Cardia
Diagram from cancer.gov: * 1. Body of stomach * 2. Fundus * 3. Anterior wall * 4. Greater curvature * 5. Lesser curvature * 6. Cardia * 9. Pyloric sphincter * 10. Pyloric antrum * 11. Pyloric canal * 12. Angular notch * 13. Gastric canal * 14. Rugal folds
Diagram of the stomach, showing its anatomical landmarks ("Antrum cardiacum" marks the opening of the cardia).
Gray's	subject #247 1162
Dorlands/Elsevier	c_10/12214493

This article is about the cardia in the human body. For the city in Greece, see Cardia (Thrace).

The cardia (or esophagogastric junction^[1][2] or gastroesophageal junction^[3][4][5][6]) is the anatomical term for the junction orifice of the stomach and the esophagus. At the cardia, the mucosa of the esophagus transitions into gastric mucosa. Image File history File linksMetadata Illu_stomach. ... A plane passing through the incisura angularis on the lesser curvature and the left limit of the opposed dilatation on the greater curvature divides the stomach into a left portion or body and a right or pyloric portion. ... The left portion of the body of the stomach is known as the fundus, and is marked off from the remainder of the body by a plane passing horizontally through the cardiac orifice. ... The greater curvature of the stomach is directed mainly forward, and is four or five times as long as the lesser curvature. ... The lesser curvature of the stomach, extending between the cardiac and pyloric orifices, forms the right or posterior border of the stomach. ... From Greek pylorus; pyl- = gate, -orus = guard. ... Pyloric antrum is initial portion of the pyloric part of the stomach, which may temporarily become partially or completely shut off from the remainder of the stomach during digestion by peristaltic contraction of the prepyloric sphincter; it is demarcated, sometimes, from the second part of the pyloric part of the... The pyloric canal, also known as the canalis pyloricus, is the opening between the stomach and the small intestine [1]. Pylorus University of Illinois Medical Center at Chicago Health Library Category: ... Nearer the pyloric end of the stomach than its cardiac end is a well-marked notch, the angular incisure (or notch), which varies somewhat in position with the state of distension of the viscus. ... Nearer the pyloric end of the stomach than its cardiac end is a well-marked notch, the angular incisure (or notch), which varies somewhat in position with the state of distension of the viscus. ... Rugae are the mucus-covered ridges, or folds, located on the inside of the stomach wall. ... Image File history File links Gray1046. ... Elseviers logo. ... Cardia (in Greek Kαρδια), anciently the chief town of the Thracian Chersonese (today Gallipoli peninsula), was situated at the head of the gulf of Melas (today Saros bay). ... Human heart and lungs, from an older edition of Grays Anatomy. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... The esophagus (also spelled oesophagus/œsophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ... The gastric mucosa the mucous membrane layer of the stomach which contains the glands and the gastric pits. ...

The cardia is also the site of the lower esophageal sphincter (LES)^[7][8][9] (also termed cardiac sphincter^[10], gastroesophageal sphincter^[11], and esophageal sphincter^[12]).

Nomenclature and classification

There is disagreement in the academic anatomy community over whether the cardia is part of the stomach, part of the esophagus or a distinct entity, as described in this article. The difference is more than semantic when used in clinical studies and applied to individual patients.

Classical anatomy textbooks, and some other resources^[13][14], describe the cardia as the first of 4 regions of the stomach. This makes sense histologically because the mucosa of the cardia is the same as that of the stomach. Human heart and lungs, from an older edition of Grays Anatomy. ... A thin section of lung tissue stained with hematoxylin and eosin. ...

Many recent writings describe it as the LES.

Function

The stomach generates strong acids and enzymes to aid in food digestion. This digestive mixture is called gastric juice. The inner lining of the stomach has several mechanisms to resist the effect of gastric juice on itself, but the mucosa of the esophagus does not. The esophagus is normally protected from these acids by a one-way valve mechanism at its junction with the stomach. This one-way valve is called the lower esophageal sphincter (LES), and prevents gastric juice from flowing back into the esophagus. For other uses, see Acid (disambiguation). ... Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... For the industrial process, see anaerobic digestion. ... Gastric juice is a strong acidic liquid, pH 1 to 3, which is close to being colourless. ...

