1. Anatomy of Esophagus & stomach
Dr. Mohammed Abuelnor

2. Objectives:
Describe the anatomy of the esophagus; extent, length, parts, structures, relations, blood & nerve supply and lymphatic.
Describe the anatomy of the stomach; location, shape, parts, relations, blood & nerve supply and lymphatic.
اسم ورقم المقرر – Course Name and No.
4/25/2019

3. Esophagus Esophagus is a muscular tube about 25 cm long
It extends from pharynx to the stomach
It begins at the level of cricoid cartilage in the neck passes behind the trachea
It passes down in the thorax through mediastinum
It enters the abdominal cavity by piercing diaphragm at the level of 10th thoracic vertebra
It enters the right side of the stomach
4/25/2019

4. Relations in the Neck Anteriorly: Trachea, recurrent laryngeal nerve
Posteriorly: Prevertebral muscles, vertebral column
Laterally: Thyroid gland, carotid sheath, carotid artery.
اسم ورقم المقرر – Course Name and No.
4/25/2019

5. Relations in the Thorax & Abdomen
Anteriorly:
Trachea, and the heart
Posteriorly:
vertebral column, descending thoracic aorta
Right :
Mediastinal pleura, azygos vein
Left :
aortic arch, left mediastinal pleura
Left and right vagi lie on its anterior and posterior surfaces, respectively

6. Blood Supply, Nerve Supply, Lymph drainage
Inferior thyroid artery, descending thoracic aorta, left gastric artery
Venous Drainage: inferior thyroid vein, azygos veins, left gastric veins, tributaries of portal vein
Recurrent laryngeal nerve, branches from sympathetic trunk, vagal trunks, esophageal plexus, anterior and posterior gastric nerves (vagi)
Lymph: Deep cervical lymph nodes, mediastinal nodes, celiac nodes.
اسم ورقم المقرر – Course Name and No.
4/25/2019

7. Stomach
Is the dilated portion of the alimentary canal and has three main functions:
Stores food
Mixes the food with gastric secretions to form a semifluid chyme
Controls the rate of delivery of the chyme to the small intestine

8. Stomach Situated in the upper part of the abdomen
Located into the epigastric and umbilical regions
Much of it lies under cover of the lower ribs
Is “J” shaped and has two openings, the cardiac and pyloric orifices

9. Stomach Has two curvatures, lesser and greater
Has two surfaces, anterior and posterior
Is relatively fixed at both ends but is very mobile in between

10. PARTS 2 Orifices: Cardiac orifice Pyloric orifice 2 Borders:
Greater curvature
Lesser curvature
2 Surfaces:
Anterior surface
Posterior surface
3 Parts:
Fundus
Body
Pylorus:
The pylorus is formed of :
Pyloric antrum
Pyloric sphincter
PARTS

11. Pylorus
The pyloric antrum extends from the incisura angularis to the pylorus
Pylorus is the tubular part of the stomach
Has a thick muscular wall called the pyloric sphincter
The cavity of the pylorus is the pyloric canal

12. ANATOMY OF STOMACH Lesser curvature (LC) forms right border
(concave medial border)
it is connected to the liver by lesser omentum
Greater curvature (GC)
forms longer convex lateral border of stomach
Gastrosplenic omentum extends from upper part of GC to spleen
greater omentum extends from lower part of GC to transverse colon

13. ANTERIOR RELATIONS
Anterior abdominal wall.
Diaphragm.
The liver.

14. POSTERIOR RELATIONS Left suprarenal gland. Part of left kidney Spleen.
Splenic artery.
Pancreas.
Transverse mesocolon.
Transverse colon.
Lesser sac.
All these structures form the stomach bed.

15. Mucous Membrane
Mucous membrane of the stomach is thick and vascular and is thrown into numerous folds or rugae
Mainly longitudinal in direction
The folds flatten out when the stomach is distended

16. ARTERIES 5 arteries: 1- Left gastric artery:
It is a branch of celiac artery.
Ascends along the lesser curvature.
2- Right gastric artery:
From the hepatic artery of celiac.
Runs to the left along the lesser curvature.

17. ARTERIES 3- Short gastric arteries – arise from the splenic artery.
Pass in the gastrosplenic ligament.
4-Left gastroepiploic artery:
from splenic artery
5- Right gastroepiploic artery:
from the gastroduodenal artery of hepatic .
Passes to the left along the greater curvature.

18. VEINS All of them drain into the portal circulation.
The right and left gastric veins drain directly in the portal vein.
The short gastric veins and the left gastroepiploic vein join the splenic vein.
The right gastroepiploic vein drain in the vein. superior mesenteric

19. LYMPH DRAINAGE The lymph vessels follow the arteries.
They first drain to the:
Left and right gastric nodes.
Left and right gastroepiploic nodes and the
Short gastric nodes.
all the lymph from the stomach is collected at the celiac nodes.

20. NERVE SUPPLY Sympathetic fibers are derived from the celiac plexus.
Parasympathetic fibers from both vagi.
Anterior vagal trunk:
Formed from the left vagus
Supply the anterior surface of the stomach
Gives off a hepatic branch and from it - a branch to the pylorus.
Posterior vagal trunk:
Formed from the right vagus
Supply the posterior surface of the stomach
Gives off a large branch to the celiac and the superior mesenteric plexuses.

21. References: Gray's Anatomy for Students- Second edition.
Clinically Oriented Anatomy , Keith L. Moore- Sixth edition.
Netter’s Clinical Anatomy, Second edition.