Stomach and Spleen

Gross Anatomy


Celiac Trunk, Stomach, Spleen, Liver and Gallbladder


Anatomy Tables for Today's Topic

Branches of the Celiac Trunk
Veins
Viscera
Nerves
Lymphatics

Branches of the Celiac Trunk

Artery Source Branches Supply to Notes
celiac trunk 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
cystic right hepatic a. (or superior mesenteric a., proper hepatic a., left hepatic a., gastroduodenal a.) no named branches gall bladder cystic a. arises from the right hepatic a. in ~72% of cases; other possible origins are noted at left and are clinically relevant during gall bladder surgery
esophageal descending thoracic aorta; left gastric a. no named branches lower 2/3rds of the thoracic esophagus there are usually two (sometimes 3) esophageal brs. off of the aorta; the left gastric a. gives esophageal brs. that ascend to supply the abdominal esophagus and lowest part of the thoracic esophagus; anastomoses occur between the esophageal brs. of the aorta and left gastric a.
gastric, left 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
gastric, right 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 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 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 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 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
hepatic, common 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, left proper hepatic a. segmental aa. left lobe of the liver, quadrate lobe of the liver, part of the caudate lobe of the liver left hepatic a. supplies the liver parenchyma and stroma; an aberrant left hepatic a. may arise from the left gastric a.
hepatic, proper 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
hepatic, right proper hepatic a. cystic a., segmental aa. right lobe of the liver, part of the caudate lobe of the liver right hepatic a. supplies the liver parenchyma and stroma
splenic celiac trunk dorsal pancreatic a., pancreatic brs., pancreatica magna a., caudal pancreatic a., short gastric aa., left gastro-omental a., splenic brs. pancreas, spleen, greater curvature of the stomach splenic a. courses through the substance of the pancreas near its superior border; splenic artery is very tortuous
supraduodenal gastroduodenal a. no named branches superior portion of the 1st part of the duodenum supraduodenal a. supplies branches to both the anterior and posterior surfaces of the duodenum

Veins

Vein Tributaries Drains Into Regions Drained Notes
gastric, left 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 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
gastro-omental, left gastric brs., omental brs. splenic v. greater curvature of the stomach and the greater omentum also known as: left gastroepiploic v.
gastro-omental, right gastric brs., omental brs. superior mesenteric v. greater curvature of the stomach and the greater omentum also known as: right gastroepiploic v.
hepatic, left segmental vv. inferior vena cava entire lateral segment of the left lobe of the liver; superior portion of the medial segment of the left lobe of the liver the lumen of the left hepatic v. is clearly visible within the portion of the inferior vena cave that passes through the liver
hepatic, middle segmental vv. inferior vena cava inferior portion of the medial segment of the left lobe of the liver; inferior part of the anterior segment of the right lobe of the liver the lumen of the middle hepatic v. is clearly visible within the portion of the inferior vena cave that passes through the liver
hepatic, right segmental vv. inferior vena cava superior portion of the anterior segment of the right lobe of the liver; entire posterior segment of the liver the lumen of the right hepatic v. is clearly visible within the portion of the inferior vena cave that passes through the liver
pancreaticoduodenal, anterior inferior numerous unnamed tributaries from the duodenum and pancreas inferior pancreaticoduodenal v. anterior part of the head of the pancreas; anterior aspect of the 3rd and 4th parts of the duodenum anterior inferior pancreaticoduodenal v. connects with the anterior superior pancreaticoduodenal v
pancreaticoduodenal, anterior superior numerous unnamed tributaries from the duodenum and pancreas right gastro-omental v. anterior part of the head of the pancreas; anterior aspect of the 1st and 2nd parts of the duodenum anterior superior pancreaticoduodenal v. connects with the anterior inferior pancreaticoduodenal v
pancreaticoduodenal, inferior anterior inferior and posterior inferior pancreaticoduodenal vv. superior mesenteric v. lower part of duodenum & head of pancreas connects with anterior & posterior superior pancreaticoduodenal vv.
pancreaticoduodenal, posterior inferior numerous unnamed tributaries from the duodenum and pancreas inferior pancreaticoduodenal v. posterior part of the head of the pancreas; posterior aspect of the 3rd and 4th parts of the duodenum posterior inferior pancreaticoduodenal v. connects with the posterior superior pancreaticoduodenal v
pancreaticoduodenal, posterior superior numerous unnamed tributaries from the duodenum and pancreas portal v. posterior part of the head of the pancreas; posterior aspect of the 1st and 2nd parts of the duodenum posterior superior pancreaticoduodenal v. connects with the posterior inferior pancreaticoduodenal v.
portal v. 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)

