1154 DIGESTIVE SYSTEM 



diaphragm (which separates it from the lung and heart) , opposite the sixth sterno- 

 costal junction. The fundus of course rises and falls with respiratory movements 

 of the diaphragm, the excursion being from 2 to 6 cm. 1 /' - V .J--^.,-. / 



The relations of the stomach with surrounding organs are indicated diagram- 

 maticalty in figs. 915 and 916. The anterior surface is in contact on the right with 

 the left lobe of the liver, the pylorus reaching the quadrate lobe; on the left it 

 is in contact with the diapliragm (separating it from the heart and left lung); 

 and below with the anterior body wall by a triangular area of variable size. 

 The posterior surface is in relation (separated by the lesser sac) with the pancreas, 

 above which are areas of contact with the diaphragm, spleen, left kidney and 

 suprarenal bod}-; below the pancreas, the stomach is in contact with the trans- 

 verse mesocolon, and through this with the transverse colon and coils of small 

 intestine. The relation with the duodeno-jejunal angle is indicated in fig. 895. 

 Further details concerning topography of the stomach are given in section XIII 

 on Clinical and Topographical Anatomy. 



Peritoneal relations. — The stomach is covered by peritoneum in its whole 

 extent, except immediately along the curvatures and upon a small triangular 

 space at the back of the cardiac orifice, where the viscus lies in direct contact with 

 the diaphragm and possibly with the upper part of the left suprarenal gland. 

 It is enclosed between two layers. These two layers at its lesser curvature 

 come together to form the gastro-hepatic portion of the lesser omentum, and at 

 the greater curvature extend downward to form the great omentum (figs. 903, 

 904). At the left of the oesophagus the two layers pass to the diaphragm, form- 



FiG. 909. — Surface View of Gastric Mucosa. X 4. fSobotta-McMurrich.) 





■Sbi&. 







Gastric areas and foveolse 



ing the gastro-phrenic ligament; and at the fundus they pass on to the spleen, 

 forming the gastro-splenic ligament. 



The posterior surface of the stomach is in relation with the lesser sac (bursa 

 omentalis), forming part of its anterior wall. The anterior surface of the stomach 

 is in relation with the greater sac of the peritoneal cavity. 



Minute anatomy. — The stomach is composed of the four typical layers of the alimentary 

 canal — mucosa, sul)mucosa, muscularis and serosa. The mucosa (figs. 907, 908, and 909) is 

 thrown into a series of coarse folds (pliciii mucosa)), chiefly longitudinal, which disappear when 

 the stomach is distended. Along the lesser curvature, the ridges are more regular (corre- 

 sponding to Waldeyer's 'Magenstrasse') and form a longitudinal grooved channel from cardia 

 to pylorus. Upon closer examination (fig. 909) the inner surface of the mucosa presents a 

 somewhat warty ('mainniilatod') appearance, due to numerous small elevated areas [areae 

 gastrica-], varying from 1 to G mm. in diameter. When examined with a lens, it is seen that 

 each area is be.set with numerous siriall jnls [fovcola; gastricsc], separated by partitions which 

 sometimes (especially in the pyloric region) bear villus-like prolongations [plicae villosa;]. 

 The average number of foveohe is estimated at 87 per sq. mm., or more than 6 millions for 

 the entire stomach (Toldt). Into each pit or foveola open 'S to 5 gastric glands. The entire 

 surface is covered with a simple columnar mucigenous e])ithelium. 



The relations of the muco.sa in section are shown in fig. 910. The thickness of the mucosa 

 varies, being greatest (about 2 mm.) in the pyloric region, decreasing to less than .5 mm. in 

 the cardiac regir)n (K(illiker). The Imnmd propria is crowded with glands, of which three 

 varieties an; distinguished. 'J'he rdnlioc glands an^ tubulo-racemose (chiefly mucous) glands 

 occupying a narrow zone a few milliinet''rs in width adjacent to the cardiac orifice. The 

 fundic ghmds [gl. gastrica- ])ropria'] occupy the greater part of the stomach, and ar£ simple 

 (partly branched) tubuhir glands (fig. 910). They contain three varieties of cells — mucous 

 cells, peptic cells, anfl parietal cells. The parietal cells may secrete an organic chloride com- 

 pound, but the IICl of the gastric juice is formed not in the gland tubules but at the surface of 



