Overview of Micro & Macro anatomy on oesophagus and upper GI...
Transcript of Overview of Micro & Macro anatomy on oesophagus and upper GI...
Overview of Micro & Macro Anatomy on Esophagus and Upper
GI tract
29 December 2016 (Thursday)
Association of Hong Kong Operating Room Nurses
Certificate Course in Upper Gastrointestinal Surgery & Perioperative Nursing
Where exactly is Upper GI Tract?
• Concentrate on the ESOPHAGUS and STOMACH today
Esophagus
• Around 25cm long
• Divided into 3 parts
• Cervical
• Thoracic
• Abdominal, 2cm in length
Esophagus
• Just anterior to the spine and posterior to the trachea
• Thoracic aorta crosses in front and to the left in the thorax
Esophagus
• Muscular tube
• Inner circular fibers
• Outer longitudinal fibers
Esophagus
• Muscular tube
• Inner circular fibers
• Outer longitudinal fibers
Esophagus
• Ends at the gastro-esophageal junction
• Landmark is the phreno-esophageal ligment
Arterial Supply
• Cervical part from inferior thyroid arteries
• Thoracic part directly from the aorta
• Abdominal part from the left gastric artery and inferior phrenic arteries
Venous Drainage
• Cervical part to inferior thyroid veins
• Thoracic part to azygous and hemiazygous vein
• Abdominal part to the coronary vein
Lymphatic Drainage
Nerve Supply
• Sympathetic and Para-sympathetic
• Sympathetic from Middle cervical ganglion and sympathetic chain
Nerve Supply
• Parasympathetic from the vagusnerve
Stomach
• Cardia
• Fundus
• Body
• Antrum
• pylorus
Stomach
Close relationship to:
• Pancreas
• Spleen
• Transverse colon
Stomach
Close relationship to:
• Pancreas
• Spleen
• Transverse colon
Arterial Supply
• Originate from the abdominal aorta celiac trunk
• Celiac trunk gives out 3 branches
Arterial Supply
• Left gastric artery
• Splenic artery
• Common hepatic artery
Arterial Supply
• Common hepatic arterygastroduodenalartery right gastroepiploicartery
Arterial Supply
• Splenic artery gives off the short gastric arteries + left gastroepiploicartery
Venous Drainage
• Same as the arterial supply
Venous Drainage
• Left gastric vein (coronary vein)
• Right gastric vein
• Left gastroepiploicvein
• Right gastroepiploicvein
• Short gastric veins
Lymphatic Drainage
Lymphatic Drainage
Nerve Supply
• Parasympathetic via the vagusnerve
• Anterior and posterior vagal trunks
Nerve Supply
• Sympathetic via the celiac ganglia and plexus
• Hepatic branch of the vagus nerve supplies the pylorus and the gallbladder
Nerve Supply
• Parasympathetic via the vagusnerve
• Anterior and posterior vagal trunks
• Sympathetic via the celiac ganglia and plexus
Nerve Supply
• Vagus nerve is a cord like structure on the surface of the esophagus
Histology of Esophagus
4 layers
• Mucosa
• Submucosa
• Muscularispropria
• Adventitia
Histology of Esophagus
Mucosa can be further divided into 4 layers
• Epithelium
• Basement membrane
• Lamina propria
• Muscularismucosa
Histology of Esophagus
• Epithelium is made of non-keratinized, stratified squamous epithelium
• protective function against the abrasive effects of food
Histology of Esophagus
• 2 layers of muscle
• Inner circular muscle
• Outer longitudinal muscle
Histology of Stomach
4 layers
• Mucosa
• Submucosa
• Muscularispropria
• Adventitia
Histology of Stomach
• Many different cells on the epithelium
• Parietal cells secrete hydrochloric acid + intrinsic factor
• Chief cells secrete pepsinogen + lipase (enzymes)
Histology of Stomach
• 3 layers of muscle
Histology of Stomach
• Oblique muscle
• Circular muscle
• Longitudinal muscle
Questions?