Esophagus, Stomach, Duo, Jejun
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1
The esophagus ends at the
The esophagus ends at the stomach
2
How long is the abdominal segement of the esophagus?
1-2 cm
3
Where does the esophagus enter the somach? What Costal Cartilage is this posterior to?
Cardiac orifice, posterior to CC7
4
Right border of esophagus? Left?
Right = lesser curvature of stomach
Left = separated from fundus by cardiac notch
Left = separated from fundus by cardiac notch
5
What is located at the inferior end of the esophagus?
Esophageal sphincter
6
The esopahgus travels in the groove of the
The esopahgus travels in the groove of the left lobe of liver
7
What is achalasia? What sign is it associated with?
Disorder where the LES fails to relax
Bird's beak sign
Bird's beak sign
8
What is the arterial supply of the esophagus?
-
-
-
-
What is the arterial supply of the esophagus?
-Left gastric artery from the celiac trunk
-Left inferior phrenic artery from the abdominal aorta
-Left gastric artery from the celiac trunk
-Left inferior phrenic artery from the abdominal aorta
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What are the 3 divisions left gastric artery?
- =
- =
- =
- =
- =
- =
What are the 3 divisions left gastric artery?
-Ventral = anterior surface
of the stomach
- Dorsal = lesser curvature
- Cardioesophageal = cardia
and esophagus
-Ventral = anterior surface
of the stomach
- Dorsal = lesser curvature
- Cardioesophageal = cardia
and esophagus
10
What are the two the venous supplies of the esophagus?
The azygous and left gastric vein (portal vein)
11
What is the parasympathetic supply of the esophagus? Sympathetic?
Parasympathetic:
Sympathetic:
Parasympathetic:
Sympathetic:
What is the parasympathetic supply of the esophagus? Sympathetic?
Parasympathetic: Vagus
Sympathetic: Thoracic sympathetic trunks and greater sympathetic trunks
Parasympathetic: Vagus
Sympathetic: Thoracic sympathetic trunks and greater sympathetic trunks
12
3 main branches of the celiac trunk?
1. Left gastric
2. Common hepatic
3. Splenic
2. Common hepatic
3. Splenic
13
The right gastric comes from the
The right gastric comes from the common hepatic a.
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What are the 3 branches of the left gastric artery?
1. Ventral
2. Dorsal
3. Cardioesophageal
2. Dorsal
3. Cardioesophageal
15
What are the 3 branches of the common hepatic artery?
1. Proper hepatic
2. Right gastric
3. Gastroduodenal
2. Right gastric
3. Gastroduodenal
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The right hepatic supplies the and
The right hepatic supplies the liver and gallbladder
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The proper heaptic 3 main branches
-
-
-
-
-
-
The proper heaptic 3 main branches
-Right Heaptic artery (-> Cystic artery)
-Middle Heaptic artery
-left Heapatic artery
-Right Heaptic artery (-> Cystic artery)
-Middle Heaptic artery
-left Heapatic artery
18
What does the right gastric supply?
The distal curvature of the stomach
19
What 3 things does the gastroduodenal supply?
Supplies the stomach, duodenum, and pancreas
20
What are the branches of the gastroduodenal?
1. Retroduodenal
2. Right gastroepuploic
3. Superior pancreaticoduodenal
2. Right gastroepuploic
3. Superior pancreaticoduodenal
21
What are the 5 branches of the splenic artery
(1) Dorsal pancreatic - pancreas
(2) Great pancreatic - Body
(3) Caudual pancreatic - Tail
(4) Left gastroepiploic - Greater curvature of stomach
(5) Short Gastric
(2) Great pancreatic - Body
(3) Caudual pancreatic - Tail
(4) Left gastroepiploic - Greater curvature of stomach
(5) Short Gastric
22
Which quadrant is the stomach located in?
LUQ, but pylorus in RUQ
23
What regions is the stomach in?
