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Esophagus 25 cm muscular tube From pharynx (C6, cricoid cartilage) To stomach (T11) Enters mediastinum between trachea & vertebral column passes through the diaphragm (T10) Function: conducts food from pharynx to stomach

Esophagus Relations Anteriorly: Trachea Recurrent laryngeal nerves Left bronchus Left atrium Left vagus Left lobe of liver

Esophagus Relations Posteriorly Vertebral column Azygos Thoracic aorta Right vagus

Esophagus Relations Right side Pleura Azygos Thyroid gland Left side Subclavian artery Aortic arch

Esophageal constrictions At the junction of the esophagus with the pharynx where the esophagus is crossed by the arch of aorta; where the esophagus is compressed by the left main bronchus; at the esophageal hiatus in the diaphragm.

Esophagus Arteries: Inferior thyroid Thoracic Aorta Left gastric Veins: Azygos Nerves: Vagus (recurrent laryngeal, ant. & post. gastric, esophageal plexus) Sympathetic branches

Stomach (gaster, ventriculus) Widest part of GI tract Capacity: 30, 1000 & 1500 ml Situation: Epigastrium Lt. hypochondriac Umbilical Stomach bed Functions: Storage and Digestion of food

Stomach Has: Two borders (curvatures) Two surfaces Two orifices

Lesser curvature Between cardiac and pyloric orifices Descends from right side of esophagus Curving to the right at the angular notch Ends at the pylorus just right to the midline Lesser omentum is attachmented which contains Rt. and Lt. gastric arts.

Greater curvature Longer than lesser From cardiac notch Up & postrolateral to the left Highest level at 5th intercostal space To 10th costal cartilage Turn right to the pylorus Bulge opposite of angular notch

Greater curvature Gastrosplenic lig. & greater omentum are atthached here

Surface Anterior (Antrosuperior) related to the; Lt. costal margin 6-9th intercostal space Diaphrgam Ant. Abdominal wall pericardium Lt. pleura & lung Lt and quadrate lobes of liver

Surface Posterior (Postro-inferior) Related to the Lesser sac Diaphrgam Lt. suprarenal G. Lt kidney spleen splenic art. Pancreas Lt. colic flexure T. mesocolon

Cardiac orifice Behind of the 7th rib At the level of T11 Lt. to the midline Physiological sphincter 40 cm from incisor teeth Cardiac notch

Pyloric orifice Pyloric constrictor (sphincter) 1-2 cm right to the midline At the level of TPP

stomach Has: Body Fundus Pylorus Pyloric Antrum Pyloric canal; 2-3cm

Interior of the stomach

Blood supply Arteries Left gastric Right gastric Left gastroepiploic Right gastroepiploic Short gastric veins Left gastric Right gastric Left gastroepiploic Right gastroepiploic Short gastric

Duodenum 20-25 cm Retroperitoneal Above umbilicus Curves around L2 From pylorus Turns abruptly forward to form duodenojejunal flexure 1 cm below TPP

Duodenum Divided into: Superior (first), Descending, (second) Horizontal (third) & Ascending (forth) parts

Duodenum First part 5 cm, mobile From pylorus to superior flexure First 2.5 cm intraperitoneal duodenal ulcers Second part 8-10 cm From superior flexure to the lower border of L3 Right to the vertebral column hepatopancreatic ampulla Major and minor duodenal papilla

Duodenum Third part 10 cm From inferior flexure L3 lower border to the Lt. side Fourth part From … to the level of L2 upper border Left to the Aorta

Duodenum Relations Pancreas Liver Gall bladder Epiploic foramen gasteroduodenal art. Rt. Colic flexure T. mesocolon Jejunum Sup. Mesenteric vv

Duodenum bill duct portal vein Rt. Kidney Renal vv IVC Rt. ureter Rt. psoas Rt. & Lt. Gonadal vv Aorta at the level of inf. mesenteric origin

Duodenum Duodenal cap Suspensory lig (Treitz) Skeletal and smooth muscles

Blood supply Arteries Superior and Inferior pancreaticoduodenal veins

Pancreas Grayish – pink 12-15 cm Situation Epigastric Lt hypochondriac Umbilical

Pancreas Consists: Head, Uncinate process Neck, Constricted part Body & Triangular Tail In the splenorenal

Pancreas Relations: Anterior; Duodenum, Sup. Mesentric VV., Sup. & inf. Pancreaticoduodenal AA Transeverse colon, Transeverse mesocolon Jejunum Stomach Lt. colic flexure …………….. Celiac trunk Splenic art.

Pancreas Relations: Posterior; Bile duct, Prtal vein Splenic vein IVC, Aorta, Sup. Mesentric VV., Left suprarenal gland Left kidney Renal vein,

Pancreas Tail In (splenorenal) lienorenal lig. Main pancreatic duct Accessory duct ascending in front of main