Anatomy Tables - Stomach & Spleen

Peritoneal Specializations and Associated Structures
Specialization Location/Description Notes
gastrocolic ligament (N261,TG5-12,N264,TG5-18) peritoneum connecting the greater curvature of the stomach with the transverse colon part of the greater omentum; derived from the dorsal mesogastrium in the embryo
gastrolienal ligament peritoneum connecting the greater curvature of stomach with the hilum of the spleen part of the greater omentum; derived from the dorsal mesogastrium in the embryo; also known as: gastrosplenic ligament
gastrophrenic ligament (TG5-29) peritoneum connecting the fundus of the stomach to the left side of the diaphragm above the spleen part of the greater omentum; derived from the dorsal mesogastrium in the embryo
gastrosplenic ligament (N264,TG5-18) peritoneum connecting the greater curvature of stomach with the hilum of the spleen part of the greater omentum; derived from the dorsal mesogastrium in the embryo; also known as: gastrolienal ligament
greater omentum (adult dorsal mesogastrium) (N261,TG5-12) apron-like specialization of peritoneum attaching along the greater curvature of the stomach subdivisions: gastrophrenic ligament, gastrosplenic ligament, gastrocolic ligament, omental apron (Latin, omentum = the membrane which encloses the bowels)
greater peritoneal sac the portion of the peritoneal cavity that is not located posterior to the stomach the lesser peritoneal sac is the only part of the peritoneal cavity that is not part of the greater peritoneal sac
hepatoduodenal ligament (N267,TG5-18) part of the lesser omentum connecting the liver to the 1st part of duodenum hepatoduodenal ligament contains the bile duct, proper hepatic a. and portal v.; it forms the anterior wall of the omental (epiploic) foramen
hepatogastric ligament (N267,TG5-18) part of the lesser omentum connecting the liver to the lesser curvature of the stomach hepatogastric ligament forms the anterior wall of the lesser peritoneal sac
omental bursa (N264,TG5-18,N265,N335,N336,TG5-42) part of the peritoneal cavity located posterior to the stomach and lesser omentum omental bursa is continuous with the greater peritoneal sac at the omental (epiploic) foramen; also known as: lesser peritoneal sac
omental foramen (N264,TG5-18,N267,TG5-18) passageway between the greater peritoneal sac and the lesser peritoneal sac located posterior to the hepatoduodenal ligament; also known as: epiploic foramen
lesser omentum (adult ventral mesogastrium) (N267,TG5-18) peritoneum stretching between the lesser curvature of the stomach and the visceral surface of the liver subdivisions of the lesser omentum are the heptogastric and hepatoduodenal ligaments; lesser peritoneal sac (omental bursa) lies posterior to the lesser omentum and stomach (Latin, omentum = the membrane which encloses the bowels)
lesser peritoneal sac (TG5-18) part of the peritoneal cavity located posterior to the stomach and lesser omentum lesser peritoneal sac is continuous with the greater peritoneal sac at the omental (epiploic) foramen; also known as: omental bursa
lienorenal ligament peritoneum that attaches the spleen to the posterior abdominal wall over the left kidney lienorenal ligament develops from the dorsal mesogastrium of the embryo; also known as: splenorenal ligament

Nerves
Nerve Source Branches Motor Sensory Notes
vagus n.(TG5-40, TG7-13, TG7-15, TG7-25) medulla: dorsal motor nucleus (GVE preganglionic parasympathetic); inferior ganglion (GVA); nucleus ambiguus (SVE); superior ganglion (GSA); inferior ganglion(SVA) auricular br., pharyngeal br., superior laryngeal, superior and inferior cervical cardiac brs., recurrent laryngeal n., thoracic cardiac brs., brs. to the pulmonary plexus, brs. to the esophageal plexus, anterior and posterior vagal trunks SVE: intrinsic muscles of the larynx, pharynx (except stylopharyngeus), and palate (except tensor veli palatini); GVE: smooth muscle of the respiratory tree & gut (proximal to the left colic flexure), heart; secretomotor: mucous glands of the larynx, respiratory tree, pharynx and gut; secretomotor to digestive glands GSA: skin of the external auditory meatus; GVA: viscera of head, neck, thorax & abdomen proximal to the left colic flexure; SVA: taste from the epiglottis also known as: CN X, 10th cranial nerve; the vagus n. passes through the jugular foramen to exit the posterior cranial fossa; (Latin, vagus = wanderer, so called because of its wide distribution to the body cavities)
celiac ganglion (TG5-39, TG5-40) preganglionic sympathetic axons arrive via the greater thoracic splanchnic n. postganglionic sympathetic axons distribute via the celiac plexus along brs. of the celiac trunk vascular smooth muscle of the brs. of the celiac trunk pain from the stomach, liver & biliary system, spleen, upper half of the duodenum & pancreas a sympathetic ganglion; usually 2 celiac ganglia are located on the abdominal aorta at the origin of the celiac trunk; brs. of the vagal trunks pass through the celiac ganglion without synapsing (Greek, celiac = belly + ganglion = a swelling or knot)

