A. Changes in the Position of the Stomach.
The primitive position of the organ above outlined ([p. 41]) is changed during the course of further development by a twofold rotation.
1. The primitive vertical position, in which the œsophageal entrance occupies the highest cephalic extremity, while the pyloric opening is at the opposite caudal end, is exchanged for one directed more transversely, approximating the two gastric orifices to the same horizontal level. In human embryos of 13.9 mm. the fundus has already descended, the pylorus moving cephalad and to the right, while the cardia becomes shifted more to the left. At the same time the greater growth and prominence of the convex border or greater curvature becomes marked in comparison with the relatively short extent of the opposite margin or lesser curvature.
Figs. 169, 170.—Two front views of the entodermal canal. (Minot,after His.) | ||
2. Coincident with this change in position is a rotation around the vertical axis, by means of which the original left side of the stomach is turned ventrad, becoming the ventral or “anterior” surface, while the original right surface of the organ now looks dorsad toward the vertebral column, becoming the dorsal or “posterior” surface of human anatomy. The œsophageal or cephalic end is placed to the left of the median line, while the caudal or pyloric end is situated on the right side (Figs. 169 and 170).
The original ventral border, now the “lesser curvature” or “upper border,” looks cephalad and to the right, toward the caudal surface of the liver, while the original dorsal border, as the “greater curvature” or “lower border” is directed in the main caudad and to the left.
The prominence of this border is still further increased by the greater development of the stomach to the left of the œsophageal entrance resulting in the formation of the “fundus” or “great cul-de-sac.”
This rotation of the stomach explains the asymmetrical position of the vagus nerve in the adult, the left side of the embryonic stomach, innervated by the left vagus, becoming the “anterior” surface of adult descriptive anatomy and vice versa.
It will be readily appreciated that a comparatively flat organ like the stomach, will, as long as it occupies a sagittal position, with right and left surfaces, help to divide the upper part of the abdominal cavity to a certain extent into a right and left half, even if the peritoneal connections of the organ are left out of consideration. As soon, however, as the above-described changes in position take place and the surfaces of the stomach are directed ventrad and dorsad, the relative arrangement and extent of this right and left abdominal space becomes altered by the different disposition of the septum, i. e., the stomach. The original right side of the organ is now directed dorsad, and the rotation of the organ has created a space between this dorsal or “posterior” surface of the stomach and the background of the abdominal cavity, which is the inception of the “lesser peritoneal cavity” or retrogastric space. We will find that this space becomes well defined and circumscribed by the peritoneal connections of the stomach, but we will realize, even at this stage, that the dorsal surface of the stomach will form a part of the general ventral wall of the lesser peritoneal space.
On the other hand, the partial division of the abdomen into a right and left half, effected by the stomach in its primitive sagittal position, disappears after rotation of the organ. We now pass uninterruptedly from left to right across the ventral (original left) surface of the stomach.