1: Anatomy - Jaundice 1 Flashcards
(88 cards)
1
Q
What is jaundice?
A
Yellowing of the sclera and skin
2
Q
What causes jaundice?
A
Increase in blood concentration of bilirubin
3
Q
What is a byproduct of red blood cell breakdown in the spleen?
A
Bilirubin
4
Q
Where does red blood cell breakdown occur?
A
Spleen
5
Q
What is bilirubin used to form in the liver?
A
Bile
6
Q
Bilirubin is a major component of ___.
A
bile
7
Q
What is the biliary tree?
A
Liver, gall bladder and the ducts connecting them to the duodenum
8
Q
What does the gall bladder do?
A
Stores and concentrates bile
(This question comes up in the anatomy spot and you need to quote it verbatim to get the mark)
9
Q
Bile is important in the absorption of (carbohydrate / protein / fat).
A
fat
10
Q
Which organ excretes digestive enzymes into the duodenum?
A
Pancreas
11
Q
The pancreas excretes digestive ___ into the duodenum.
A
enzymes
12
Q
Which organ is the largest in the body?
A
Liver
13
Q
The liver receives nutrients absorbed from the __ tract.
A
GI
14
Q
Which energy storage molecule is held in the liver?
A
Glycogen
15
Q
The liver is involved in the secretion of ___ into the duodenum.
A
bile
16
Q
The ___ secretes ___ into the duodenum.
The ___ secretes ___ ___ into the duodenum.
(digestive enzymes , liver , pancreas , bile)
A
liver, bile
pancreas, digestive enzymes
17
Q
In which quadrant is the liver found?
A
Right upper quadrant
18
Q
Which ribs protect the liver?
A
Ribs 7-11
1 true rib, 3 false ribs and 1 floating rib
19
Q
The liver moves inferiorly during ___.
A
inspiration
20
Q
The liver moves superiorly during ___.
A
expiration
21
Q
Where is the liver in relation to the gall bladder?
A
Anterior and superior
22
Q
What is the hepatic flexure?
A
Sharp bend between:
ascending colon
transverse colon
23
Q
Where is the liver in relation to the hepatic flexure?
A
Superior
24
Q
Where is the liver in relation to the right kidney, right adrenal gland, inferior vena cava and abdominal aorta?
A
Anterior
25
How many **anatomical lobes** (i.e those visible to the naked eye) does the **liver** have?
4
26
What are the **four anatomical lobes** of the liver?
**Right lobe**
**Left lobe**
**Caudate lobe**
**Quadrate lobe**
27
Why is the **caudate lobe** named like that?
**Looks like a tail**
NOT inferior (caudal) as name suggests
28
The **caudate lobe** is found at the **(superior / inferior)** aspect of the **(anterior / posterior)** surface of the liver.
**superior**
**posterior**
29
The **quadrate lobe** is found at the **(superior / inferior)** aspect of the **(anterior / posterior)** surface of the liver.
**inferior**
**posterior**
30
Which **ligament** joins the **right** and **left lobes** of the liver?
**Falciform ligament**
31
Which ligament is found at the **inferior** aspect of the **anterior** surface of the liver?
**Round ligament / Ligamentum teres**
32
The **round ligament of the liver** is a remnant of which embryological **structure**?
**Umbilical vein**
33
What is found in the **porta hepatis**?
Everything except the **hepatic** **veins** draining deoxygenated blood from the liver, so the **portal triad** structures:
**right and left hepatic ducts** (for bile)
**right and left hepatic arteries** (oxygenated blood supply)
**hepatic portal vein** (from the portal system of the intestines, bringing absorbed stuff)
34
The **porta hepatis** carries the structures found within the omental foramen - the ___ \_\_\_ structures.
**portal triad**
35
What is the **bare area** of the liver?
Area with **no peritoneal covering**
36
What covers the **bare area** of the liver?
**Right hemi-diaphragm**
NOT peritoneum
37
How many **functional lobes** does the liver have?
**8**
38
The **functional lobes** of the liver are named in a **(clockwise / anticlockwise)** fashion.
**clockwise**
39
What name is given to the procedure which removes a **functional lobe** of the liver?
**Segmentectomy**
or lobectomy, doesn't really matter
40
What **vessels** are found in each segment of liver?
Branch of **hepatic artery**
Branch of **hepatic portal vein**
**Bile drainage** to bile duct
**Venous drainage** to IVC
41
Why does an **increase** in central venous pressure damage the liver?
**IVC** and **hepatic veins** have **NO VALVES**
42
The **hepatic veins** draining deoxygenated blood from the **functional lobes** come together to form ___ veins which then enter the __ \_\_ \_\_.
**three**
**inferior vena cava**
43
What imaging method can be used to visualise the **three hepatic veins** entering the **inferior vena cava**?
**Ultrasound**
44
What three vessels are found in the **portal triad**?
**Hepatic artery PROPER**
**Hepatic PORTAL vein**
**Bile duct**
45
Which **ligament** does the portal triad run within?
