1. In the name of God
In the name of Allah

2. 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

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

4. Esophagus Relations Posteriorly Vertebral column Azygos Thoracic aorta
Right vagus

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

6. 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.

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

9. 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

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

11. 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.

12. 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

13. Greater curvature
Gastrosplenic lig. & greater omentum are atthached here

14. 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

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

16. 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

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

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

19. Interior of the stomach

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

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

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

24. 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

25. 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

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

27. 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

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

29. Blood supply Arteries Superior and Inferior pancreaticoduodenal veins

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

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

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

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

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