1.2 LYMPHATIC DRAINAGE
The lymphatics
follow the arteries and thus the lymph
from the
upper lesser currature flows to the left gastric and paracardial
lymphnodes.
Similarly, the antral vessal from lesser
curvature
flow to the right
gastric and suprapancreatic
lymphnodes. The
greater curvature drains into gastroenpiploic artery
lymph nodes
(Rt + Lt).
This knowledge helps to predict
the direction of
spread if the
site of a tumour is know.
This also helps
to
define the minimum
limits of surgery required so as the tumour
draining lymph nodes and the lymphatics.
1.3 The
parasympathetic supply is through the vagus
nerves and
stimulates motility and secretion of acid and pepsin
(fig16.2a).
1.4 The wall
of the stomach has four
distinct layers from
outwards - the
serosa (visceral peritoneum)
- muscle
- submucosa
- and mucosa the
inner most layer.
The mucosal structure varies, the fundus has (fig above)
- parietal cells that secrete acid and intrinsic factor.
- Chief cells that secrete pepsinogen
The antral mucosa has
- G cells that secrete gastrin
- Delta cells that secrete somatostatin.
There are in addition in the mucosa
- Goblet cells that secrete mucus.
- Mast cells that store heparin and histamine
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