Stomach Ulcers – Esophagus and Stomach

by James Pickering, PhD

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    00:01 You have got these acid producing cells, these parietal cells creating acid within the lumen of the stomach. The problem is that the acid could burn away could destroy the mucosal lining of stomach. And in the diagram we can see what is a gastric ulcer, an ulcer within the walls of the stomach. So there is a balance There is a balance to be had between the acid in the lumen and the amount of mucus that is produced. To protect the lining of stomach a carpet of alkaline mucus is secreted by the epithelial layer of the stomach. So that produces mucus, that lines the internal surface. So the acidic lumen cannot destroy/damage the internal surface. So there is balance which is depicted here. Reduction in mucus production or increase in the acid content of the lumen can lead to perforation of the walls of the stomach. And that could be, particularly, nasty, can be particularly, painful and very serious. Perforation, the content of the stomach can leak into the peritoneal cavity leading to peritonitis and infection. Haemorrhaging if the perforation was to damage blood vessels could lead to blood in your stools or vomiting out blood if you are to be sick. Bleed into the gastrointestinal tract and that is excreted, that is how we get in our stools. Or if the ulcer repairs and you have some starving, this can cause a blockage. And if the food can't progress down the gastrointestinal tract then that can lead to a build up of food within the stomach and you can have the projectile vomiting. So with those really important that we have this acid production in the lumen. It’s also important that we have this alkaline mucus and we have this balance to prevent the wall of the stomach from being damaged. Let's turn to some of the gross anatomy, the position of the stomach.

    02:10 And here we can see really nicely how the stomach is positioned in situ how it's actually positioned if you were to open up one's abdomen and view it.

    02:19 The liver here is been uplifted here slightly. But like I mentioned before we can see the lesser curvature of the stomach here. We can see the greater curvature of the stomach here up here, we have got the fundus, we have got the body, we have got the pylorus and we have got the pyloric sphincter over here. Remember me saying that the lesser curvature was connected to the liver, while here we have got an important membrane that is connecting the stomach to the liver. We will come across this in later lecture.

    02:46 It's really important, it's the lesser omentum, specifically the hepatogastric ligament of the lesser omentum, we will come to that later on.

    02:55 So in this side of screen we can also see the relations of other organs to the stomach. So in this side, we can see what is the anterior view and here we can see the posterior view. Now, you may not be familiar with the position of these organs, so it may not make a lot of sense right now, but by the end of the course we spoke about these other regions, these other organs you will be able to imagine the precise position of the stomach.

    03:22 So we can see anteriorly and it's linked very well to this diagram here.

    03:28 We can see we have got a liver here and so we can see the liver is having this impression if the liver would float down if haven't been elevated which we can see in this diagram. It will be lying over the stomach. Over here we have got the diaphragm. So in this anterior surface of the stomach, we have got the diaphragm which is coming down covering this region here.

    03:51 So if you immediately open up the abdomen in this region you will find the stomach.

    03:54 And then down the bottom you just have the other parts of the anterior abdominal wall where the diaphragm is finished. Importantly, though what does the stomach sit on, what's known as the stomach bag? What lies immediately posterior to the stomach? So with this, we float the liver. We float the...

    04:18 stomach over, posteriorly we can see we have relations to spleen. So the stomach would be coming in this kind of position here. So immediately behind the stomach, we have the spleen, we have the kidney, we have the pancreas we can also see in this region down here, we have the transverse mesocolon. We will look on the trasverse mesocolon in more detail later on. So we can see the position and relations of the stomach to the other abdominal organs.

    About the Lecture

    The lecture Stomach Ulcers – Esophagus and Stomach by James Pickering, PhD is from the course Abdomen.

    Included Quiz Questions

    1. Posterior
    2. Anterior
    3. Lateral
    4. Medial
    5. Superior
    1. Peritonitis
    2. Appendicitis
    3. Hemorrhage
    4. Cholecystitis
    5. Pancreatitis

    Author of lecture Stomach Ulcers – Esophagus and Stomach

     James Pickering, PhD

    James Pickering, PhD

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    excellent use of images
    By CAMILO E. on 29. March 2020 for Stomach Ulcers – Esophagus and Stomach

    excellent use of images and highlights during the lecture, congrats