UPSC MainsMEDICAL-SCIENCE-PAPER-I201510 Marks150 Words
Q1.

Describe stomach under the following headings : (i) Location (ii) External features (iii) Arterial supply (iv) Clinical anatomy

How to Approach

This question requires a detailed anatomical description of the stomach. The approach should be systematic, addressing each heading (location, external features, arterial supply, and clinical anatomy) sequentially. Focus on providing precise anatomical details, using appropriate terminology. The clinical anatomy section should highlight common pathologies and their anatomical basis. A concise and structured answer is key to maximizing marks within the word limit.

Model Answer

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Introduction

The stomach is a vital organ of the digestive system, responsible for the initial stages of protein digestion and temporary storage of food. Its unique structure and location are crucial for its function. Understanding its anatomy is fundamental to diagnosing and treating a wide range of gastrointestinal disorders. This answer will detail the stomach’s location, external features, arterial supply, and clinically relevant anatomical considerations.

(i) Location

The stomach is located in the upper left quadrant of the abdominal cavity, nestled beneath the diaphragm and anterior to the spleen and left kidney. It lies between the 7th and 11th ribs. Its position is not fixed; it changes with body position and the amount of food it contains. The stomach is continuous superiorly with the esophagus at the cardiac orifice and inferiorly with the duodenum at the pyloric orifice.

(ii) External Features

The stomach has four main parts:

  • Cardia: The region surrounding the cardiac orifice, where the esophagus enters.
  • Fundus: The dome-shaped portion superior to the cardia, often filled with gas.
  • Body: The main central region of the stomach.
  • Pylorus: The funnel-shaped distal portion, leading to the duodenum. It consists of the pyloric antrum and the pyloric canal.

Externally, the stomach exhibits several features:

  • Greater Curvature: The long, convex lateral border.
  • Lesser Curvature: The short, concave medial border.
  • Greater Omentum: Attached to the greater curvature, it drapes over the intestines.
  • Lesser Omentum: Extends between the lesser curvature and the liver.

(iii) Arterial Supply

The stomach receives a rich blood supply from branches of the celiac trunk:

  • Left Gastric Artery: Supplies the lesser curvature and the cardia.
  • Right Gastric Artery: Supplies the lower part of the lesser curvature.
  • Left Gastroepiploic Artery: Runs along the greater curvature and supplies the fundus and body.
  • Right Gastroepiploic Artery: Runs along the greater curvature and supplies the pylorus.

These arteries form an anastomotic network along the greater and lesser curvatures, providing collateral circulation. Venous drainage mirrors the arterial supply, ultimately draining into the portal vein.

(iv) Clinical Anatomy

Understanding the stomach’s anatomy is crucial for several clinical scenarios:

  • Gastric Ulcers: Commonly occur along the lesser curvature near the junction of the body and antrum, often due to Helicobacter pylori infection.
  • Gastric Cancer: Frequently develops in the antrum or along the lesser curvature. Early detection relies on endoscopic examination.
  • Gastric Varices: Enlarged veins in the stomach, often associated with portal hypertension due to liver cirrhosis. They can rupture and cause life-threatening bleeding.
  • Laparoscopic Gastrectomy: Surgical removal of part or all of the stomach, requiring precise anatomical knowledge to avoid injury to surrounding structures.
  • Hiatal Hernia: Protrusion of the stomach through the esophageal hiatus of the diaphragm, often causing heartburn and regurgitation.

The proximity of the stomach to other organs like the pancreas, spleen, and liver means that pathologies in these organs can often present with referred pain in the epigastric region.

Conclusion

In conclusion, the stomach’s location, external features, arterial supply, and clinical relevance are intricately linked. A thorough understanding of its anatomy is essential for medical professionals to accurately diagnose and effectively manage a wide spectrum of gastrointestinal conditions. Continued advancements in endoscopic and imaging techniques further emphasize the importance of detailed anatomical knowledge in modern clinical practice.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Peristalsis
The involuntary, wave-like muscle contractions that propel food through the digestive tract, including the stomach.
Chyme
The semi-fluid mass of partially digested food and gastric secretions that is formed in the stomach.

Key Statistics

Gastric cancer is the 5th most common cancer worldwide, with an estimated 1.09 million new cases in 2020 (Source: WHO, IARC Globocan 2020).

Source: WHO, IARC Globocan 2020

<i>Helicobacter pylori</i> infection is present in approximately 50% of the world’s population (Source: National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK, 2023).

Source: NIDDK, 2023

Examples

Zollinger-Ellison Syndrome

A rare condition where gastrin-secreting tumors (gastrinomas) cause excessive gastric acid production, leading to peptic ulcers. Anatomical knowledge of the pancreas (where these tumors often reside) is crucial for diagnosis and treatment.

Frequently Asked Questions

What is the function of the rugae in the stomach?

Rugae are the folds in the stomach lining. They allow the stomach to expand after a meal, increasing its capacity without increasing tension.

Topics Covered

AnatomyPhysiologyDigestive SystemStomachArterial SupplyClinical Anatomy