Hello all I'm Glenn Fox
Hello all I'm Glenn Fox

and in this video I'll discuss the stomach my objectives for this video are for you to understand the relative location gross anatomy and
and in this video I'll discuss the stomach my objectives for this video are for you to understand the relative location gross anatomy and

neurovascular of the stomach
neurovascular of the stomach

The stomach straddles both the left upper and the right upper quadrants
The stomach straddles both the left upper and the right upper quadrants

Although it's predominantly found in the left upper quadrant
Although it's predominantly found in the left upper quadrant

It connects the esophagus to
It connects the esophagus to

the duodenum and
the duodenum and

it's anchored in place by both the greater omentum which anchors from the greater curvature of the stomach and
it's anchored in place by both the greater omentum which anchors from the greater curvature of the stomach and

the lesser omentum from the lesser curvature of the stomach as
the lesser omentum from the lesser curvature of the stomach as

You can see from this illustration
You can see from this illustration

The stomach is the widest part of the gut tube or the gastrointestinal tract and it's very diverse in its function
The stomach is the widest part of the gut tube or the gastrointestinal tract and it's very diverse in its function

So not only does it help to store some of those ingested materials
So not only does it help to store some of those ingested materials

But it also physically and chemically breaks down or digests
But it also physically and chemically breaks down or digests

Those materials and as an extension of that it regulates the movement of materials forward in
Those materials and as an extension of that it regulates the movement of materials forward in

Particular the movement of chyme, which is the digested material of the stomach
Particular the movement of chyme, which is the digested material of the stomach

into the duodenum
into the duodenum

like the remainder of the gut tube it helps to participate in microbial defense and it has
like the remainder of the gut tube it helps to participate in microbial defense and it has

endocrine functions related to the secretion of materials into the gut tube or
endocrine functions related to the secretion of materials into the gut tube or

motility of materials through the gut tube
motility of materials through the gut tube

Etc
Etc

When we look at the gross anatomy of the stomach, we see that there are several different parts
When we look at the gross anatomy of the stomach, we see that there are several different parts

there's the fundus or the roof of
there's the fundus or the roof of

the stomach there's the body of
the stomach there's the body of

the stomach
the stomach

There's also the pyloric antrum
There's also the pyloric antrum

Which feeds into the
Which feeds into the

pyloric canal which then narrows into
pyloric canal which then narrows into

the pyloric orifice which is surrounded by the pylorus and that pylorus is the sphincter that
the pyloric orifice which is surrounded by the pylorus and that pylorus is the sphincter that

regulates the movement of
regulates the movement of

time into the duodenum
time into the duodenum

in terms of its overall shape and this is going to be important for
in terms of its overall shape and this is going to be important for

the neurovascular which serves the stomach we have a greater curvature dates with remnants of the
the neurovascular which serves the stomach we have a greater curvature dates with remnants of the

greater omentum and we also have a lesser curvature of
greater omentum and we also have a lesser curvature of

the stomach which associates with remnants of the
the stomach which associates with remnants of the

lesser omentum
lesser omentum

So here we can see the stomach with the omen to added and we can see the lesser omentum here
So here we can see the stomach with the omen to added and we can see the lesser omentum here

within the bounds of the lesser curvature of the stomach and we can see its associations with the liver in
within the bounds of the lesser curvature of the stomach and we can see its associations with the liver in

particular the bulk of this lesser omentum is
particular the bulk of this lesser omentum is

comprised of the pad of gastric ligament hepato from liver
comprised of the pad of gastric ligament hepato from liver

Gastric to stomach as well as the hepatoduodenal ligament which runs from the liver adjacent to the gallbladder
Gastric to stomach as well as the hepatoduodenal ligament which runs from the liver adjacent to the gallbladder

down to the duodenum the
down to the duodenum the

greater omentum hangs from the greater curvature of
greater omentum hangs from the greater curvature of

The stomach and there are several parts to it. The lion's share is the gastrocolic ligament
The stomach and there are several parts to it. The lion's share is the gastrocolic ligament

or the omental apron which
or the omental apron which

falls down over or anterior to the
falls down over or anterior to the

transverse colon and then comes back around so to the
transverse colon and then comes back around so to the

The transverse colon. So this would be four layers of
The transverse colon. So this would be four layers of

Serous peritoneum
Serous peritoneum

We also have a gastro phrenic ligament not pictured here which helps to connect the greater curvature
We also have a gastro phrenic ligament not pictured here which helps to connect the greater curvature

to the diaphragm and a gastro splenic ligament which connects the greater curvature
to the diaphragm and a gastro splenic ligament which connects the greater curvature

to the spleen
to the spleen

With respect to the arterial supply of the stomach all of the branches supplying the stomach come from the celiac trunk
With respect to the arterial supply of the stomach all of the branches supplying the stomach come from the celiac trunk

That celiac trunk is an anterior major branch of the abdominal aorta
That celiac trunk is an anterior major branch of the abdominal aorta

There are three branches to the celiac. We have the splenic the left gastric and
There are three branches to the celiac. We have the splenic the left gastric and

The common hepatic artery
The common hepatic artery

Serving the stomach we have the left gastric artery coming directly from the celiac trunk and
Serving the stomach we have the left gastric artery coming directly from the celiac trunk and

supplying the lesser curvature of
supplying the lesser curvature of

the stomach
the stomach

Also supplying that lesser curvature of the stomach is a branch of the hepatic artery proper
Also supplying that lesser curvature of the stomach is a branch of the hepatic artery proper

Which is a continuation of the common hepatic artery
Which is a continuation of the common hepatic artery

