which is approximately there and we can follow that greater curvature
all the way over to about there which is where the pyloric orifice would be um the lesser curvature
starts at the esophagus and wraps around down this way comes to that point that's the angular
incisure and then goes over to the pyloric orifice there and so um we can see both the greater
and the lesser curvatures of the stomach there and as you know the the greater and lesser omenta
are associated with these curvatures and so we'll have the the gastrocolic ligament that's kind of
coming down here and spreading out over the uh the intestines it's richly imbued with
adipose connective tissue and it's wrapping back up around to the uh the transverse
colon so you call it the the gastrocolic ligament a lot of people also call it the omental apron
those are used synonymously in terms of the lesser omentum
which runs between the lesser curvature of the stomach and the liver there are
two peritoneal ligaments between the lesser curvature of the stomach and the liver here
this is the hepatogastric ligament and then between the duodenum and the liver
this area there that would be the hepatoduodenal ligament
and the hypergastric and hepatoduodenal ligaments are contiguous so they form a solid sheet there
we can also see i'm just peeking out here in the left hypochondriac region the spleen
here's a view of just the esophagus and the stomach so here we can see there's quite a
bit of probably thoracic esophagus there and the anterior wall of the stomach has been
cut to and reflected away and we can see folds here these folds are rugae specifically gastric
rugae because they're of the stomach so because the stomach is an expansive organ
the more that it expands those folds of mucosa become less plentiful when it
returns back to its uh its typical size then those those gastric rugae reform
coming from the pyloric part of the stomach this has been cut here away
and we can see within the pyloric sphincter that's a congregation of smooth muscle that
halts the progression of chyme between the stomach and the duodenum and small amounts of of chyme are
ejected from the stomach into the duodenum for further digestion and absorption now finally
what you're looking at here is is quite a large view of the stomach so this here is the abdominal
esophagus and i'll just outline here's the greater curvature of the stomach it's been cut there
here's the lesser curvature of the stomach there and let me switch colors on us here
coming down through the esophageal hiatus along with the esophagus we can see here is the anterior
vagal trunk the vagal trunks are formed from the vagus nerves so the left vagus nerve is the
predominant supplier to the anterior vagal trunk there are some fibers from the right there
and we can also see some of the posterior vagal trunk coming down through there as well
now those are heading down towards um the celiac plexus and we can see let me outline
this in red so as not to be confusing here are the branches of the celiac trunk so there's the
splenic artery and then there's the left gastric artery and then there's the common hepatic artery
you can see it all sort of arising like a beautiful flower
and we know that there is a perivascular plexus associated with the uh the celiac
trunk here and we can see just flanking here this is one of two celiac ganglia and these
ganglia are the pre-aortic ganglia into which the thoracic splanchnic nerves are going to come and
synapse and there will also be fibers from that posterior vagal trunk that will run through there
and then those fibers are distributed along the perivascular plexuses out towards target organs
so we've discussed the uh the abdominal part of the esophagus the stomach and its features
as well as the some of the autonomics that pertain to the foregut thank you very much for your time