Arteries
Artery Source Branches Supply to Notes
celiac trunk (N255,TG5-33) abdominal aorta at the level of the T12-L1 intervertebral disc left gastric a., splenic a., common hepatic a. stomach, lower esophagus, liver, upper duodenum, pancreas, spleen celiac trunk supplies the foregut derivatives (Greek, celiac = belly)
gastric, left (N290,TG5-19) celiac a. esophageal brs. superior part of the stomach near the lesser curvature left gastric a. anastomoses with the right gastric a. on the lesser curvature of the stomach; it also anastomoses with the esophageal brs. of the thoracic aorta
splenic (N291,TG5-27B,TG5-27C) celiac trunk dorsal pancreatic, pancreatic brs., pancreatica magna, caudal pancreatic, short gastric, left gastro-omental, splenic brs. pancreas, spleen, greater curvature of stomach
gastric, right (N290,TG5-19) proper hepatic a. no named branches inferior part of the stomach near the lesser curvature right gastric a. anastomoses with the left gastric a. on the lesser curvature of the stomach
gastric, short (N291,TG5-27B,TG5-27C) splenic a. no named branches fundus and upper part of the stomach near the greater curvature short gastric aa. reach the stomach by passing through the gastrosplenic ligament; they are usually 4-5 in number
gastro-omental, left (N290,TG5-19,N291) splenic a. gastric brs., omental brs. mid-part of the stomach near the greater curvature; greater omentum left gastro-omental a. anastomoses with the right gastro-omental a. near the greater curvature of the stomach; also known as: left gastroepiploic a.
gastro-omental, right (N290,TG5-19,N291) gastroduodenal a. gastric brs., omental brs. lower part of the pyloric region of the stomach, right part of greater curvature of the stomach, greater omentum right gastro-omental a anastomoses with the left gastro-omental a. near the greater curvature of the stomach; also known as: right gastroepiploic a.
gastroduodenal (TG5-27,TG5-27) common hepatic a. supraduodenal aa., retroduodenal aa., posterior superior pancreaticoduodenal a., anterior superior pancreaticoduodenal a., right gastro-omental a. upper duodenum, upper part of the head of the pancreas; greater curvature of the stomach on the right gastroduodenal a. supplies the lowest portion of the foregut and its derivatives (Latin, duodeni = 12 each, the duodenum is about 12 finger breadths long)
hepatic, common (N290,TG5-19) celiac trunk gastroduodenal a., proper hepatic a. liver, upper parts of the duodenum, upper part of the pancreas, right side of the stomach common hepatic a. supplies some of the foregut derivatives
hepatic, proper (N290,TG5-19) common hepatic a. right gastric, right & left hepatic liver, lesser curvature of the stomach proper hepatic a. supplies the foregut derivatives associated with the liver bud

Veins
Vein Tributaries Drains Into Regions Drained Notes
portal v. (N299,N302,TG5-28) formed by the union of the superior mesenteric v. and the splenic v.; tributaries: posterior superior pancreaticoduodenal v., right gastric v., left gastric v. divides into right and left branches before entering the liver; into the liver sinusoids all of the gut and its glands portal v. connects with the vena caval drainage at 1) esophagus, 2) rectum, 3) umbilicus, 4) retroperitoneal gut structures; portal v. courses between two capillary beds (gut and liver)
gastric, left (N299,N302,TG5-28) esophageal vv.; gastric brs. portal v. lesser curvature of the stomach, lower part of the esophagus left gastric v. communicates with the esophageal vv., forming a portal-caval venous anastomosis (esophageal varices when enlarged); the left gastric v. and right gastric v. are together called the coronary v. because they form a circle
gastric, right (N299,N302,TG5-28) gastric brs. portal v. lesser curvature of the stomach the left gastric v. and right gastric v. are together called the coronary v. because they form a circle
splenic v. (N299,N302,TG5-28) proper splenic vv. portal v. spleen multiple proper splenic vv. emerge from the hilum of the spleen and join to form the splenic v.

