Abdominal viscera: liver, pancreas and spleen Flashcards

1
Q

Is the spleen a foregut derivative?

A

No, it is a mesoderm derivative but shares the foregut blood supply

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2
Q

In the embryo, how does the stomach rotate to form the lesser sac?

A

The stomach rotates 90° to the right and 90° clockwise to form the lesser sac

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3
Q

Which mesentery does the liver grow in?

A

The liver grows in the ventral mesentery and eventually grows out of the top of it

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4
Q

What does the falciform ligament contain in the embryo and the adult?

A

Embryo: umbilical vein
Adult: ligamentum teres (remnant of umbilical vein)

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5
Q

What are the 4 lobes of the liver?

A

Right
Left
Caudate
Quadrate

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6
Q

What is the bare area of the liver in contact with?

A

Diaphragm

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7
Q

How many functionally independent segments are there in the liver?

A

8

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8
Q

What is the blood supply of the liver?

A

30% from hepatic artery, 70% from portal vein

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9
Q

How does the blood supply enter the liver?

A

Via the free edge of the lesser omentum - epiploic foramen:

bile duct, hepatic artery, portal vein (BPH)

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10
Q

What are the classic symptoms of gall stones?

A

Gall stones can obstruct the duct system and cause symptoms including pain (biliary colic), cholecystitis and jaundice

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11
Q

What is the most important thing to remember about peritoneal recesses?

A

Accumulate fluid / be a focus for abscess formation

Are gravity dependent

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12
Q

Where does the gallbladder sit? (anatomical landmark)

A

Around the top of 9th costal cartilage

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13
Q

What is Murphy’s sign?

A

Murphy’s sign is elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner’s hand +ve

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14
Q

What is an annular pancreas and what could it cause?

A

2nd part of the duodenum is surrounded by a ring of pancreatic tissue - narrow the duodenal lumen

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15
Q

What do the minor and major duodenal papilla receive/drain?

A

Minor - receives accessory pancreatic duct

Major - drainage point for pancreatic and hepatic secretion

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16
Q

Why might pancreatic cancer cause jaundice?

A

Major duodenal papilla can be blocked by stones or tumours of the pancreatic head - drains the bile duct so can cause jaundice

17
Q

What are the anatomical relations of the spleen?

A

Diaphragm, ribs 9-11 and costodiaphragmatic recess

18
Q

Can the spleen cause epigastric pain?

A

NO! Even though it receives blood from the coeliac trunk, it is not a foregut structure, it is of mesenchymal origin