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r which is used as gastric in medical terms related to the stomach 3 the stomach has a dilated structure and functions as a vital organ in the digestive system the stomach is involved in the gastric phase of digestion following the cephalic phase in which the sight and smell of food and the act of chewing are stimuli in the stomach a chemical breakdown of food takes place by means of secreted digestive enzymes and gastric acid it also plays a role in regulating gut microbiota influencing digestion and overall health 4 the stomach is located between the esophagus and the small intestine the pyloric sphincter controls the passage of partially digested food chyme from the stomach into the duodenum the first and shortest part of the small intestine where peristalsis takes over to move this through the rest of the intestines structure edit in the human digestive system the stomach lies between the esophagus and the duodenum the first part of the small intestine it is in the left upper quadrant of the abdominal cavity the top of the stomach lies against the diaphragm lying behind the stomach is the pancreas a large double fold of visceral peritoneum called the greater omentum hangs down from the greater curvature of the stomach two sphincters keep the contents of the stomach contained the lower esophageal sphincter found in the cardiac region at the junction of the esophagus and stomach and the pyloric sphincter at the junction of the stomach with the duodenum the stomach is surrounded by parasympathetic inhibitor and sympathetic stimulant plexuses networks of blood vessels and nerves in the anterior gastric posterior superior and inferior celiac and myenteric which regulate both the secretory activity of the stomach and the motor motion activity of its muscles the stomach is distensible and can normally expand to hold about one litre of food 5 the shape of the stomach depends upon the degree of its distension and that of surrounding viscera e g the colon 4 when empty the stomach is somewhat j shaped when partially distended it becomes pyriform in shape in obese persons it is more horizontal 4 in a newborn human baby the stomach will only be able to hold about 30 millilitres the maximum stomach volume in adults is between 2 and 4 litres 6 7 although volumes of up to 15 litres have been observed in extreme circumstances 8 sections edit cardia redirects here for the ancient greek colony see cardia thrace not to be confused with cardiac diagram showing parts of the stomach the human stomach can be divided into four sections beginning at the cardia followed by the fundus the body and the pylorus 9 10 the gastric cardia is where the contents of the esophagus empty from the gastroesophageal sphincter into the cardiac orifice the opening into the gastric cardia 11 10 a cardiac notch at the left of the cardiac orifice marks the beginning of the greater curvature of the stomach a horizontal line across from the cardiac notch gives the dome shaped region called the fundus 10 the cardia is a very small region of the stomach that surrounds the esophageal opening 10 the fundus from latin bottom is formed in the upper curved part 12 the body or corpus is the main central region of the stomach 12 the pylorus from greek gatekeeper connects the stomach to the duodenum at the pyloric sphincter the pyloric antrum opens to the body of the stomach 12 the cardia is defined as the region following the z line of the gastroesophageal junction the point at which the epithelium changes from stratified squamous to columnar near the cardia is the lower esophageal sphincter 11 anatomical proximity edit the stomach bed refers to the structures upon which the stomach rests in mammals 13 14 these include the tail of the pancreas splenic artery left kidney left suprarenal gland transverse colon and its mesocolon and the left crus of diaphragm and the left colic flexure the term was introduced around 1896 by philip polson of the catholic university school of medicine dublin however this was brought into disrepute by surgeon anatomist j massey 15 16 17 blood supply edit schematic image of the blood supply to the human stomach left and right gastric artery left and right gastroepiploic artery and short gastric arteries 18 the lesser curvature of the human stomach is supplied by the right gastric artery inferiorly and the left gastric artery superiorly which also supplies the cardiac region the greater curvature is supplied by the right gastroepiploic artery inferiorly and the left gastroepiploic artery superiorly the fundus of the stomach and also the upper portion of the greater curvature is supplied by 5 7 short gastric arteries which arise from the splenic artery 4 lymphatic drainage edit the two sets of gastric lymph nodes drain the stomach s tissue fluid into the lymphatic system through the intestinal lymph trunk to the cisterna chyli 4 microanatomy edit wall edit main article gastrointestinal wall the gastrointestinal wall of