Viscera
Organ/Part of Organ Location/Description Notes
esophagus (N228,TG4-37,N267,TG5-18) the portion of the gastrointestinal tract between the pharynx and the stomach connects: superiorly with laryngopharynx at lower border of cricoid cartilage; inferiorly it passes through diaphragm at the T10 vertebral level to reach the stomach; the upper 1/3 is skeletal muscle innervated by the recurrent laryngeal, the lower 2/3rds is smooth muscle innervated by the vagus nn. via the esophageal plexus
spleen (N264,TG5-18,N265,N267,TG5-18,N289,TG5-20,TG5-20) lymphatic organ suspended within the greater omentum in the upper left quadrant spleen is connected to the greater curvature of the stomach by the gastrosplenic (gastrolienal) ligament; it is connected to the left kidney by the splenorenal (lienorenal) ligament; spleen is covered by visceral peritoneum on all of its surfaces
stomach (N267,TG5-18) dilated portion of the digestive system located primarily in the upper left quadrant stomach rotates during embryonic development so that the lesser curvature (originally the anterior surface) faces superiorly and to the right, the greater curvature (originally the posterior surface) faces inferiorly and to the left
stomach, body of (N267,TG5-18) part of the stomach between the fundus and the pylorus mucosal surface of the body of the stomach near the lesser curvature has gastric folds
stomach, fundus of (N267,TG5-18) expanded superior part of the stomach above the entrance of the esophagus fundus may contain a gas bubble in X rays of patients filmed in a standing position (Latin, fundus = bottom)
angular notch of stomach (N267,TG5-18) bend along lesser curvature marks transition from body to pylorus
cardiac portion of stomach (N267,TG5-18) area around the opening of the esophagus joined by esophagus
pylorus of stomach (N267,TG5-18) constricted lower part, containing pyloric antrum & sphincter the antrum exists as the path from the body to the pylorus region of the stomach; the sphincter leads from the pylorus to the duodenum (Latin, pylorus = gatekeeper)
rugae of stomach (N268,TG5-19) folds of the mucosal lining of the stomach (Latin, rugae = a wrinkle)
bile duct (N280,TG5-24,N285,TG5-24,N290,TG5-19,N292,TG5-27) union of cystic & common hepatic ducts drains to hepatopancreatic ampulla & greater duodenal papilla with main pancreatic duct

Clinical Terms
Term Definition
gastric & duodenal ulcers a local defect, or excavation, of the surface of an organ or tissue, which is produced by the sloughing of inflammatory necrotic tissue. The bacteria H. pylori plays an important role in the pathogenesis of both types of ulcers. Patients typically present with epigastric pain (from food in stomach for gastric ulcers and from a lack of food in duodenum for duodenal ulcers) as well as satiety and possibly nausea.
vagotomy cutting of the vagus nerve. Effects of bilateral vagotomy (cholinergic denervation), 1) decreased motility of stomach and intestine, 2) decreased gastric secretions, 3) decreased tone of gallbladder and bile duct, 4) increased tone of sphincters (Oddi and lower esophageal sphincter)
gastrectomy A surgical procedure where all or a portion of the stomach is removed. Indicated in some cases of intractable gastric ulcers.
splenectomy surgical removal of the spleen. This is sometimes done in leukemia or lymphoma as part of a patient's treatment. The splenic capsule may rupture as a result of trauma.
splenomegaly enlargement of the spleen.
pyloric stenosis a congenital disorder in which the pylorus is thickened causing obstruction of the gastric outlet (to the duodenum). More common in males. Symptoms of projectile vomiting begin several weeks after birth, and the emesis is non-bilious. Treatment is a surgical procedure called a pyloromyotomy where the muscular layers of the pylorus are cut all the way down to the mucosa in order to relieve the pressure. (Latin, pylorus = gatekeeper + stenosis = a narrowing)
gastroscopy examination of the abdomen/stomach with a fiber optic scope.
crepitus a crackling sound in the lungs or a grating feeling. (Latin, crepo = to rattle)
exsanguination deprivation of blood or loss of blood.
hematocrit volume of blood occupied by red blood cells. The average for an adult is 45 mls of packed red blood cells in 100 mls of blood.
peritoneal lavage a diagnostic technique performed after trauma to wash out the peritoneal cavity. (Latin, lavo = to wash)

The material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger
Published by ILOC, Inc., New York
Copyright © 1995, unauthorized use prohibited.
 The excellent editorial assistance of
Dr. Pat Tank, UAMS
is gratefully acknowledged.