Editing Stomach (section)

== '''Nerve supply''' ==

* Parasympathetic: vagus nerve
** '''Vagal nerve''' - originates in the vagal      nuclei in the floor of the fourth ventricle; traverses the neck in the      carotid sheath; enters the mediastinum; divides into several branches      around the oesophagus; these branches coalesce above the oesophageal      hiatus to form the left and right vagus nerves
** '''Anterior      vagal trunk'''      (left vagal fibres) comes down through the oesophageal hiatus, in contact      with anterior oesophageal wall, most commonly as a single trunk but      sometimes as 2-3. Anteriorly at the hiatus, but can be seen slightly to      the right below the hiatus. Divides into two branches shortly distal to      the hiatus: the larger branch is the greater anterior gastric nerve      (anterior nerve of Latarjet); and smaller branch is the hepatic nerve.      Anterior nerve of Latarjet runs down in the lesser omentum with the left      gastric artery, parallel to lesser curvature but 1cm away, giving off      2-12 branches to the anterior gastric wall and terminating at a variable      point on the antrum, but in 5% reaching as far as the pylorus. Hepatic      nerve can be double or triple, and passes in the lesser omentum to the      hilum of the liver, giving off a branch to the left of the hepatic      artery, supplying pylorus and D1.
*** If in doubt about location       of the anterior trunk, it can often be felt as a taught bowstring with       the oesophagus on tension
*** Anterior nerve of Latarjet       can sometimes be absent, with all branches coming from hepatic division
** '''Posterior      vagal trunk'''      (right vagal fibres) lies in loose tissue a little separated from the      posterior wall of the oesophagus, usually a little to the right. Divides      into two divisions: coeliac division and posterior gastric      nerve/posterior nerve of Latarjet. Coeliac division runs back along left      gastric artery to the coeliac plexus. Posterior nerve of Latarjet      parallels the anterior nerve but supplies fewer fibres to the antrum, and      none to pylorus. The first branch of posterior stomach is referred to as      the criminal branch of Grassi. Can sometimes give branch to hepatic      nerve.
** The posterior trunk is      usually larger, but not always. There is usually one large nerve and one      small one.
**
* Sympathetic:
** Originates at T5-T10
** Travels in splanchnic nerve      to coeliac plexus
** Postganglionic fibres travel      with the arterial system to the stomach
* Auerbach autonomic plexus is     found in the muscularis propria throughout
* Meissner autonomic plexus is     found in the submucosa
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