This is called the right gastric artery and the right gastric artery also supplies the lesser curvature
This is called the right gastric artery and the right gastric artery also supplies the lesser curvature

And so what we see frequently is an open anastomosis between the left and right gastric arteries
And so what we see frequently is an open anastomosis between the left and right gastric arteries

So those gastric arteries are supplying the lesser curvature
So those gastric arteries are supplying the lesser curvature

Supplying the greater curvature is a little more complex of a story if we follow
Supplying the greater curvature is a little more complex of a story if we follow

the splenic artery which is running posterior to the stomach here it
the splenic artery which is running posterior to the stomach here it

sends off short gastric branches
sends off short gastric branches

And it also
And it also

Sends a left gastro mental artery that left gastro mental artery is moving medial
Sends a left gastro mental artery that left gastro mental artery is moving medial

Supplying both the stomach and the greater omentum with blood
Supplying both the stomach and the greater omentum with blood

That left gastro mental artery has a counterpart called the right gastro mental artery
That left gastro mental artery has a counterpart called the right gastro mental artery

Which is a branch of
Which is a branch of

the
the

Gastro duodenal artery, which is also a branch of the common hepatic artery
Gastro duodenal artery, which is also a branch of the common hepatic artery

So to review the lesser curvature is supplied by the left and right gastric arteries
So to review the lesser curvature is supplied by the left and right gastric arteries

the greater curvature is supplied by
the greater curvature is supplied by

the right and left gastro mental arteries
the right and left gastro mental arteries

In terms of the venous drainage of the stomach many of these veins are named
In terms of the venous drainage of the stomach many of these veins are named

According to their arterial counterparts. So for instance, there are
According to their arterial counterparts. So for instance, there are

Short gastric branches of the splenic artery and there are short gastric veins that feed into the splenic vein
Short gastric branches of the splenic artery and there are short gastric veins that feed into the splenic vein

there are also right and left gastric veins which are known as
there are also right and left gastric veins which are known as

coronary veins these
coronary veins these

veins like all of the of the
veins like all of the of the

gastrointestinal
gastrointestinal

Tube are going to coalesce
Tube are going to coalesce

Into the hepatic portal vein so that the nutrients absorbed by the gut wall
Into the hepatic portal vein so that the nutrients absorbed by the gut wall

Can be delivered to the liver
Can be delivered to the liver

The stomach is innervated by the enteric nervous system
The stomach is innervated by the enteric nervous system

Which is comprised of both the my enteric and the submucosal plexus ease
Which is comprised of both the my enteric and the submucosal plexus ease

These plexus ease are part of and controlled by the autonomic nervous system
These plexus ease are part of and controlled by the autonomic nervous system

the sympathetic portion of which
the sympathetic portion of which

That supplies the stomach directly
That supplies the stomach directly

Distributes branches via the celiac plexus the celiac plexus is
Distributes branches via the celiac plexus the celiac plexus is

The nervous plexus which surrounds the root of the celiac trunk
The nervous plexus which surrounds the root of the celiac trunk

the preganglionic
the preganglionic

sympathetic fibers
sympathetic fibers

That source to the celiac plexus
That source to the celiac plexus

Come from those thoracic splanchnic nerves
Come from those thoracic splanchnic nerves

Recall that splanchnic nerves serve viscera. So coming down from the thorax. We have the greater
Recall that splanchnic nerves serve viscera. So coming down from the thorax. We have the greater

the lesser and the least splanchnic nerves
the lesser and the least splanchnic nerves

Now the stomach like much of the foregut is served
Now the stomach like much of the foregut is served

Predominantly by both the greater and the lesser splanchnic nerves. So these fibers are sourced from
Predominantly by both the greater and the lesser splanchnic nerves. So these fibers are sourced from

thoracic levels 5 through 12 and
thoracic levels 5 through 12 and

when active
when active

The functions are going to include
The functions are going to include

vasoconstriction of these arteries a decreased gut motility
vasoconstriction of these arteries a decreased gut motility

constriction of the pylorus and in addition to this the visceral a efferent fibers
constriction of the pylorus and in addition to this the visceral a efferent fibers

those which we would colloquially refer to as
those which we would colloquially refer to as

visceral pain fibers follow these
visceral pain fibers follow these

sympathetic fibers
sympathetic fibers

The parasympathetics are sourced from both the anterior and the posterior vagal trunk
The parasympathetics are sourced from both the anterior and the posterior vagal trunk

now
now

Predominantly the gut tube is going to be
Predominantly the gut tube is going to be

innervated parasympathetic pre ganglionicly by the posterior vagal trunk
innervated parasympathetic pre ganglionicly by the posterior vagal trunk

the stomach in particular has a
the stomach in particular has a

significant parasympathetic innervation from the anterior vagal trunk with inactivated
significant parasympathetic innervation from the anterior vagal trunk with inactivated

Parasympathetics the functions are going to be more digestive
Parasympathetics the functions are going to be more digestive

So for instance, we're going to see more secrete a motor function
So for instance, we're going to see more secrete a motor function

more motility of the gut tube a relaxation of the pylorus so that we can move chyme into the duodenum as
more motility of the gut tube a relaxation of the pylorus so that we can move chyme into the duodenum as

Well as some sensation
Well as some sensation

Overall referred pain which isn't true pain but is interpreted by the brain as true pain
Overall referred pain which isn't true pain but is interpreted by the brain as true pain

That comes from the stomach is referred to the epigastrium
That comes from the stomach is referred to the epigastrium

Thank you for your time. And if you have any questions or would like to see any additional visuals
Thank you for your time. And if you have any questions or would like to see any additional visuals

Please do visit the blue link web page. Thank you
Please do visit the blue link web page. Thank you