During peristalsis, the LES allows the food bolus to pass into the stomach. It prevents chyme, a mixture of bolus, stomach acid, and digestive enzymes, from returning up the esophagus. The LES is aided in the task of keeping the flow of materials in one direction by the diaphragm. Peristalsis is the rhythmic contraction of smooth muscles to propel contents through the digestive tract. ... Look up bolus in Wiktionary, the free dictionary. ... Chyme, also known as Chymus is the liquid substance found in the stomach before passing through the pyloric valve and entering the duodenum. ... Gastric acid is the main secretion of the stomach, characterised by H2O, hydrochloric acid and several enzymes (mainly pepsinogen). ... Digestive enzymes are enzymes in the alimentary tract that break down food so that the organism can absorb it. ... In the anatomy of mammals, the diaphragm is a shelf of muscle extending across the bottom of the ribcage. ...

Microscopic shot of a cross section of human gastro-esophageal junction wall.

Image File history File linksMetadata Size of this preview: 800 × 600 pixel Image in higher resolution (2816 × 2112 pixel, file size: 2. ... Image File history File linksMetadata Size of this preview: 800 × 600 pixel Image in higher resolution (2816 × 2112 pixel, file size: 2. ...

Histology

On histological examination, the junction can be identified by the following transition:^[15][16]

• nonkeratinized stratified squamous epithelium in the esophagus
• simple columnar epithelium in the stomach

However, in Barrett's esophagus, the epithelial distinction may vary, so the histological border may not be identical with the functional border. H&E stain of biopsy of normal esophagus showing the stratified squamous cell epithelium Section of the human esophagus. ... The esophagus (also spelled oesophagus/Å“sophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... The simple columnar epithelium is made up of one layer of cells that are relatively thick and protective of the underlying tissues due to its elongated shape. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Barretts esophagus (sometimes called Barretts syndrome, CELLO, columnar epithelium lined lower (o)esophagus or colloquially as Barretts) refers to an abnormal change (metaplasia) in the cells of the lower end of the esophagus thought to be caused by damage from chronic acid exposure, or reflux esophagitis. ...

The cardiac glands can be seen in this region. They can be distinguished from other stomach glands (fundic glands and pyloric glands) because the glands are shallow and simple tubular. The cardiac glands of the stomach are few in number and occur close to the cardiac orifice where the esophagus joins the stomach. ... The fundus glands (or fundic glands) are found in the body and fundus of the stomach; they are simple tubes, two or more of which open into a single duct. ... The pyloric glands are found in the pyloric portion of the stomach. ... If a gland retains its shape as a tube throughout it is termed a tubular gland. ...

Pathology

Deficiencies in the strength or the efficiency of the LES lead to various medical problems involving acid damage on the esophagus.

In achalasia, one of the defects is failure of the LES to relax properly. Achalasia, also known as esophageal achalasia, achalasia cardiae, cardiospasm, dyssynergia esophagus, and esophageal aperistalsis, is an esophageal motility disorder. ...

Etymology

The word comes from the Greek kardia meaning heart, the cardiac orifice of the stomach.

Additional images

Section of mucous membrane of human stomach, near the cardiac orifice. X 45. Image File history File links Gray1050. ... Image File history File links Gray1053. ...

References

1. ^ esophagogastric+junction at eMedicine Dictionary
2. ^ j_02/12465956 at Dorland's Medical Dictionary
3. ^ MedEd at Loyola Radio/curriculum/GI/Image105b.jpg
4. ^ http://cellbio.utmb.edu/microanatomy/digestive/Esophagus.htm
5. ^ http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_esophagus_cancer_12.asp?sitearea=cri
6. ^ http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=302458
7. ^ http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ=1&disease=13&lang_id=1
8. ^ http://www.physio.unr.edu/ICC/gallery/LES-1.htm
9. ^ med/2965 at eMedicine
10. ^ cardiac+sphincter at eMedicine Dictionary
11. ^ s_18/12748540 at Dorland's Medical Dictionary
12. ^ http://www.mcg.edu/Otolaryngology/patientGERD.htm
13. ^ c_10/12214493 at Dorland's Medical Dictionary
14. ^ SUNY Labs 37:06-0103 - "Abdominal Cavity: The Stomach"
15. ^ Histology at BU 11101loa
16. ^ Histology at BU 11111ooa