Cardia 196802 223632074 2008-07-05T00:03:46Z Arcadian 104523 /* References */ ref format {{Infobox Anatomy | Name = Cardia | Latin = | GraySubject = 247 | GrayPage = 1162 | Image = Illu stomach.jpg | Caption = '''Diagram from [http://training.seer.cancer.gov/ss_module07_ugi/unit02_sec02_anatomy.html cancer.gov]:<BR>'''* 1. [[Body of stomach]]<BR>* 2. [[Fundus (stomach)|Fundus]]<BR>* 3. [[Anterior wall]]<BR>* 4. [[Greater curvature]]<BR>* 5. [[Lesser curvature]]<BR>* 6. Cardia<BR>* 9. [[Pyloric sphincter]]<BR>* 10. [[Pyloric antrum]]<BR>* 11. [[Pyloric canal]]<BR>* 12. [[Angular notch]]<BR>* 13. [[Gastric canal]]<BR>* 14. [[Rugal folds]] | Image2 = Gray1046.svg | Caption2 = Diagram of the stomach, showing its anatomical landmarks ("Antrum cardiacum" marks the opening of the cardia). | Precursor = | System = | Artery = | Vein = | Nerve = | Lymph = | MeshName = | MeshNumber = | DorlandsPre = c_10 | DorlandsSuf = 12214493 | }} :''This article is about the cardia in the human body. For the city in Greece, see [[Cardia (Thrace)]].'' The '''cardia''' (also known as '''Z-line''' or '''esophagogastric junction'''<ref>{{eMedicineDictionary|esophagogastric+junction}}</ref><ref>{{Dorlands|j_02|12465956}}</ref> or '''gastroesophageal junction'''<ref>{{LoyolaMedEd|Radio/curriculum/GI/Image105b.jpg}}</ref><ref>[http://cellbio.utmb.edu/microanatomy/digestive/Esophagus.htm Lab Exercises- Esophagus<!-- Bot generated title -->]</ref><ref>[http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_esophagus_cancer_12.asp?sitearea=cri ACS :: What Is Cancer of the Esophagus?<!-- Bot generated title -->]</ref><ref>[http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=302458 Definition of gastroesophageal junction - NCI Dictionary of Cancer Terms<!-- Bot generated title -->]</ref>) is the [[anatomy|anatomical]] term for the junction orifice of the [[stomach]] and the [[esophagus]]. At the cardia, the [[mucosa]] of the esophagus transitions into [[gastric mucosa]]. The cardia is also the site of the '''lower esophageal sphincter (LES)'''<ref>[http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ=1&disease=13&lang_id=1 Digestive Disease Library<!-- Bot generated title -->]</ref><ref>[http://www.physio.unr.edu/ICC/gallery/LES-1.htm Department of Physiology and Cell Biology<!-- Bot generated title -->]</ref><ref>{{eMedicine|med|2965}}</ref> (also termed '''cardiac sphincter'''<ref>{{eMedicineDictionary|cardiac+sphincter}}</ref>, '''gastroesophageal sphincter'''<ref>{{Dorlands|s_18|12748540}}</ref>, and '''esophageal sphincter'''<ref>[http://www.mcg.edu/Otolaryngology/patientGERD.htm Patient Handout: Gastroesophageal Reflux Disease (GERD)<!-- Bot generated title -->]</ref>). ==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<ref>{{Dorlands|c_10|12214493}}</ref><ref>{{SUNYAnatomyLabs|37|06|01|03}} - "Abdominal Cavity: The Stomach"</ref>, describe the cardia as the first of 4 regions of the stomach. This makes sense [[Histology|histologically]] because the mucosa of the cardia is the same as that of the stomach. Many recent writings describe it as the esophageal sphincter. ==Function== The stomach generates strong [[acid]]s and [[enzyme]]s 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 esophageal sphincter (ES), and prevents gastric juice from flowing back into the esophagus. During [[peristalsis]], the ES allows the food [[Bolus (digestion)|bolus]] to pass into the stomach. It prevents [[chyme]], a mixture of bolus, [[stomach acid]], and [[digestive enzyme]]s, from returning up the esophagus. The ES is aided in the task of keeping the flow of materials in one direction by the [[diaphragm (anatomy)|diaphragm]]. [[Image:Gastro-esophageal jxn.JPG|thumb|Microscopic shot of a cross section of human gastro-esophageal junction wall.]] ==Histology== On histological examination, the junction can be identified by the following transition:<ref>{{BUHistology|11101loa}}</ref><ref>{{BUHistology|11111ooa}}</ref> * 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. 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 glands|tubular]]. ==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. ==Removal== <!-- Cardiectomy redirects here--> Surgical removal of this area is a called a [[cardiectomy]] a term that is also used to describe removal of the [[Heart]]. <ref>[http://dictionary.reference.com/browse/cardiectomy cardiectomy] at dictionary.reference.com</ref><ref Name="BARLOW">{{cite web | last =O. W. BARLOW | title =THE SURVIVAL OF THE CIRCULATION IN THE FROG WEB AFTER CARDIECTOMY | work = | publisher =Journal of Pharmacology And Experimental Therapeutics, Vol. 35, Issue 1, 17-24, 1929 | date = | url =http://jpet.aspetjournals.org/cgi/content/abstract/35/1/17 | format =web | accessdate = Feburuary 24, 2008 }}</ref><ref Name="MELTZER">{{cite book | last =S.J. MELTZER | title =THE EFFECT OF STRYCHNIN IN CARDIECTOMIZED FROGS WITH DESTROYED LYMPH HEARTS | publisher =American Journal of Physiology | date =1913 | location = | pages =Page xix | url =http://books.google.com/books?id=pnsZI2vxfH8C&pg=RA1-PR19&dq=Cardiectomy&as_brr=1 | doi = | id = }}</ref> ==Etymology== The word comes from the [[Greek language|Greek]] ''kardia'' meaning ''heart'', the cardiac orifice of the stomach. == See also == * [[Artificial organ|Artificial cardia]], that can be used to fight, between other diseases, [[esophageal cancer]], [[achalasia]] and [[gastroesophageal reflux disease]]. ==Additional images== <gallery> Image:Gray1050.png Image:Gray1053.png|Section of mucous membrane of human stomach, near the cardiac orifice. X 45. </gallery> ==References== {{reflist|2}} {{Digestive tract}} [[Category:Abdomen]] [[Category:Digestive system]] [[de:Cardia]] [[et:Maolävis]] [[fr:Cardia (anatomie)]] [[it:Cardias]] [[la:Cardia]] [[pl:Dolny zwieracz przełyku]] [[pt:Cárdia]] [[ru:Нижний пищеводный сфинктер]] [[sv:Övre magmunnen]] [[zh:贲门]]