Classification of the ligamentous apparatus
The anatomical structures fixing the organ are divided into two main groups depending on their spatial arrangement:
- Superficial ligaments (located in the frontal plane) form a continuous ligamentous halo.
- Deep ligaments (lying in the horizontal plane) are exposed after dissecting the lig. gastrocolicum and displacing the stomach upwards.
Anatomy of the lesser curvature
In the region of the lesser curvature, the peritoneal cover splits into two layers that continue into the visceral peritoneum of both walls of the organ.
Features of the adipose tissue:
- The space along the lesser curvature is filled with adipose tissue.
- The anastomosing right and left gastric arteries, as well as the left gastric lymph nodes, run here.
- The volume of adipose tissue gradually decreases toward the porta hepatis.
Deep ligaments of the stomach
These structures are two peritoneal folds extending from the upper margin of the pancreas to the cardia and pylorus of the organ:
- Gastropancreatic ligament (lig. gastropancreaticum) — formed by the transition of the parietal peritoneum onto the posterior surface of the cardia and body of the stomach. It contains the left gastric vessels (a. et v. gastricae sinistra) and the celiac branch of the vagus nerve (n. vagus).
- Pyloropancreatic ligament (lig. pyloropancreaticum) — a triangular fold between the pylorus and the right part of the body of the pancreas, enclosing adipose tissue and lymph nodes.
Briefly: answers to topical questions
Which blood vessels run within the gastrocolic ligament?
The right and left gastroepiploic arteries run within the thickness of the gastrocolic ligament.
- Right gastroepiploic artery (a. gastroepiploica dextra) — runs from the right along the greater curvature.
- Left gastroepiploic artery (a. gastroepiploica sinistra) — runs from the left toward the right, anastomosing with it.
Which peritoneal ligaments form the lesser omentum?
The lesser omentum is formed by two peritoneal ligaments extending from the liver to the stomach and duodenum.
- Hepatogastric ligament (lig. hepatogastricum) — connects the inferior surface of the liver to the lesser curvature of the stomach, trapezoidal in shape.
- Hepatoduodenal ligament (lig. hepatoduodenale) — located between the porta hepatis and the superior wall of the duodenal bulb, representing the rightmost part of the lesser omentum.
Which lymph nodes are located along the greater curvature of the stomach?
Regional perigastric lymph nodes are located along the greater curvature of the stomach.
They serve as the first-tier collectors of lymph drainage, which is the primary site of lymphogenic metastasis in malignant neoplasms. Involvement of these nodes is clinically critical and is detected in more than half of patients with gastric cancer. Metastasis to these nodes can occur via both orthograde (along the lymph flow) and retrograde pathways.
Which branches of the vagus nerve approach the stomach, and in which ligaments do they run?
The anterior and posterior gastric branches of the vagus nerve, as well as the celiac branch, approach the stomach.
- Anterior trunk (truncus vagalis anterior) — originates from the left vagus nerve and is located on the anterior surface of the stomach.
- Posterior trunk (truncus vagalis posterior) — originates from the right vagus nerve and is located on the posterior surface of the stomach.
- Celiac branch of the vagus nerve runs within the deep gastropancreatic ligament (lig. gastropancreaticum).
Class and exam questions
What are the main groups of gastric ligaments?
In topographical anatomy, a distinction is made between superficial ligaments, located in the frontal plane and forming a ligamentous halo, and deep ligaments in the horizontal plane.
What is contained in the adipose tissue along the lesser curvature of the stomach?
The anastomosing left and right gastric arteries, as well as the left gastric lymph nodes, are located there.
Where are the deep ligaments of the stomach located?
They extend from the upper margin of the pancreas to the cardiac and pyloric parts of the stomach, becoming exposed after dissection of the gastrocolic ligament.
What structures does the gastropancreatic ligament contain?
It includes the left gastric vessels and the celiac branch of the vagus nerve.
What else to study on this topic
- Anatomical structure of the gastrocolic ligament (lig. gastrocolicum)
- Topography of the left and right gastric arteries
- Lymph drainage pathways and location of the left gastric lymph nodes
- Projection of the vagus nerve branches onto the posterior surface of the cardia
- Relationship of the stomach with the pancreas and porta hepatis
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