**Hepatoduodenal ligament**
46
The **coeliac** **trunk** is the first midline branch of the \_\_\_.
**abdominal aorta**
47
Is the **coeliac trunk** intraperitoneal or retroperitoneal?
**retroperitoneal**
48
At which **vertebral level** does the coeliac trunk leave the aorta?
**T12**
49
The **coeliac trunk** supplies the **(foregut / midgut / hindgut)**.
**foregut**
50
What are the **three branches** of the **trifurcation of the coeliac trunk?**
**Left gastric artery**
**Splenic artery**
**Common hepatic artery**
51
Which artery, part of the portal triad, branches from the common hepatic artery?
**Hepatic artery proper**
52
Which two arteries anastomose to supply the **lesser curvature** of the stomach?
**Right gastric artery**
**Left gastric artery**
53
The course of the **splenic artery** is **(straight / torturous)**.
**torturous**
54
The **splenic artery** runs along the superior border of which organ?
**Pancreas**
55
The **splenic artery** runs along the **superior** aspect of the \_\_\_.
**pancreas**
56
In which abdominal **region** is the **spleen** found?
**Left hypochondrium**
57
Is the **spleen** intraperitoneal or retroperitoneal?
**Intraperitoneal**
58
Which bend in the large intestine is the **spleen** superior to?
Which aspects of the large intestine are connected by this bend?
**Splenic flexure**
**Transverse** **colon** to **descending colon**
59
Which ribs protect the **spleen**?
**Ribs 9-11**
2 false ribs, 1 floating rib
60
The **spleen** breaks down red blood cells to produce \_\_\_.
**bilirubin**
61
Why may a rib fracture in the **left hypochondrium** cause **massive** internal bleeding?
**Punctured** **spleen**
62
Apart from the liver, which other organ moves with the diaphragm during inspiration and expiration?
**Spleen**
63
Which arteries supply the **liver**?
Which artery do these arteries originally branch from?
**Right** and **left hepatic arteries**
## Footnote
**Hepatic artery proper**
64
The right and left **hepatic arteries** account for the **(majority / minority)** of hepatic blood supply.
**minority**
65
Which structure accounts for most of the liver's blood supply?
**Hepatic portal vein**
66
The liver has a **dual blood supply** - which structures are responsible?
**Hepatic portal vein** (from the portal system carrying nutrients from the intestines)
**Right** and **left hepatic arteries** - branches of the hepatic artery proper, which carries blood from the coeliac trunk, which is a branch of the aorta
67
What are the two recesses you stuck your hand in during the first dissections?
**Subphrenic recess**
**Hepatorenal recess -** behind the liver, towards the kidneys
68
What can collect in the **recesses** of the abdominal cavity if a patient has **peritonitis**?
**Pus**
69
What is an **abscess**?
A painful build-up of **pus** in the tissue
70
Which abdominal recess will fluid drain into if a patient lies supine?
**Hepatorenal recess**
71
The **hepatic portal vein** drains blood from which collections of abdominal organs?
**Foregut**
**Midgut**
**Hindgut**
i.e all of them
72
What happens to blood in the liver?
**First pass metabolism**
"cleaned"
73
Which **vein** drains the **foregut**?
**Splenic vein**
74
Which **vein** drains the midgut?
**Superior mesenteric vein**
75
Which vein drains the hindgut?
Which vein does it then merge with?
**INFERIOR mesenteric vein**
Drains into the **splenic vein**
76
Which two veins form the **hepatic portal vein**?
**Splenic vein** (which the **inferior mesenteric vein** has already drained into)
## Footnote
**Superior mesenteric vein**
77
Which vein drains blood from the **hepatic veins** into the **right atrium**?
**Inferior vena cava**
78
The **gall bladder** lies on the **(anterior / posterior)** aspect of the liver.
**posterior**
79
The **gall bladder** lies **(anterior / posterior)** to the duodenum.
**anterior**
80
What can become stuck in the gall bladder?
**Gallstones**
81
How does **bile** flow in and out of the **gall bladder**?
**Cystic duct**
82
Which artery supplies the **gall bladder**?
In most people, this artery is a branch of the **right** ___ artery.
**cystic artery**
**right hepatic artery**
83
In which "triangle" can the cystic artery and cystic duct be found?
**Triangle of Calot**
84
What can cause **inflammation** of the gall bladder?
**Gallstones**
85
Given that the **gall bladder** is a **foregut** organ, in which region of the abdomen does gall bladder pain present?
**Epigastric region**
also the hypochondrium
86
Where is pain associated with **gallbladder inflammation** **referred**?
**Right shoulder / neck**
87
Why does gall bladder pain sometimes refer to the **right shoulder** and **neck**?
If the **diaphragm** is irritated by the **gall bladder**, refers to the diaphraghm spinal nerves C345, dermatomes for C345 are found in the right shoulder / neck
88
What is a **cholecystectomy**?
**Removal of the gallbladder**