Viscera

Organ/Part of Organ Location/Description Notes
esophagus 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
stomach 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
angular notch of the stomach a sharp indentation located about 2/3 of the way down the lesser curvature of the stomach angular notch marks the transition from body of stomach to pylorus
cardia of the stomach part of the stomach surrounding the opening of the esophagus esophagus empties into the stomach at this location; also known as: cardiac region of the stomach
gastric folds folds of the mucosal lining of the stomach gastric folds are ridges that generally run from the cardia of the stomach toward the pyloris along the lesser curvature; also known as: rugae
pylorus of the stomach constricted distal part of the stomach to the right of the angular notch pyloris contains the pyloric antrum and the pyloric sphincter
rugae of the stomach folds of the mucosal lining of the stomach rugae are ridges that generally run from the cardia of the stomach toward the pyloris along the lesser curvature; also known as: gastric folds
stomach, body of 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 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
spleen 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
gallbladder diverticulum of the biliary tract that hangs below the liver between the right and quadrate lobes located in the right upper quadrant; gallbladder is connected to the common bile duct via the cystic duct; it both stores and concentrates bile; pain from the gallbladder may be referred to the right shoulder
gallbladder, body of the main part of the gallbladder body of the gallbladder lies in the bed of the gallbladder, between the right and quadrate lobes of the liver
gallbladder, fundus of expanded inferior part of the gallbladder fundus of the gallbladder is located near the inner surface of the anterior abdominal wall at the junction of the right 9th costal cartilage and the right semilunar line; it normally hangs below the margin of the liver
gallbladder, neck of constricted superior part of the gallbladder neck of the gallbladder is the portion that connects the body of the gallbladder to the cystic duct; it contains a spiral fold
liver largest digestive organ in the body, located mostly in the right upper quadrant the liver consists of 4 anatomical lobes: left, right, quadrate and caudate; it lies inferior to the diaphragm and rises as high as the 5th rib on the right side; liver functions include: synthesis, storage and release of glycogen and vitamins; synthesis of blood proteins; phagocytosis of old red blood cells; removal of toxic substances
porta hepatis region of the visceral surface of the liver where hepatic ducts, hepatic aa. & portal v. enter/leave porta hepatis is equivalent to the hilum of the spleen or lung
bare area of the liver the part of the diaphragmatic surface of the liver that is not covered by visceral peritoneum bare area is between the anterior and posterior laminae of the coronary ligament and is in contact with the diaphragm
hepatic duct, common duct formed by the joining of the of right and left hepatic ducts common hepatic duct unites with the cystic duct to form the common bile duct
hepatic duct, left duct that drains the left lobe of the liver, quadrate lobe and part of the caudate lobe of the liver left hepatic duct joins with right hepatic duct to form the common hepatic duct
hepatic duct, right duct that drains the right lobe of the liver and part of the caudate lobe of the liver right hepatic duct joins with the left hepatic duct to form the common hepatic duct
bile duct, common part of the biliary tree that is formed by the union of the cystic and common hepatic ducts; located in the hepatoduodenal ligament common bile duct drains into the hepatopancreatic ampulla and greater duodenal papilla in company with the main pancreatic duct
cystic duct duct of the gallbladder cystic duct joins with the common hepatic duct to form the common bile duct; cystic duct both fills and drains the gallbladder
hepatoduodenal ligament part of the lesser omentum connecting the liver to the 1st part of duodenum hepatoduodenal ligament contains the common bile duct, proper hepatic a. and portal v.; it forms the anterior wall of the omental (epiploic) foramen
hepatogastric ligament 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
round ligament of the liver cord-like ligament that lies within the free margin of the falciform ligament round ligament of the liver courses from the liver to the umbilicus; it is the remnant of the umbilical v.; also known as: ligamentum teres hepatis
triangular ligament extreme left or right end of the coronary ligament of the liver triangular ligaments are formed by the joining of the anterior and posterior laminae of the coronary ligament; they delineate the right and left extremes of the bare area of the liver
ligamentum teres hepatis cord-like ligament that lies within the free margin of the falciform ligament ligamentum teres hepatis courses from the liver to the umbilicus; it is the remnant of the umbilical v.; also known as: round ligament of liver
ligamentum venosum cord-like ligament that lies within the attachment of the hepatogastric ligament to the liver, between the caudate lobe and the left lobe ligamentum venosum is a remnant of the obliterated ductus venosus which shunted oxygenated blood from the placenta around the liver to the inferior vena cava during development
coronary ligament peritoneum connecting the liver to the inferior surface of the diaphragm it has three parts which together form a complete circle: right triangular ligament, left triangular ligament, falciform ligament; area between the anterior and posterior laminae of the coronary ligament is called the bare area of the liver
falciform ligament sickle-shaped fold of peritoneum connecting the liver to the umbilicus falciform ligament contains the round ligament of the liver (ligament teres hepatis); it is a remnant of the ventral mesogastrium of the embryo