1. Epigastric
2. Left hypochondriac
3. Umbilical
2. Left hypochondriac
3. Umbilical
24
Stomach is covered by peritoneum except "bare" area on
Stomach is covered by peritoneum except "bare" area on posterior aspect
25
Stomach
Lesser curvature =
Greater curvature =
Body =
Lesser curvature =
Greater curvature =
Body =
Stomach
Lesser curvature = medial side
Greater curvature = lateral side
Body = Pyloric antrum and canal
Lesser curvature = medial side
Greater curvature = lateral side
Body = Pyloric antrum and canal
26
Stomach
= posterior
= superior
= sphincter
= posterior
= superior
= sphincter
Stomach
Cardiac = posterior
Fundus = superior
Pylorus = sphincter
Cardiac = posterior
Fundus = superior
Pylorus = sphincter
27
What costal costal cartilage and vertebrae are associated with the cardiac, fundus, and pylorus of stomach
Cardiac =
Fundus =
Pylorus =
Cardiac =
Fundus =
Pylorus =
What costal costal cartilage and vertebrae are associated with the cardiac, fundus, and pylorus of stomach
Cardiac = 7 CC at T11
Fundus = 5 CC at MCL
Pylorus = 9 CC at L1 supine, L2-L4 standing
Cardiac = 7 CC at T11
Fundus = 5 CC at MCL
Pylorus = 9 CC at L1 supine, L2-L4 standing
28
The cardia is located from
The cardia is located 2-4 cm left from midline 
29
The pylorus is located
The pylorus is located 1.25 cm right of midline 
30
What are the 4 aterial supplies of the stomach?
Left gastric (celiac trunk)
Right gastric (common heaptic)
L and R gastroepiploics (gastroduodenal, splenic)
Right gastric (common heaptic)
L and R gastroepiploics (gastroduodenal, splenic)
31
What are the 3 venous supplies of the stomach? What do they drain into?
(1) Right and left gastric (DIRECTLY INTO PORTAL)
(2) Right gastro-omental (SMV)
(3) Left gastro-omental and short gastrix (drains into splenic vein)
(2) Right gastro-omental (SMV)
(3) Left gastro-omental and short gastrix (drains into splenic vein)
32
The portal vein forms the connection of the and behind
The portal vein forms the connection of the SMV and splenic veins behind NECK of pancreas
33
What is the parasympathetic supply of the stomach? Sympathetic?
Parasympathetic = vagus, Sympathetic = Greater splanchnic (T5-T9)
34
The duodenum ends at the
The duodenum ends at the duodenojejunal junction
35
What are the 2 duodenal arterial supplies?
1. The superior pancreaticoduodenal (from gastroduodenal)
2. The Inferior pancreaticoduodenal (drom superior mesenteric)
2. The Inferior pancreaticoduodenal (drom superior mesenteric)
36
What is the 2 venous supply of the duodenum?
Portal system of veins and SMV
37
What are the two nerve supplies of the duodenum?
(1) Vagus
(2) Greater (T5-T9) and Lesser Splanchnic nerves (T10-T11)
(2) Greater (T5-T9) and Lesser Splanchnic nerves (T10-T11)
38
What is the anterior and posterior relationship of the 1st part of the duodenum?
Posterior to liver and gallbladder
Anterior to bile ducts and portal vein
Anterior to bile ducts and portal vein
39
What is the anterior and posteromedial relationship of the 2nd part of the duodenum?
Anterior to renal vessels
Posteromedial to ampulla of vater and sphincter of Oddi
Posteromedial to ampulla of vater and sphincter of Oddi
40
The Hepatopancreatic ampulla (of Vater) receives the and main
The Hepatopancreatic ampulla (of Vater) receives the common bile duct and main pancreatic duct
41
What is the anterior and posterior relationship of the 3rd part of the duodenum?
Anterior to IVC, aorta, R ureter, R gondal artery
Post to SMV
Post to SMV
42
The suspensory ligament of treitz is a musculofibrous band from the to the of the diaphram and tissues around the
The suspensory ligament of treitz is a musculofibrous band from the duodenojejunal junction to the right crus of the diaphram and tissues around the celiac trunk
43
In superior mesenteric artery syndrome, the of the duodenum is compressed between the narrow angle of the and the
In superior mesenteric artery syndrome, the 3rd portion of the duodenum is compressed between the narrow angle of the SMA and the Aorta
44
Most of the jejunum is in the and most of the Illeum is in the
Most of the jejunum is in the LUQ and most of the Illeum is in the RLQ
45
Where does the small intestine end?
The ileocolic/cecal junction
46
What is the arterial supply of the jejunum and illeum?
SMA
47
What is the parasympathetic and sympathetic nerve supply of the jejunum and illeum?
Vagus and Lesser splanchnic (T10-T11)
48
Venous supply of the jejunum and illeum?
Portal vein
49
