Which one of the following structure is NOT present in the stomach bed?

NIA - 29 January 2023

Applied Anatomy

Easy

Appeared in: NIA - 29 January 2023

Explanation

The stomach bed consists of structures located directly posterior to the stomach.
The Hepatic flexure, also known as the right colic flexure, is the sharp bend between the ascending and transverse colon.
It is located in the upper right quadrant of the abdomen, near the liver ('hepatic' refers to the liver), and is therefore not posterior to the stomach, which is primarily in the upper left quadrant.

Option B: The left suprarenal (adrenal) gland lies on top of the left kidney, which is directly posterior to the stomach, making it a component of the stomach bed.
Option C: The splenic flexure of the colon (or left colic flexure) is the bend in the colon near the spleen. It is situated posterior and inferior to the stomach, forming part of the stomach bed.
Option D: The body and tail of the pancreas run horizontally across the posterior abdominal wall, directly behind the stomach. It is a major structure of the stomach bed.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Anatomical relations of the stomach, specifically the structures forming the stomach bed as background academic context rather than a clinical decision trigger.
Understanding the stomach bed is vital for diagnosing complications of posterior gastric ulcers. Perforation can lead to peritonitis or erosion into adjacent organs.
If an ulcer erodes into the pancreas, it causes intense back pain. If it erodes the splenic artery, it can cause life-threatening intraperitoneal hemorrhage.
What if? If a patient with a known gastric ulcer presents with sudden, severe epigastric pain radiating to the back and signs of shock (hypotension, tachycardia), the nurse should suspect perforation into the stomach bed with possible splenic artery involvement and immediately notify the physician, as this is a surgical emergency.

How to Approach the Question

First, identify the core of the question: you need to find the structure that is NOT part of the stomach bed.
Recall the anatomical location of the stomach: it's in the upper left quadrant of the abdomen.
The 'stomach bed' refers to the structures lying immediately posterior to it.
Analyze the options based on their anatomical location. 'Hepatic' refers to the liver, which is on the right side. The hepatic flexure is the bend in the colon near the liver.
Contrast this with the other options: the left suprarenal gland, splenic flexure, and pancreas are all located in the upper left abdomen, posterior to the stomach.
Conclude that the right-sided structure (hepatic flexure) cannot be part of the bed of the left-sided stomach.

Concept Tested & Keywords

Concept Tested: Anatomical relations of the stomach, specifically the structures forming the stomach bed.
Stem keywords: stomach bed, structure, present
Lead-in keywords: NOT
Negative lead-in flag: Question asks for the exception

QYwEkJRRAiKLLFFF5HPzzo

E6 Anatomy BDChaurasia V2 10e Part 2 p. 25-27