Anatomy and Physiology of Stomach.

Synonyms:
The stomach is also called the gaster or venter from which we have the adjective
gastric applied to structures related to organ.
Definition:
The stomach is a muscular bag forming the widest and most distensible
part of the digestive tube.
It is connected above to the lower end of the oesophagus, and below to
the duodenum.
It acts as a reservoir of food and helps in digestion of carbohydrates,
proteins and fats.
Location:
The stomach lies obliquely in the upper and left part of the abdomen
occupying the epigastric, umbilical and left hypochondriac regions.
Most of it lies under cover of the left costal margin and the ribs (Fig. 19.1).

Pic 2 : Location of Stomach

Shape and Position:

The shape of the stomach depends upon the degree of its distension and
that of the surrounding viscera
When empty, the stomach is somewhat I Jshaped (vertical);
when partially distended, it becomes pyriform in shape. In obese persons,
it is more horizontal.
The shape of the stomach can be studied in the living by radiographic
examination after giving a barium meal.
Size:
The stomach is a very distensible organ.
It is about 25 cm long
the mean capacity is one ounce (30 ml) I at birth
one litre (1000 ml) at puberty
2 J litres or more in adults.

Two Orifices
The cardiac orifice is joined by the lower end of the oesophagus.
It lies behind the left 7th costal cartilage 2.5 cm from its junction with the
sternum, at the level of vertebra Tl 1.
There is physiological evidence of sphincteric action at this site, but a
sphincter cannot be demonstrated anatomically.
The pyloric orifice opens into the duodenum. In an empty stomach and in
the supine position, it lies 1.2 lei cm to the right of the median plane, at
the level of the lower border of vertebra LI or transpyloric plane.
Its position is indicated on the surface of the stomach
(a)by a circular groove [pyloric constriction) produced by the underlying
pyloric sphincter or pylorus (pyloros = gateguard) which feels like a large
firm nodule; and
(b) by the prepyloric vein which lies in front of the constriction.

Pic 3 : Surface marking of some abdominal organs.

Pic 4 : External features of the stomach.

Pic 5 : Arteries supplying the stomach.

HISTOLOGY OF STOMACH:
At the cardiac end of stomach the stratified epithelium of oesophagus abruptly
changes to simple columnar epithelium of stomach.
Cardiac End
Mucous membranes: The epithelium is simple columnar with small tubular
glands. Lower half of the gland is secretory and upper half is the conducting part.
Muscularis mucosae : consists of smooth muscle fibres.
Submucosa: It consists of loose connective tissue with Meissner's plexus.
Muscularis externa : It is made of outer longitudinal and inner circular layer
including the myenteric plexus of nerves.
Serosa: It is lined by single layer of squamous cells.
Fundus and Body of Stomach

Mucous membrane: It contains tall simple tubular gastric glands. Upper onethird is conducting, while lower two-thirds is secretory. The various cell types
seen in the gland are chief or zymogenic, oxyntic or parietal and mucous neck
cells.
Muscularis mucosae and submucosa are same as of cardiac end.
Muscularis externa: It contains an additional innermost oblique coat of muscle
fibres.
Serosa is same as of cardiac end.
Pyloric Part
Mucous membrane: There are pyloric glands which consist of basal one-third
as mucus secretory
component and upper two-thirds as conducting part.
Muscularis mucosae is made of two layers of fibres.
Submucosa is same as in the cardiac end.
Muscularis externa comprises thick layer of circular fibres forming the pyloric
sphincter.
Serosa is same as of cardiac END.