07-06 GIT Gx Liver & Hepatobiliary Flashcards Preview

ANATOMY > 07-06 GIT Gx Liver & Hepatobiliary > Flashcards

Flashcards in 07-06 GIT Gx Liver & Hepatobiliary Deck (81)
1

The Cantlie’s line is an oblique plane extending from the ___ to the ___

center of the gallbladder bed to the the inferior vena cava

2

The right hemiliver comprises segments

5, 6, 7, 8

3

The left medial section is Couinaud’s segment

4

4

The superior border of Calot’s triangle is formed by the

inferior surface of the liver

5

Liver receives 75% of blood flow from the

portal vein

6

location of the liver

It lies in the RUQ of the abdomen (~7-11th rib)

7

true or false. Easily palpable at the subcostal margin in normal individuals

false

8

weight of the liver

around 1200 – 1800gms in a normal individual

9

Majority of the blood from the small and large intestines is transmitted to the liver thru the

portal vein

10

it is a potential space above and anterior the diaphragmatic surface of the liver

Sub-phrenic recess of the liver

11

Sub-phrenic recess of the liver is divided into Left and Right recesses by the

falciform ligament

12

it is a “dependent area” in the abdomen where one would look for free intraperitoneal fluid

Sub-phrenic recess of the liver

13

true or false. sub-phrenic recess of the liver is the area where “pneumoperitoneum” in Upright chest x-rays is most evident

false

14

it is the potential space between the liver and right kidney

Morison pouch

15

Morison pouch contains the “Bare area” of the liver. true or false

true

16

Morison pouch. Free blood in the peritoneal cavity is usually evident in this area on ultrasound or CT scan. true or fase

true

17

Morison pouch is lined/surrounded by peritoneum

false

18

Boundaries of the “Bare Area” of the liver, EXCEPT: A. Coronary ligaments
B. Left triangular ligament
C. Falciform ligament
D. Right triangular ligament

C. Falciform ligament

19

Portal Hepatis contains

bile duct,
hepatic artery,
hepatic portal vein

20

The portal vein is usually formed by the union of:

Superior mesenteric vein & Splenic vein

21

Which of the following is NOT TRUE about the hepatic veins:
A. Funnels blood from the central veins of the liver into the inferior vena cava B. there are 3x: Right, Middle and Left
C. They are intersegmental, draining the segments adjacent to each
D. Lies in the porta hepatis

all are true

22

The Right sagittal fissure of the liver is formed by:

Gallbladder & Inferior vena cava

23

Calot's Triangle is important because it is the usual location of:

Cystic artery

24

The valves of Heister are mucosal folds in the

cystic duct

25

The cystic artery usually arises from the

right hepatic artery

26

The Ligamentum venosum

is the remnant of the ductus venosus which shunts blood into the inferior vena cava

27

Which of the following statements is NOT TRUE about the Functional Lobes of the liver?
A. There are 8 functional segments of the liver
B. These segments are not well demarcated from each other
C. Each segment has its own supply from the portal vein and hepatic artery
D. Each segment is drained by individual hepatic ducts and veins

D. Each segment is drained by individual hepatic ducts and veins

28

A "Left lateral segmentectomy" of the liver entails the removal of which functional lobes:

2 & 3

29

Which of the following is NOT TRUE about the Caudate lobe:
A. it is also known as the Quadrate lobe
B. it receives its own blood supply from the hepatic artery and portal vein
C. it is often drained by its own hepatic veins which drain directly into the inferior vena cava
D. Corresponds to segment 1 of the functional divisions of the liver

A. it is also known as the Quadrate lobe

30

the liver is covered by peritoneum EXCEPT in this surface

posterior

31

the liver is anatomically divided into right and left lobes by the

falciform ligament

32

the liver is functionally or surgically divided into right and left lobes by the

Cantlie's line

33

each liver segment is individually supplied and drained by the ff structures EXCEPT:
a) portal vein
b) hepatic vein
c) segmental brances of the hepatic artery
d) tributaries of the bile duct

b) hepatic vein

34

bare area of the liver

diaphragmatic surface

35

Morison pouch is aka

Hepatorenal recess

36

superior extensions of the peritoneal cavity (greater sac); exist between diaphragm and the anterior and superior aspects of the diaphragmatic surface of the liver

subphrenic recesses

37

subphrenic recesses is separated into right and left recesses by the

falciform ligament

38

fluid draining from the omental bursa flows into recess

hepatorenal recess (Morison pouch)

39

visceral surface of the liver is also covered with visceral peritoneum EXCEPT

fossa for gallbladder and
porta hepatis

40

a transverse fissure that contains the portal triad

porta hepatis

41

continuous groove formed anteriorly by the fissurefor the round ligament and posteriorly by the fissure for the ligamentum venosum

umbilical (left sagittal) fissure

42

fibrous remnant of the "umbilical vein", which carried well-oxygenated and nutrient-rich blood from the placenta to the fetus

round ligament of the liver (L. ligamentum teres hepatis)