the human stomach layers of the gastrointestinal wall of which the stomach is a dilated part like the other parts of the gastrointestinal wall the human stomach wall from inner to outer consists of a mucosa submucosa muscular layer subserosa and serosa 19 the inner part of the stomach wall is the gastric mucosa a mucous membrane that forms the lining of the stomach the membrane consists of an outer layer of columnar epithelium a lamina propria and a thin layer of smooth muscle called the muscularis mucosa beneath the mucosa lies the submucosa consisting of fibrous connective tissue 20 meissner s plexus is in this layer interior to the oblique muscle layer 21 outside of the submucosa lies the muscular layer it consists of three layers of muscular fibres with fibres lying at angles to each other these are the inner oblique middle circular and outer longitudinal layers 22 the presence of the inner oblique layer is distinct from other parts of the gastrointestinal tract which do not possess this layer 23 the stomach contains the thickest muscular layer consisting of three layers thus maximum peristalsis occurs here the inner oblique layer this layer is responsible for creating the motion that churns and physically breaks down the food it is the only layer of the three which is not seen in other parts of the digestive system the antrum has thicker skin cells in its walls and performs more forceful contractions than the fundus the middle circular layer at this layer the pylorus is surrounded by a thick circular muscular wall which is normally tonically constricted forming a functional if not anatomically discrete pyloric sphincter which controls the movement of chyme into the duodenum this layer is concentric to the longitudinal axis of the stomach the myenteric plexus auerbach s plexus is found between the outer longitudinal and the middle circular layer and is responsible for the innervation of both causing peristalsis and mixing the outer longitudinal layer is responsible for moving the semi digested food towards the pylorus of the stomach through muscular shortening to the outside of the muscular layer lies a serosa consisting of layers of connective tissue continuous with the peritoneum smooth mucosa along the inside of the lesser curvature forms a passageway the gastric canal that fast tracks liquids entering the stomach to the pylorus 10 glands edit main article gastric glands diagram showing gastric pits 13 gastric glands 12 lamina propria 10 epithelium 11 histology of normal fundic mucosa fundic glands are simple branched tubular glands that extend from the bottom of the gastric pits to the muscularis mucosae the more distinctive cells are parietal cells h e stain histology of normal antral mucosa antral mucosa is formed by branched coiled tubular glands lined by secretory cells similar in appearance to the surface mucous cells h e stain the mucosa lining the stomach is lined with gastric pits which receive gastric juice secreted by between 2 and 7 gastric glands 24 gastric juice is an acidic fluid containing hydrochloric acid and digestive enzymes 25 the glands contains a number of cells with the function of the glands changing depending on their position within the stomach 26 within the body and fundus of the stomach lie the fundic glands in general these glands are lined by column shaped cells that secrete a protective layer of mucus and bicarbonate additional cells present include parietal cells that secrete hydrochloric acid and intrinsic factor chief cells that secrete pepsinogen this is a precursor to pepsin the highly acidic environment converts the pepsinogen to pepsin and neuroendocrine cells that secrete serotonin 27 citation needed glands differ where the stomach meets the esophagus and near the pylorus 28 near the gastroesophageal junction lie cardiac glands which primarily secrete mucus 27 they are fewer in number than the other gastric glands and are more shallowly positioned in the mucosa there are two kinds either simple tubular glands with short ducts or compound racemose resembling the duodenal brunner s glands citation needed near the pylorus lie pyloric glands located in the antrum of the pylorus they secrete mucus as well as gastrin produced by their g cells 29 citation needed gene and protein expression edit further information bioinformatics gene and protein expression about 20 000 protein coding genes are expressed in human cells and nearly 70 of these genes are expressed in the normal stomach 30 31 just over 150 of these genes are more specifically expressed in the stomach compared to other organs with only some 20 genes being highly specific the corresponding specific proteins expressed in stomach are mainly involved in creating a suitable environment for handling the digestion of food for uptake of nutrients highly stomach specific proteins include gastrokine 1 expressed in the mucosa pepsinogen and gastric lipase expressed in gastric chief cells and a gastric atpase and gastric intrinsic factor expressed in