Henry Gray (18251861). Anatomy of the Human Body. 1918.
the base of the cone being continuous with the cardiac orifice of the stomach. The right margin of the esophagus is continuous with the lesser curvature of the stomach, while the left margin joins the greater curvature at an acute angle, termed the incisura cardiaca.
The pyloric orifice communicates with the duodenum, and its position is usually indicated on the surface of the stomach by a circular groove, the duodenopyloric constriction. This orifice lies to the right of the middle line at the level of the upper border of the first lumbar vertebra.
Curvatures.The lesser curvature (curvatura ventriculi minor), extending between the cardiac and pyloric orifices, forms the right or posterior border of the stomach. It descends as a continuation of the right margin of the esophagus in front of the fibers of the right crus of the diaphragm, and then, turning to the right, it crosses the first lumbar vertebra and ends at the pylorus. Nearer its pyloric than its cardiac end is a well-marked notch, the incisura angularis, which varies somewhat in position with the state of distension of the viscus; it serves to separate the stomach into a right and a left portion. The lesser curvature gives attachment to the two layers of the hepatogastric ligament, and between these two layers are the left gastric artery and the right gastric branch of the hepatic artery.
The greater curvature (curvatura ventriculi major) is directed mainly forward, and is four or five times as long as the lesser curvature. Starting from the cardiac orifice at the incisura cardiaca, it forms an arch backward, upward, and to the left; the highest point of the convexity is on a level with the sixth left costal cartilage. From this level it may be followed downward and forward, with a slight convexity to the left as low as the cartilage of the ninth rib; it then turns to the right, to the end of the pylorus. Directly opposite the incisura angularis of the lesser curvature the greater curvature presents a dilatation, which is the left extremity of the pyloric part; this dilatation is limited on the right by a slight groove, the sulcus intermedius, which is about 2.5 cm, from the duodenopyloric constriction. The portion between the sulcus intermedius and the duodenopyloric constriction is termed the pyloric antrum. At its commencement the greater curvature is covered by peritoneum continuous with that covering the front of the organ. The left part of the curvature gives attachment to the gastrolienal ligament, while to its anterior portion are attached the two layers of the greater omentum, separated from each other by the gastroepiploic vessels.
Surfaces.When the stomach is in the contracted condition, its surfaces are directed upward and downward respectively, but when the viscus is distended they are directed forward, and backward. They may therefore be described as anterosuperior and postero-inferior.
Antero-superior Surface.The left half of this surface is in contact with the diaphragm, which separates it from the base of the left lung, the pericardium, and the seventh, eighth, and ninth ribs, and intercostal spaces of the left side. The right half is in relation with the left and quadrate lobes of the liver and with the anterior abdominal wall. When the stomach is empty, the transverse colon may lie on the front part of this surface. The whole surface is covered by peritoneum.
The Postero-inferior Surface is in relation with the diaphragm, the spleen, the left suprarenal gland, the upper part of the front of the left kidney, the anterior surface of the pancreas, the left colic flexure, and the upper layer of the transverse mesocolon. These structures form a shallow bed, the stomach bed, on which the viscus rests. The transverse mesocolon separates the stomach from the duodenojejunal flexure and small intestine. The postero-inferior surface is covered by peritoneum, except over a small area close to the cardiac orifice; this area is limited by the lines of attachment of the gastrophrenic ligament, and lies in apposition with the diaphragm, and frequently with the upper portion of the left suprarenal gland.