43

fibrous remnant of the fetal "ductus venosus", which shunted blood from the umbilical vein to the IVC, short-circuiting the liver

ligamentum venosum

44

which functional lobe is segment I

caudate lobe

45

the left and right livers are subdivided into medial and lateral divisions by ___

right portal and umbilical fissures

46

a "transverse hepatic plane" at the level of the horizontal parts of the right and left branches of the portal triad subdivides 3 of the 4 (all but the _____), creating six hepatic segments, each receiving tertiary branches of the triad

left medial division

47

hepatic artery, branch of the ___, may be divided into ___

celiac trunk;

common hepatic artery and hepatic artery proper

48

common hepatic duct is joined by the ___ to form the bile duct

cystic duct

49

circular muscle around the distal end of the bile duct is thickened to form the

sphincter of the bile duct (L. ductus choledochus)

50

blood supply of the proximal part of the bile duct

cystic artery

51

blood supply of the middle part of the bile duct

right hepatic artery

52

blood supply of the retroduodenal part of the bile duct

posterior superior pancreaticoduodenal artery and
gastroduodenal artery

53

venous drainage from the proximal part of the bile duct and hepatic ducts

usually enter the liver directly

54

venous drainage from the distal part of the bile duct

posterior superior pancreaticoduodenal vein >>> which empties into hepatic portal vein or one of its tributaries

55

lymphatic vessels from the bile duct passes to the

cystic lymph nodes (near the neck of the gallbladder) >>> lymph nodes of the omental fissure >> hepatic lymph node of the omental foramen >>> hepatic lymph nodes

efferent lymphatic vessels from the bile duct passes to the celiac lymph nodes

56

storage area which can hold up to 50mL bile

gallbladder

57

3 parts of the gallbladder

fundus, body, neck

58

main portion of the gallbladder that contacts the visceral surface of the liver, transverse colon, and superior part of the duodenum

body of gallbladder

59

part of gallbladder where stones are usually stuck

neck of the gallbladder

60

connects the neck of the gallbladder to the common hepatic duct

cystic duct

61

connects with the common hepatic duct to form the bile duct

cystic duct (has anatomical variants)

62

blood supply of the gallbladder

cystic artery

63

cystic artery commonly arises from the ____ in the triangle between the common hepatic duct, cystic duct, and visceral surface of the liver called ___

right hepatic artery;

cystohepatic triangle (of Calot)

64

venous drainage from the neck of the gallbladder and cystic duct

cystic veins

65

small and usually multiple veins that enter the liver directly or drain through the hepatic portal vein to the liver

cystic veins

66

veins from the fundus and body of the gallbladder

pass directly into the visceral surface of the liver and drain into the hepatic sinusoids

67

lymphatic drainage of the gallbladder

hepatic lymph nodes >> cystic lymph nodes

efferent lymphatic vessels from these nodes pass tot he celiac lymph nodes

68

sympathetic nerve supply of gallbladder and cystic duct

celiac (nerve) plexus

69

parasympathetic nerve supply of the gallbladder and cystic duct

vagus nerve

70

somatic afferent fibers of the gallbladder and cystic duct (nerve supply)

right phrenic nerve

71

innervation of the gallbladder and cystic duct

celiac (nerve) plexus,
vagus nerve,
right phrenic nerve

72

parasympathetic stimulation of nerves of gallbladder causes

contractions of the gallbladder and
relaxation of the sphincters at the hepatopancreatic ampulla

(stimulated by hormone cholecystokinin, CCK - produced by duodenal walls in response to arrival of fatty meal)

73

part of the gallbladder that may be palpated in the right border of the right rectus muscle and at the tip of the 9th costal cartilage

fundus

74

part of the hepatobiliary tree that run along the hepatoduodenal ligament

common bile duct

75

which part of the common bile duct lies behind the firs part of the duodenum

2nd

76

hepatocystic triangle is an important part of gall bladder surgery.. used to identify

cystic artery

77

inflammation of the subdiaphragmatic parietal peritoneum due to an acute cholecystitis may manifest as pain in the shoulder due to the irritation of

phrenic

78

obstruction of the portal circulation may lead to varicosities in the systemic circulation. The appearance of "caput medusa" is a manifestation of varicosity involving which collateral portal circulation?

paraumbilical

79

main channel of portal venous system

hepatic portal vein

80

hepatic portal vein is the union of

superior mesenteric and
splenic veins
+ inferior mesenteric vein (IMV) in 1/3 of individuals

81

in most people IMV enters the

splenic vein (60%) or the SMV (40%)