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Curvatures of the stomach | |
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Details | |
Artery | Greater: short gastric (upper part), left gastroepiploic (middle) Lesser: right gastric artery and left gastric artery |
Vein | Lesser: right gastric vein and left gastric vein |
Identifiers | |
Latin | curvatura major gastris, curvatura minor gastris |
TA98 | A05.5.01.004 |
TA2 | 2904 |
FMA | 14574 |
Anatomical terminology |
The curvatures of the stomach are the long, convex, lateral surface, and the shorter, concave, medial surface of the stomach, which are referred to as the greater and lesser curvatures, respectively. The greater curvature, which begins at the cardiac notch, and arches backwards, passing inferiorly to the left, [1] is four or five times longer than the lesser curvature, [2] which attaches to the hepatogastric ligament and is supplied by the left gastric artery and right gastric branch of the hepatic artery. [1]
The greater curvatureof the stomach forms the lower left or lateral border of the stomach. [3] Starting from the cardiac orifice it begins at the cardiac notch, forming an arch backward, upward, and to the left. A horizontal plane across from the cardiac notch encloses an area called the fundus of the stomach. The highest point of the fundic convex is on a level with the sixth left costal cartilage. The greater curvature continues downward and forward, with a slight convexity to the left as low as the cartilage of the ninth rib; it then turns to the right, to the end of the pylorus.
Directly opposite the incisura angularis of the lesser curvature the greater curvature presents a dilatation, which is the left extremity of the pyloric part; this dilatation is limited on the right by a slight groove, the sulcus intermedius, which is about 2.5 cm from the pyloric sphincter.
The portion between the sulcus intermedius and the pyloric sphincter is termed the pyloric antrum.
At its commencement the greater curvature is covered by peritoneum continuous with that covering the front of the organ.
The left part of the curvature gives attachment to the gastrosplenic ligament, while its anterior portion is attached to the two layers of the greater omentum, separated from each other by the gastroepiploic vessels.
The lesser curvature of the stomach forms the upper right or medial border of the stomach. [3] The lesser curvature of the stomach travels between the cardiac and pyloric orifices. It descends as a continuation of the right margin of the esophagus in front of the fibers of the right crus of the diaphragm, and then, turning to the right, it crosses the first lumbar vertebra and ends at the pylorus.
Nearer its pyloric than its cardiac end is a well-marked notch, the incisura angularis, which varies somewhat in position with the state of distension of the stomach; it serves to separate the stomach into a right and a left portion.
The lesser curvature gives attachment to the two layers of the hepatogastric ligament – part of the lesser omentum, and between these two layers are the left gastric artery and the right gastric branch of the hepatic artery.
Arteries that primarily supply the greater curvature are the short gastric arteries that supply the upper part, the gastric branches of the left gastroepiploic artery (middle part), and the right gastroepiploic artery (lower part).
The stomach is a muscular, hollow organ in the upper gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach is involved in the gastric phase of digestion, following the cephalic phase in which the sight and smell of food and the act of chewing are stimuli. In the stomach a chemical breakdown of food takes place by means of secreted digestive enzymes and gastric acid.
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The pyloruspyloric region or pyloric part connects the stomach to the duodenum. The pylorus is considered as having two parts, the pyloric antrum and the pyloric canal. The pyloric canal ends as the pyloric orifice, which marks the junction between the stomach and the duodenum. The orifice is surrounded by a sphincter, a band of muscle, called the pyloric sphincter. The word pylorus comes from Greek πυλωρός, via Latin. The word pylorus in Greek means "gatekeeper", related to "gate" and is thus linguistically related to the word "pylon".
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta.
The common hepatic artery is a short blood vessel that supplies oxygenated blood to the liver, pylorus of the stomach, duodenum, pancreas, and gallbladder.
The lesser omentum is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum. The lesser omentum is usually divided into these two connecting parts: the hepatogastric ligament, and the hepatoduodenal ligament.
The right gastroepiploic artery is one of the two terminal branches of the gastroduodenal artery. It runs from right to left along the greater curvature of the stomach, between the layers of the greater omentum, anastomosing with the left gastroepiploic artery, a branch of the splenic artery.
The left gastroepiploic artery, the largest branch of the splenic artery, runs from left to right about a finger's breadth or more from the greater curvature of the stomach, between the layers of the greater omentum, and anastomoses with the right gastroepiploic.
The short gastric arteries are 5-7 small branches of the splenic artery that pass along part of the greater curvature of the stomach from left to right between the layers of the gastrolienal ligament, and are distributed to the greater curvature of the stomach.
The right gastric artery usually arises from the proper hepatic artery. It descends to the pyloric end of the stomach before passing from right to left along its lesser curvature, supplying it with branches, and finally anastomosing with the left gastric artery.
The greater omentum is a large apron-like fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and doubles back to ascend to the transverse colon before reaching to the posterior abdominal wall. The greater omentum is larger than the lesser omentum, which hangs down from the liver to the lesser curvature. The common anatomical term "epiploic" derives from "epiploon", from the Greek epipleein, meaning to float or sail on, since the greater omentum appears to float on the surface of the intestines. It is the first structure observed when the abdominal cavity is opened anteriorly.
The right gastroepiploic vein is a blood vessel that drains blood from the greater curvature and left part of the body of the stomach into the superior mesenteric vein. It runs from left to right along the greater curvature of the stomach between the two layers of the greater omentum, along with the right gastroepiploic artery.
The hepatogastric ligament or gastrohepatic ligament connects the liver to the lesser curvature of the stomach. It contains the right and the left gastric arteries. In the abdominal cavity, it separates the greater and lesser sacs on the right. It is sometimes cut during surgery in order to access the lesser sac. The hepatogastric ligament consists of a dense cranial portion and the caudal portion termed the pars flaccida.
The gastrosplenic ligament is part of the greater omentum extending between the stomach and the spleen. It contains several blood vessels.
The gastric mucosa is the mucous membrane layer of the stomach, which contains the gastric pits, to which the gastric glands empty. In humans, it is about one mm thick, and its surface is smooth, soft, and velvety. It consists of simple secretory columnar epithelium, an underlying supportive layer of loose connective tissue called the lamina propria, and the muscularis mucosae, a thin layer of muscle that separates the mucosa from the underlying submucosa.
The angular incisure is a small notch on the stomach. It is located on the lesser curvature of the stomach near the pyloric end. Its location varies depending on how distended the stomach is.
The right gastric vein drains blood from the lesser curvature of the stomach into the hepatic portal vein. It is part of the portal circulation.
The following outline is provided as an overview of and topical guide to human anatomy:
The gastric lymph nodes are lymph nodes which drain the stomach and consist of two sets, superior and inferior:
Antrectomy, also called distal gastrectomy, is a type of gastric resection surgery that involves the removal of the stomach antrum to treat gastric diseases causing the damage, bleeding, or blockage of the stomach. This is performed using either the Billroth I (BI) or Billroth II (BII) reconstruction method. Quite often, antrectomy is used alongside vagotomy to maximise its safety and effectiveness. Modern antrectomies typically have a high success rate and low mortality rate, but the exact numbers depend on the specific conditions being treated.
This article incorporates text in the public domain from page 1162 of the 20th edition of Gray's Anatomy (1918)