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M1: Anatomy and Embryology Lecture BW > Block 2: Anatomy of the Gallbladder, Liver & Spleen > Flashcards

Block 2: Anatomy of the Gallbladder, Liver & Spleen Flashcards

1
Q

Blood supply to the gallbladder

A

cystic artery, branch of right hepatic artery

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2
Q

Where is the gallbladder blood supply located?

A

triangle of calot

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3
Q

Venous drainage of the gallbladder

A

small veins directly into liver or portal vein

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4
Q

What is the blood supply of the bile duct?

A
  1. cystic artery
  2. right/left hepatic artery
    anterior/posterior superior pancreatico- duodenal arteries
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5
Q

Venous drainage of the gallbladder

A

portal venous system

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6
Q

How does bile drain into the gallbladder?

A

via the cystic duct

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7
Q

What ducts drain into the cystic duct?

A

common hepatic duct (above cystic duct insertion)

common bile duct (below cystic duct insertion)

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8
Q

What are the common locations of a biliary stone? (3)

A
  1. cystic duct (exit site of the gallbladder)
  2. blocking common bile duct & pancreatic duct
  3. blocking common bile duct
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9
Q

Explain pain related to gallstones

A

pain is poorly localized and periodic b/c peristaltic movements that would attempt to expel the stones are periodic

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10
Q

Significance of portal triad anatomy

A

notorious for a wide variety of anatomical anomalies

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11
Q

Borders of Calot’s Triangle

A

Common hepatic Duct
Cystic Duct
Liver

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12
Q

What is located in Calot’s Triangle?

A

the cystic artery

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13
Q

Percutaneous Transhepatic Cholangiography

A

insertion of a needle to the skin to release contrast medium into the bile duct, allowing for visualization of the bile duct

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14
Q

How is the liver fixed to the diaphragm and the abdominal wall?

A

Triangular ligaments
Coronary ligaments
Falciform ligament
Round ligament

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15
Q

Describe the surface anatomy of the liver

A

-marked by fissures that can help divide the liver into R and L (anatomically)

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16
Q

Venous drainage of liver

A

into the IVC via 3 main hepataic veins

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17
Q

R Hepatic Vein drains

A

right lobe of liver

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18
Q

Middle hepatic vein drains

A

left medial section of liver

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19
Q

Left hepatic vein drains

A

left lateral section of the liver

20
Q

Caudate Lobe drainage

A

directly into the IVC, multiple small veins

21
Q

Left Hemiliver Segments

A
  1. segments I-IV
  2. I-caudate lobe
  3. II-III left lateral segment
  4. IVa/IVb left medial segment
22
Q

Right hemiliver segments

A

V-VII

a. V/VII right anterior
b. VI/VII right posterior

23
Q

Caudate lobe significance

A

independent; does not belong to the R or L hemiliver

24
Q

What are the hemiliver segments divided by?

A

the hepatic veins

25
Q

What divides the liver into upper and lower parts?

A

transverse portion of the portal vein

26
Q

How does live donor transplantation work?

A

the segmental structure of the liver allows you to take one segment from the donor, and the remainder will regenerate in both the donor and the recipient

27
Q

Explain portal vein embolization for massive hepatectomy

A

we need to leave at least 30% of the liver behind, so you can put embolic materials to plug the R portal vein to divert the entire portal venous flow into the other side

the designated lobe will get bigger, and you can safely take out the other portion

28
Q

Effect of PVE

A

safe and effective way to indue liver hypertrophy to prevent postresection failure due to insiffucient liver remains

29
Q

What is the dual blood supply of the liver?

A

hepatic arteries

portal vein

30
Q

Pringle Maneuver

A

the hepatoduodenal ligament is clamped to interrupt blood flow through the hepatic artery and portal vein

31
Q

Benefits of the Pringle Maneuver

A

control bleeding from the liver

32
Q

Anatomy of the portal venous system

A
  1. inferior mesenteric vein joins the splenic vein
  2. superior mesenteric vein joins the splenic vein

at this confluence, it becomes the portal vein

33
Q

Difference b/w portal venous system & systemic venous system

A

in the portal venous system there is no valve

in systemic venous system there are valves

34
Q

Caput Medusa

A

appearance of distended & engorged superficial epigastri veins

35
Q

Transjugular Intrahepatic Portosystemic Shunt

A

using a guidewire, a stent is passed via a vein in the neck (jugular) into the hepatic vein, through the liver, to the portal vein

36
Q

Is the pancreas intra or retropertioneal?

A

Retroperitoneal

37
Q

Pancreas location

A

posterior to stomach & transverse colon

head anterior to R kidney

38
Q

List the blood supplies that the pancreas wrap around

A

around the superior mesenteric artery and vein

39
Q

What is the consequence of having a mass in the main pancreas?

A

can compress the bile duct, causing blockage of the bile duct

40
Q

What is the arterial supply to the head of the pancreas?

A
  1. collaterals from celiac trunk & SMA
  2. anterior superior pancreaticoduodenal off of GDA (celiac)
  3. inferior PD artery from SMA
41
Q

Periampullary Tumor Location

A

around the ampullae of the pancreas

42
Q

Significance of the periampullary tumor

A

potentially invades into the large blood vessels and create metastasis

43
Q

Whipple Operation Removes

A

removal of gallbladder, extrahepatic bile duct, distal stomach, duodenum, head of pancreas and associated nodes

44
Q

Describe the cause and effect Whipple Operation

A

cause: disease in the head of the pancreas
effect: organs are removed in a Whipple and reconnected to the intestine

45
Q

Tumor of the pancreatic tail

A

you can just chop it off

46
Q

Spleen location

A

LUQ b/w stomach & diaphragm

47
Q

Ligaments of the Spleen (4)

A

gastrosplenic
splenonephric
splenocolic
splenophrenic

M1: Anatomy and Embryology Lecture BW (37 decks)

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