7. Hepatic, Biliary, and Pancreatic Anatomy Flashcards Preview

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Flashcards in 7. Hepatic, Biliary, and Pancreatic Anatomy Deck (57):
1

The right lobe of the liver is __% of the mass, while the left lobe of the liver is __%

60-70%
20-30%

2

What structure divides the right and left lobes of the liver?

Falciform ligament

3

What do the right and left hepatic ducts combine to form?

Common hepatic duct

4

What does the cystic duct join the common hepatic duct to form?

Common bile duct

5

Where does the common bile duct enter the duodenum

2nd segment at the sphincter or oddi, near where the pancreas empties into the duodenum

6

The hepatic artery is a branch off:

The celiac trunk of the abdominal aorta

7

At the base of the falciform ligament is the __ __, which is the obliterated:

Round ligament
Umbilical vein

8

What are the anterior and posterior structures that are peritoneal reflections holding the liver to the diaphragm?

Anterior and posterior coronary ligaments

9

The anterior and posterior layers converge on the right and left sides of the liver to form the:

Right and left triangular ligaments

10

What is the small lobe of the live that is found adjacent to the gallbladder?

Quadrate lobe

11

What is the porta hepatis

Where the portal triad comes into the liver -- hepatic artery, portal vein, bile duct

12

What is the small lobe of that is found more cranial and near the IVC?

Caudate

13

What is the area of the liver that is located at the top of the liver between the anterior and posterior coronary ligaments

Bare area--not covered by peritoneum

14

The left lobe is made up of segments:

II, III, IV

15

The right lobe is made up of segments:

V, VI, VII, VIII

16

What is segment 1 of the liver, which receive blood flow from the right and left sides?

Caudate

17

What drains the caudate lobe?

Had its oven hepatic vein draining directly into the IVC

18

What liver segments are donated to an adult patient? Pediatric?

Adult: V, VI, VII, VIII (right lobe)
Child: II, III (portion of the left lobe)

19

What vein drains the midgut? Hindgut? Ultimate drainage?

Superior mesenteric
Inferior mesenteric
(Hepatic vein which drains into the IVC and back into the heart)

20

Venous blood in the portal vein is high in ____ but low in ___

Nutrients
Oxygen

21

Central veins from each lobule join to form the ____

Hepatic vein

22

What cells in the sinusoids are responsible for filtering unwanted substances?

Kupffer cells

23

What is the space between the sinusoids and the liver cell plates called?

Space of Disse

24

What cells are found in the Space of Disse?

Stellate cells

25

What happens to substances that get stuck in the Space of Disse and cant return to the sinusoids?

Enter the lymphatics--drain the same direction as the bile--away form the central vein

26

What is the endocrine subunit of the liver?

Hexagonal lobule

27

What is the exocrine unit of the liver?

Triangle between three central veins, focus on the bile exiting the lobules

28

What is the liver acinus?

Short axis between two triads at the hexagon corners
Long axis between two central veins

29

What cell is responsible for the formation of scar tissue?

Stellate cells--lay down collagen and can eventually cause cirrhosis

30

What is the mechanism for concentration of gallbladder contents?

Absorption of water, sodium, and chloride leads to the concentration of bile salts, cholesterol, lecithin, and bilirubin

31

What are cholesterol and lecithin solubilized by in the gallbladder?

Bile salts
**prevents the bile salts from precipitating

32

The gallbladder volume goes from 500 ml to __ with concentration

50 ml

33

What is emulsification?

Decrease in surface tension and breaking of fat glubules into smaller size particles

34

Formation of ____ after emulsification helps the absorption of fat breakdown products?

Micelles-incorporate fatty acids, monoglycerides, and cholesterol
**allow fats to remain soluble in an aquous solution

35

What stimulates the release of cholecystokinin (CCK)?

Fatty foods in the duodenum

36

What are the two main effects of CCK on bile movement?

1. Gallbladder contraction and emptying in 1 hr
2. Relaxation of the sphincter or Oddi

37

What substance has a similar effect to CCK on gallbladder contraction, but is a weaker stimulus?

Acetylcholine

38

What is the effect of secretin on biliary epithelium?

Stimulates the epithelium to produce a solution rich in sodium bicarbonate to help neutralize acids and optimize pancreatic function

39

What part of the GI tract absorbs bile acids?

Ileum

40

What are the key enzymes secreted by the pancreas?

Trypsin (trypsinogen)
Chymotrypsin (chymotrypsinogen)
Carboxypolypeptidase (procarboxypeptidase)
**secreted in inactive forms

41

What activates trypsinogen to trypsin?

Enterokinase (vili of the small intestine)

42

What happens once trypsinogen is converted to trypsin?

Furtheractivates trypinogen as well as converting chymotrypsinogen to chymotrypsin and procarboxypeptidase to carboxypeptidase

43

How are proteins converted to proteoses, peptones and polypeptides?

Pepsin

44

How are proteoses, peptones, and polypeptides converted to polypeptides and amino acids?

Trypsin
Chymotrypsin
Carboxypolypeptidase
Proelastase

45

How are polypeptides converted to amino acids for absorption?

Peptidases located in the vili of the small intestine

46

What degrades starches to maltose and 3-9 glucose polymers

Ptyalin (saliva) 20-40%
Pancreatic amylase 50-80%

47

What converts maltose and 3-9 glucose polymers to glucose?

Maltase and alpha dextrinase in the intestinal villi

48

What enzyme of the intestinal villi converts lactose to galactose? Sucrose to fructose?

Lactase
Sucrase

49

Majority of dietary fats are in the form of:

Triglycerides (TG)--glycerol backbone with 3 fatty acid side chains
**diet includes small amounts of phospholipids and cholesterol esters

50

What digests all the TG that is can reach within 1 minute (into free fatty acids and 2 monoglycerides?

Pancreatic lipase (provided that the fats are esterified)

51

What breaks down phosphlipids and cholesterol esters?

Phospholipase
Cholesterol esterase

52

What prevents fat components that have been broken down by emulsification and pancreatic lipase from reassembling?

Formation of micelles and removal of monoglycerides and fatty acids, transport through the brush border for absorption

53

How do the pancreatic ductule cells form bicarbonate?

CO2 diffuses in from the blood
Carbonic anhydrase converts it to carbonic acid
Dissociation to bicarbonate and H+; bicarbonate into the lumen and H+ active transport into the blood

54

What is the effect of CCK and secretin on pancreatic secretion?

CCK: acts on ACINI to produce digestive enzymes
Secretin: acts on duct cells to produce bicarbonate rich solution

55

Which molecule has the greatest effect on sphincter of oddi relaxation?

Cholecystokinin

56

What hepatic acinus zone will have the greatest exposure to viral particles?

Zone 1 (greatest blood flow, most Kupffer cells)

57

What hepatic acinus zone is at the greatest risk for ischemia?

Zone 3