Flashcards in 7. Hepatic, Biliary, and Pancreatic Anatomy Deck (57):
The right lobe of the liver is __% of the mass, while the left lobe of the liver is __%
What structure divides the right and left lobes of the liver?
What do the right and left hepatic ducts combine to form?
Common hepatic duct
What does the cystic duct join the common hepatic duct to form?
Common bile duct
Where does the common bile duct enter the duodenum
2nd segment at the sphincter or oddi, near where the pancreas empties into the duodenum
The hepatic artery is a branch off:
The celiac trunk of the abdominal aorta
At the base of the falciform ligament is the __ __, which is the obliterated:
What are the anterior and posterior structures that are peritoneal reflections holding the liver to the diaphragm?
Anterior and posterior coronary ligaments
The anterior and posterior layers converge on the right and left sides of the liver to form the:
Right and left triangular ligaments
What is the small lobe of the live that is found adjacent to the gallbladder?
What is the porta hepatis
Where the portal triad comes into the liver -- hepatic artery, portal vein, bile duct
What is the small lobe of that is found more cranial and near the IVC?
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
The left lobe is made up of segments:
II, III, IV
The right lobe is made up of segments:
V, VI, VII, VIII
What is segment 1 of the liver, which receive blood flow from the right and left sides?
What drains the caudate lobe?
Had its oven hepatic vein draining directly into the IVC
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)
What vein drains the midgut? Hindgut? Ultimate drainage?
(Hepatic vein which drains into the IVC and back into the heart)
Venous blood in the portal vein is high in ____ but low in ___
Central veins from each lobule join to form the ____
What cells in the sinusoids are responsible for filtering unwanted substances?
What is the space between the sinusoids and the liver cell plates called?
Space of Disse
What cells are found in the Space of Disse?
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
What is the endocrine subunit of the liver?
What is the exocrine unit of the liver?
Triangle between three central veins, focus on the bile exiting the lobules
What is the liver acinus?
Short axis between two triads at the hexagon corners
Long axis between two central veins
What cell is responsible for the formation of scar tissue?
Stellate cells--lay down collagen and can eventually cause cirrhosis
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
What are cholesterol and lecithin solubilized by in the gallbladder?
**prevents the bile salts from precipitating
The gallbladder volume goes from 500 ml to __ with concentration
What is emulsification?
Decrease in surface tension and breaking of fat glubules into smaller size particles
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
What stimulates the release of cholecystokinin (CCK)?
Fatty foods in the duodenum
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
What substance has a similar effect to CCK on gallbladder contraction, but is a weaker stimulus?
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
What part of the GI tract absorbs bile acids?
What are the key enzymes secreted by the pancreas?
**secreted in inactive forms
What activates trypsinogen to trypsin?
Enterokinase (vili of the small intestine)
What happens once trypsinogen is converted to trypsin?
Furtheractivates trypinogen as well as converting chymotrypsinogen to chymotrypsin and procarboxypeptidase to carboxypeptidase
How are proteins converted to proteoses, peptones and polypeptides?
How are proteoses, peptones, and polypeptides converted to polypeptides and amino acids?
How are polypeptides converted to amino acids for absorption?
Peptidases located in the vili of the small intestine
What degrades starches to maltose and 3-9 glucose polymers
Ptyalin (saliva) 20-40%
Pancreatic amylase 50-80%
What converts maltose and 3-9 glucose polymers to glucose?
Maltase and alpha dextrinase in the intestinal villi
What enzyme of the intestinal villi converts lactose to galactose? Sucrose to fructose?
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
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)
What breaks down phosphlipids and cholesterol esters?
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
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
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
Which molecule has the greatest effect on sphincter of oddi relaxation?
What hepatic acinus zone will have the greatest exposure to viral particles?
Zone 1 (greatest blood flow, most Kupffer cells)