Question

2. Upper Digestive Tract

(A) Discuss the stomach and include one usual abnormal finding

(B) Discuss the esophagus and include one usual abnormal finding

(C) Discuss the components of the "Moth" and include one usual abnormal finding

(D) Discuss the tongue and include one usual abnormal finding

Answer 1

Stomach-

The stomach is the most dilated part of the digestive tube.It is j shaped and located in the abdominal cavity below the diaphragm slightly to the left of the midline.The capacity of the stomach is about 1500ml in adult.

Functions:

1.churning and breaking of food and mixing it with the gastric juice secreted by specialized glands in its mucosa.

2.storing the food temporarily.

3.Secreting intrinsic factor needed for absorption of vitamin b12

External features:

Two ends: cardiac and pyloric end

Two curvatures: Greater and lesser

Two surfaces: Anterior and Posterior

Parts:

1.cardiac part

2.fundus

3.body

4.pyloric part

Relations of stomach

Visceral relations:

1.Relations to anterior surface

a) on the right side this surface is related to gastric impression on the left lode of the liver, and near pylorus to the quadrate love of liver.

Relations to posterior surface

Stomach bed:

1.diaphragm

2.left kidney

3.left supra renal gland

4.pancreas

5.transverse mesocolon

6.left colic flexure

7.splenic artery

8.spleen

ARTERIAL SUPPLY:

left gastric artery,right gastric artery,left gastro epiploic,right gastro epiploic,short gastric arteries.

VENOUS DRAINAGE

left gastric vein,right gastric vein,left gastro epiploic vein

Right gastro epiploic vein,short gastric vein

Clinical finding:

Gastric carcinoma:It commonly occurs in the region of pyloric antrum along the greater curvature of stomach. Spreads through lymph vessels to virchow's node.

ESOPHAGUS

The abdominal part of the ESOPHAGUS is only 1.25cm long.It enters the abdomen through the esophageal opening of a diaphragm and opens into cardiac end of stomach.

The esophageal opening of the diaphragm is situated at the level of T10 vertebra.

Relations of abdominal part of ESOPHAGUS are:

1.It is covered by the peritoneum only anteriorly and to the left

2 Posteriorly it is related to posterior vagal trunk and diaphragm.

3.Anteriorly it is related to the anterior vagal trunk and the left lobe of liver.

4.The esophageal branches of left gastric artery and accompanying veins run along its left side.

Clinical finding:

Esophageal varices:The lower end of the ESOPHAGUS is one of the site for portocaval anastomosis becomes dilated and tortuous.

MOUTH

structures of oral region include uper and lower lips

Clinical finding:

Colour of lips and oral cavity are pale in patients with severe anemia or bluish in people of cyanosis.

Tongue:

With papillae fungiform,circumvallate, filiform papillae.

Clinical finding: MACROGLOSIA- abnormal enlargement of the tongue.