parietal cells 32 development edit in the early part of the development of the human embryo the ventral part of the embryo abuts the yolk sac during the third week of development as the embryo grows it begins to surround parts of the yolk sac the enveloped portions form the basis for the adult gastrointestinal tract 33 the sac is surrounded by a network of vitelline arteries and veins over time these arteries consolidate into the three main arteries that supply the developing gastrointestinal tract the celiac artery superior mesenteric artery and inferior mesenteric artery the areas supplied by these arteries are used to define the foregut midgut and hindgut 33 the surrounded sac becomes the primitive gut sections of this gut begin to differentiate into the organs of the gastrointestinal tract and the esophagus and stomach form from the foregut 33 as the stomach rotates during early development the dorsal and ventral mesentery rotate with it this rotation produces a space anterior to the expanding stomach called the greater sac and a space posterior to the stomach called the lesser sac after this rotation the dorsal mesentery thins and forms the greater omentum which is attached to the greater curvature of the stomach the ventral mesentery forms the lesser omentum and is attached to the developing liver in the adult these connective structures of omentum and mesentery form the peritoneum and act as an insulating and protective layer while also supplying organs with blood and lymph vessels as well as nerves 34 arterial supply to all these structures is from the celiac trunk and venous drainage is by the portal venous system lymph from these organs is drained to the prevertebral celiac nodes at the origin of the celiac artery from the aorta function edit digestion edit further information human digestive system see also gastric acid in the human digestive system a bolus a small rounded mass of chewed up food enters the stomach through the esophagus via the lower esophageal sphincter the stomach releases proteases protein digesting enzymes such as pepsin and hydrochloric acid which kills or inhibits bacteria and provides the acidic ph of 2 for the proteases to work food is churned by the stomach through peristaltic muscular contractions of the wall reducing the volume of the bolus before looping around the fundus 35 and the body of stomach as the boluses are converted into chyme partially digested food chyme slowly passes through the pyloric sphincter and into the duodenum of the small intestine where the extraction of nutrients begins gastric juice in the stomach contains pepsinogen and gastric acid hydrochloric acid which activates this inactive form of enzyme into the active form pepsin pepsin breaks down proteins into polypeptides mechanical digestion edit within a few moments after food enters the stomach mixing waves begin to occur at intervals of approximately 20 seconds a mixing wave is a unique type of peristalsis that mixes and softens the food with gastric juices to create chyme the initial mixing waves are relatively gentle but these are followed by more intense waves starting at the body of the stomach and increasing in force as they reach the pylorus the pylorus which holds around 30 ml of chyme acts as a filter permitting only liquids and small food particles to pass through the mostly but not fully closed pyloric sphincter in a process called gastric emptying rhythmic mixing waves force about 3 ml of chyme at a time through the pyloric sphincter and into the duodenum release of a greater amount of chyme at one time would overwhelm the capacity of the small intestine to handle it the rest of the chyme is pushed back into the body of the stomach where it continues mixing this process is repeated when the next mixing waves force more chyme into the duodenum gastric emptying is regulated by both the stomach and the duodenum the presence of chyme in the duodenum activates receptors that inhibit gastric secretion this prevents additional chyme from being released by the stomach before the duodenum is ready to process it 36 chemical digestion edit the fundus stores both undigested food and gases that are released during the process of chemical digestion food may sit in the fundus of the stomach for a while before being mixed with the chyme while the food is in the fundus the digestive activities of salivary amylase continue until the food begins mixing with the acidic chyme ultimately mixing waves incorporate this food with the chyme the acidity of which inactivates salivary amylase and activates lingual lipase lingual lipase then begins breaking down triglycerides into free fatty acids and mono and diglycerides the breakdown of protein begins in the stomach through the actions of hydrochloric acid and the enzyme pepsin the stomach can also produce gastric lipase which can help digesting fat the contents of the stomach are completely emptied into the duodenum within two to four hours ...
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