54. GI anatomy part 4 Flashcards
(24 cards)
Where is the gallbladder located?
How much bile can it handle?
At the inferior border of the liver and superiolaterally to the duodenum
30-50ml
Describe the anatomical appearance of the gallbladder
What artery supplies the gall bladder?
Fundus- top
Body- middle
Neck- bit that leads into the cystic duct
cystic artery
Describe the pathway of the biliary tree
What artery supplies the gall bladder?
(Right and left hepatic duct—> hepatic duct)
Common hepatic duct and cystic duct–> Common bile duct
Common bile duct and pancreatic duct–> hepatopancreatic ampulla of vater
What are the range of diseases associated with the gall bladder
Cholelithiasis- uncomplicated gallstones
Biliary colic- right upper quadrant pain after a meal
Cholecystitis- inflammation of the gall bladder
Choledocholithiasis- gallstone within the common bile duct
Cholangitis- infection of the common bile duct (charcot’s triad)
Where is a common site in the gallbladder where stones will lodge and cause an impaction?
Hartmann’s pouch- a mucosal fold located in the neck of the gallbladder
Describe the positioning of the pancreas?
Lies centrally in the trans-pyloric plane (L1). Its head tucks into the curve of the duodenum
The pancreas has some major landmarks in anantomy- explain them?
Aorta and IVC passes posteriorly to the head of the pancreas
Superior mesenteric artery lies behind the neck of the pancreas
Posterior to the neck of the pancreas the splenic and superior mesenteric veins unite
Describe the five major regions of the pancreas?
Head- widesr part lies within c shaoed curve
Uncinate process- lies psoteriorally to the neck and medially to the head
Neck- located between the head and body
Body- major bit that sits centrally
Tail- near spleen
What controls the release of substances through the ampulla of vater?
The sphincter of oddi
How is the pancreas arterially supplied and drained?
branches of splenic artery
superior mesenteric branches of hepatic portal vein
What ligaments anchor the spleen?
Gastrosplenic ligament- connects spleen to greater curvature of stomach
Splenorenal ligament- connects hilum of spleen to left kidney
What covers the spleen?
Fibroelastic capsule
Describe the shape and structure of the adrenal glands?
Left- semilunar shape
Right- pyramidal
Enclosed by renal fascia
What are the two regions of the adrenal glands?
Medulla (outer)
Coretex (inner)
Discuss the layer of the cortex and what hormones they secrete?
Zona glomerulosa – produces and secretes mineralocorticoids such as aldosterone.
Zona fasciculata – produces and secretes corticosteroids such as cortisol. It also secretes a small amount of androgens.
Zona reticularis – produces and secretes androgens such as dehydroepiandrosterone (DHES). It also secretes a small amount of corticosteroids.
What does the medulla do?
Chromaffin cells which secrete catecholamines into the bloodstream
Explain the blood supply of the adrenal glands
Superior adrenal artery – arises from the inferior phrenic artery
Middle adrenal artery – arises from the abdominal aorta.
Inferior adrenal artery – arises from the renal arteries.
Discuss the positioning of the kidneys?
Retroperitoneal organs that lie from T12 to L3.
The adrenal glands sit atop it within a separate envelope renal fascia
Describe the layers of kidneys from deep to superficial?
Kidney (in the middle)
Renal capsule
Perirenal fat
Renal fascia- encloses kidneys and adrenal glands
Pararenal fat- mainly located on the posterolateral aspect of the kidney
Talk through the layers of the kidney
Encased in an outer cortex this cortex divides the medulla into triangular shapes known as the renal pyramids
apex of pyramids is the renal papilla- associated with a minor calyx. Minor calyx form major calyx. Major calyx form renal pelvis. Renal pelvis drains into ureter.
The kidneys are supplied by the renal arteries. Which artery is longer and how does it cross the vena cava?
Right renal artery- crosses IVC posteriorly
What is the line of brodel?
The line in the lateral and slightly posterior border of the kidney which delineates the segments supplied by anterior and posterior regions of the kidneys.
important for open and endoscopic surgeries
Which renal vein is larger?
How does it travel in relation to the abdominal aorta
Left renal vein, travels anteriorly to the abdominal aorta
What are the two most common developmental abnormalities of the kidneys?
Pelvic kidneys- kidney fails to ascend and remains in pelvis around common iliac artery
Horseshoe kidney- two developing kidneys fuse into a single horseshoe shaped kidney
