Lecture 12 - Alimentary 4 Flashcards

1
Q

What are the functions of the red and white pulp of the spleen

A

haemolytic and lymphoid tissue

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2
Q

What differentiates to form the framework of the spleen?

A

Connective tissue cells (mesenchyme) in the dorsal mesentery of the foetus

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3
Q

What is the spleen prior to fusion?

A

Several adjoining structures each with their own blood supply

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4
Q

Where does some lobulation remain?

A

The notching of the external surface especially the superior border

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5
Q

The spleen is a haemopoietic organ, true or false?

A

No it is initially a haemopoietic organ but later colonised by lymphoid cells

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6
Q

Where does the mature spleen sit anatomically?

A

Upper left posterior region of stomach between the fundus and the diaphragm

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7
Q

Which ribs is the spleen related to?

A

9 - 11

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8
Q

What is the long axis of the spleen parallel to?

A

Rib 10

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9
Q

Which two ligaments is the spleen suspended on

A

Gastrosplenic and splenorenal

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10
Q

What are the four borders of the spleen?

A

Superior, inferior, anterior, posterior

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11
Q

Which border of the spleen is often sharper?

A

The anterior border

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12
Q

What are the two surfaces of the spleen?

A

Diaphragmatic and visceral

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13
Q

What are the four impressions on the visceral surface of the spleen (and the relationships they indicate)

A

Gastric (broad, concave impression above the hilus)
Pancreatic (Small, may not be visible)
Colic (Anteriorly below hilus, related to left colic flexure)
Renal (Posterior, below hilus)

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14
Q

Where does the splenic artery meet the spleen?

A

At the hilus

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15
Q

How does the splenic artery enter the spleen?

A

The splenic artery terminates in 2-3 branches from which a number of smaller branches enter the substance of the spleen

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16
Q

How is the spleen drained?

A

By the tributaries of the splenic vein which ultimately drain to the portal vein

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17
Q

What else travels with the blood vessels (2)?

A

Lymph vessels

Nerves also travel as a plexus on arteries

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18
Q

What are the 5 functions of the liver?

A

Exocrine, endocrine, metabolism, detoxification and haemopoiesis

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19
Q

What cell type is the liver made up of?

A

Hepatocyte

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20
Q

As an exocrine organ, what does the liver release?

A

Bile

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21
Q

What is the function of bile?

A

Digestion especially fats, contains pigments from the breakdown of RBC in the spleen

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22
Q

As an endocrine gland what does the liver release?

A

Glucose, plasma and proteins into theblood

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23
Q

What does the liver metabolise?

A

Protein and carbohydrates

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24
Q

Where is the liver located?

A

Under the right ribs and diaphragm

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25
Q

Where does the liver extend to and from?

A

From the level of the 5th rib to the costal margin

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26
Q

Where does the gallbladder protrude from?

A

Its lower surface at about the level of the 9th costal cartilage and linea semilunaris

27
Q

What are the two surfaces of the liver?

A

Diaphragmatic and visceral

28
Q

The entire liver is covered in peritoneum true or false?

A

False, it is covered with peritoneum except at sites of attachments of the ligaments

29
Q

What are the four anatomical lobes of the liver

A

left, right, caudate and quadrate

30
Q

How are the functional lobes of the liver divided?

A

On the basis of supply by right or left hepatic arteries. The right is separated from the left by a lien drawn up through the fossa for the gallbladder

31
Q

What does the left functional liver include?

A

Left lobe + caudate and quadrate lobes

32
Q

What are the components of the liver’s dual blood supply

A

1) nutrient rich and oxygen poor blood from the portal vein

2) oxygen rich blood from hepatic artery proper

33
Q

How is the liver drained?

A

By hepatic veins into the IVC - 3 upper large veins and a variable number of lower veins

34
Q

The liver is retroperitoneal, true or false?

A

False

35
Q

All the ligaments suspending the liver are interconnected true or false?

A

True

36
Q

What are the four ligaments that suspend the liver?

A

Coronary, left and right triangular, falciform

37
Q

What parts of the diaphragm is the liver attached to and by what ligaments?

A

Right dome and central tendon by the coronary. left and right triangular ligaments

38
Q

What is the ‘bare area’

A

A region in isolated livers under the attachment of the triangular ligaments which is free from peritoneum

39
Q

What is the falciform ligament derived from?

A

Ventral mesentery

40
Q

Where does the falciform ligament extend from?

A

The anterior surface of the liver to anterior abdominal wall down to the level of umbilicus. The ligamentum teres in the lower edge runs to the umbilicus.

41
Q

What is the relationship between the lesser omentum and the liver?

A

It surrounds the porta hepatis and then superiorly into fissure to give ligamentum venosum and finally is attached to the diaphragm and surrounds oesophagus.

42
Q

Where are the fissures of the liver?

A

On the posterior aspect and they separate the left lobe from caudate and quadrate lobes

43
Q

Where is the fissure for the ligamentum venosum?

A

Between the left lobe and caudate lobe

44
Q

Where is the fissure for the ligamentum teres?

A

Between the left lobe and the quadrate lobe

45
Q

What is the region between fissures?

A

Porta hepatis

46
Q

What is the porta hepatis?

A

It is the hilus of the liver where blood vessels, nerves, lymphatics and the hepatic bile duct enter or leaves the liver

47
Q

What does the porta hepatis separate?

A

The caudate and quadrate lobes and marks the lower edge of the lesser omentum

48
Q

What are the ligaments remnants of?

A

The fetal left umbilical vein

49
Q

What does the umbilical vein do?

A

It mostly bypasses the liver and goes straight to the foetal IVC

50
Q

What becomes the ligamentum teres?

A

The part of the umbilical vein between umbilicus and the left branch of portal vein

51
Q

What becomes the ligamentum venosum?

A

The part of the left branch of portal vein and the IVC

52
Q

Where does the ligamentum teres run?

A

From the umbilicus to the liver in the free inferior border of the falciform ligament. From there it passes into the fissure for ligamentum teres.

53
Q

Ligamentum teres remains functional as a vessel under normal circumstances postnatally, true or false?

A

False

54
Q

The ligamentum venosum is a continuation of ligamentum teres true or false?

A

True

55
Q

What are the functions of the gallbladder (3)?

A

Store, concentrate and transport bile

56
Q

What are the three parts of the gallbladder?

A

Fundus, body, neck

57
Q

Where is the fundus of the gallbladder

A

Below the lower margin of liver

58
Q

What does the lining mucosa of the gallbladder do?

A

Take up water and solutes from bile

59
Q

What are the 5 ducts of the gallbladder?

A

Left and right hepatic ducts, main hepatic duct, cystic duct and bile duct

60
Q

What forms the main hepatic duct?

A

The left and right hepatic ducts emerging from the liver

61
Q

What forms the bile duct

A

The joining of the main hepatic duct and cystic duct

62
Q

Where does the bile duct travel?

A

Through the free edge of the lesser omentum, behind the first part of the duodenum then on the posterior surface of the head of the pancreas to come into close proximity to the main pancreatic duct

63
Q

What do the bile duct and main pancreatic duct fuse to form?

A

The hepatopancreatic ampulla

64
Q

Where do the bile and main pancreatic ducts empty?

A

Greater duodenal papilla