Nerves

Nerve Source Branches Motor Sensory Notes
splanchnic, greater thoracic neurons in the intermediolateral cell column of spinal cord levels T5-T9; the greater thoracic splanchnic nerve arises by multiple contributions from the sympathetic trunk no named branches celiac ganglion; preganglionic fibers supply the adrenal medulla which releases epinephrine and norepinephrine into the blood pain from the abdominal viscera greater thoracic splanchnic n. passes through the crus of the respiratory diaphragm; postganglionic processes from the celiac ganglion spread down the aorta and distribute with its branches; they innervate the vascular smooth muscle of these vessels and the organs supplied
splanchnic, least thoracic neurons in the intermediolateral cell column of spinal cord level T12 no named branches renal plexus pain from the kidney and suprarenal gland least thoracic splanchnic n. passes through the crus of the diaphragm; it synapses in minute ganglia located in the renal plexus
splanchnic, lesser thoracic neurons in the intermediolateral cell column of spinal cord levels T10-T11; the lesser thoracic splanchnic nerve arises by multiple contributions from the sympathetic trunk no named branches aorticorenal ganglion pain from the kidney and suprarenal gland lesser thoracic splanchnic n. passes through the crus of the respiratory diaphragm; postganglionic processes from the ganglion supply vascular smooth muscle of branches of the renal a. and suprarenal aa.; kidney and suprarenal gland
vagus n. 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; vagus means "wanderer" in reference to its extensive distribution to the body cavities

Lymphatics

Structure Location Afferents from Efferents to Regions drained Notes
cisterna chyli between the abdominal aorta and the inferior vena cava anterior to the body of the L1 or L2 vertebra right and & left lumbar trunks; possibly the intestinal trunk thoracic duct all of the body below the respiratory diaphragm; all of the abdominal and pelvic viscera cisterna chyli is an enlargement of the lower end of the thoracic duct; it occurs in about 25% of individuals
spleen in the abdominal cavity below the left dome of the diaphragm, anterior to the left kidney splenic brs. of the splenic a. splenic v. filters blood by phagocytosis; produces T & B-lymphocytes spleen contains nodules of lymphatic tissue
thoracic duct between the esophagus anteriorly and the thoracic vertebral bodies posteriorly formed by the union of the lumbar lymph trunks, sometimes dilated to form a cisterna chyli junction of the left subclavian v. and the left internal jugular v. all of the body and limbs below the respiratory diaphragm; the left side of the chest, left upper limb and the left side of the head and neck above the diaphragm thoracic duct is the largest lymphatic vessel; it passes through the aortic hiatus on the right side of aorta; it swings to the left side of the esophagus at the T4-T5 intervertebral disc (at the level of the sternal angle)


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Some of the material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest and Jaye Schlesinger
Published by ILOC, Inc., New York. Copyright 1995.

Content of these tables has been edited for use in this course by Patrick W. Tank, Ph.D.
Copyright 2005, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences.

Unauthorized use is prohibited.