Liver, Bile duct, & Gall bladder Flashcards

1
Q

the liver is?

A

a triangular shaped intraperitonal organ, which is covered by visceral peritoneum (except the bare area)

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2
Q

ligaments of the liver

A
  • flaciform ligament (liver connected with parietal surafce of abdominal wall)
  • hepatoduodenal ligament (liver connected with duodenum, starts from porta hepatis)
  • lesser omentuem (hepatoduodenal ligament + hepatograstric ligament)
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3
Q

surface’s of the liver

A

diaphgramatic surface (with anterior and superior surfaces), & visceral

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4
Q

what is morison’s pouch

A

a cavity between right part of visceral surface of liver and right kidney & it’s supra renal gland where fluid can accumulate

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5
Q

projection of the liver

A
  • medioclavicular line
  • medioinguinal line
  • middle line
  • *left edge of liver does not reach medioclavicular line, located on the 5th rib
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6
Q

the anterior diaphragmatic surface

A

divided sagitally by falciform ligament forming the right and left lobes of the liver

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7
Q

features of the superior diaphragmatic surface

A
  • IVC is visible
  • bare area
  • left coronary ligament
  • right coronary ligament
  • hepatorenal ligament
  • right triangular ligament
  • left triangular ligament
  • falciform ligament
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8
Q

what is the bare area? and where is it located?

A

the region on the liver where there is no visceral perioneum lining,(the liver attaching on the diaphragm),
-located between the right coronary ligament (ant) and hepatorenal ligament (post)

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9
Q

what is the termination of the left triangular ligament called?

A

in a fibrous band called fibrous appendix of liver

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10
Q

the visceral surface

A

extends diagonally from posterosuperior to anteroinferior

and subdivides by a set of H-shaped grooves

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11
Q
  • what does the porta hepatis form?
  • what is it surrounded by?
  • the structures it contains
A
  • it forms a cross bar of the H
  • surrounded by the hepatoduodenal ligament
  • bile duct (ant right),hepatic artery (ant, left), portal vein (middle post) (also nerves and lymphatic vessels)
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12
Q

what does the left saggital limb of H form?

A

formed by the fissure for the round ligament/ ligamentum teres (anteriorly) &; fissure of ligamentum venosum posteriorly (remenants of ductus venosum)

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13
Q

what does the right limb of H form?

A

fissure for the gall bladder anteriorly,& fissure for the IVC inferiorly

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14
Q

what does the left and right limb of H divide into

A
  • LEFT (right and left lobe)

- RIGHT (quadrate lobe anteriorly & caudate lobe posteriorly)

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15
Q

impressions & tuberosities in visceral surface of adjacent organs remember mnemonic (DOC RESpect God)

A
  • duodenal impression (right side)
  • omental tuberosity (left side)
  • colic impression (right side)
  • renal impression (right side)
  • esophageal impression (left side)
  • supra-renal (right side)
  • gastric impression (left side)
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16
Q

arterial supply of the liver

A

-hepatic artery (passes in the hepatoduodenal ligament) it divides into right and left hepatic proper arteries

17
Q

venous supply/ drainage of the liver

A
  • blood drains from the liver by the short hepatic veins draining into the IVC
  • portal vein: which transfer blood from the gastrointestinal tract to liver
18
Q

nervous supply of the liver

A
  • autonomic nerves from the celiac nerve plexus

* *** right phrenic nerve (sensory innervation) of the peritoneum of the liver

19
Q

the portal vein is made by?

A

the splenic vein and the superior messenteric vein

20
Q

what happens to the portal vein when it enters the liver?

A

divides into right and left branch of portal vein

21
Q

what vein drains in to right and left branches of the portal vein?

A

interlobular vein

22
Q

what is the function of the portal vein?

A

filtration of substances absorbed by the gastrointestinal tract

23
Q

what is the portal caval anastomosis?

and what are its contribution?

A
  • is specific regions of the body, where blood is drained to the hepatic portal vein and it communicates with the SVC & IVC
  • esophagus, abdominal wall, rectum, retroperitonuem
24
Q

portal caval (esophagus)

A

left gastric vein connects with esophageal vein which drains via the azygous vein and hemiazygous vein into the SVC

25
Q

portal caval (abdominal wall)

A

paraumbilical vein, empties via the thoracoepigastric vein into SVC

26
Q

portal caval (rectum)

A

superior rectal vein connects with middle and inferior recatal veins which drain via the internal ilac vein, which drains into the IVC

27
Q

portal caval (retroperitoneum)

A

by the colic vein with the retroperitoneal vein

28
Q

what is the bile duct divided into?

A

extrahepatic and intrahepatic

29
Q

extrahepatic features:

A
  • common hepatic duct (created after fusion of R. & L. hepatic duct in the hepatoduodenal ligament)
  • cystic duct
  • sphincter of the bile duct
  • hepatopancreatic ampulla
30
Q

where is the begining of the bile duct located?

A

hepatoduodenal ligament

31
Q

pathway of the bile duct

A

descends behind the superior part of the duodenum to the medial side of the descending part of the duodenum where it usually fuses with the pantreatic duct (which opens on the major duodenal papilla)

32
Q

what is the function of the sphincter of the bile duct?

A

to suround the bile duct before its junction with the pancreatic duct

33
Q

what is the hepatopancreatic ampulla?

A

an expansion of the junction of the junction between the bile and pancreatic duct

34
Q

what is the gall bladder

A

a thin walled pear shpae sac, which stores and concentrates bile, the bile duct transports the bile

35
Q

what are the parts of the gall bladder?

A

fundus, body and neck

36
Q

where does the gall bladder rests? and where is it attached to?

A

rests on the depression on the liver and is attached to it by connective tissue

37
Q

what is the internal surface of the gall bladder covered by?

A

peritoneum

38
Q

neurovascular supply of the gall bladder

A
  • arterial supply: cystic artery
  • venous: cystic vein which empties directly into the portal vein
  • nervous: autonomic nerve fibers from celiac nerve plexsus which innervated the bile duct & the gall bladder
  • *** Right phrenic nerve (sensory innervation of peritoneum of gall bladder and liver)