Abdomen, Pelvis and Perineum 2 Flashcards

(87 cards)

1
Q

Why is the liver an intraperitoneal organ?

A

it is covered on all sides by visceral peritoneum

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2
Q

What are the functions of the liver?

A
  • clears the blood of harmful substances e.g alcohol
  • produces cholesterol
  • converts glucose to glycogen to aid with its storage
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3
Q

How does the liver aid digestion?

A
  • Produces bile
  • Bile aids with the break down of dietary fats and also assists with carrying waste out of the liver
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4
Q

What is the arterial supply of the liver?

A

Right and left hepatic arteries

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5
Q

What is the innervation of the liver?

A
  • sympathetic = coeliac plexus
  • parasympathetic = vagus fibres
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6
Q

What are the four lobes of the liver?

A

Right, left, quadrate and caudate

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7
Q

How many functional segments does the liver have?

A

8

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8
Q

Where is the liver located?

A

The highest part of the right abdominal cavity, beneath the diaphragm (RUQ)

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9
Q

What are the attachments of the liver?

A

Ligaments made of peritoneum

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10
Q

Where does the falciform ligament run from?

A

From the highest part of the liver to the hepatic notch (anterior border)

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11
Q

What is the falciform ligament?

A
  • two layers of peritoneum
  • anchors surface of liver to the abdominal wall and diaphragm
  • demarcates the left and right lobes
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12
Q

Label this diagram

A
  1. Left lobe
  2. Falciform ligament
  3. Right lobe
  4. Gall bladder
  5. Inferior margin
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13
Q

What are the other ligaments of the liver?

A
  • left and right triangular ligament
  • coronary ligament
  • ligamentum teres
  • round ligament
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14
Q

What is the hilum/porta hepatis of the liver?

A

the site at which the hepatic portal vein, proper hepatic artery and the common hepatic duct enter/leave the liver

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15
Q

What is Glisson’s capsule?

A
  • dense connective tissue layer underneath the visceral peritoneum of the liver
  • pain from here is very well localised
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16
Q

What happens when the Glisson’s capsule is stretched?

A

Sharp pain over the right upper quadrant

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17
Q

What are the two surfaces of the liver?

A
  • diaphragmatic (anterior)
  • visceral (posterior)
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18
Q

What is the bare area of the liver?

A
  • area that is not covered in peritoneum
  • between liver and diaphragm
  • borders are anterior and posterior coronary ligaments and left and right triangular ligaments
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19
Q

What is the gallbladder?

A

Storage site for bile

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20
Q

What type of organ is the gallbladder?

A

Intraperitoneal

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21
Q

What are the relations of the gallbladder?

A
  • fundus projects below lower margin of the liver in line with the 9th costal cartilage
  • in contact with the transverse colon and descending duodenum posteriorly
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22
Q

What is the blood supply of the gallbladder?

A
  • cystic artery (branch of the right hepatic artery)
  • cystic vein (drains directly into the hepatic portal vein)
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23
Q

Where is a gallstone most likely to become lodged in the gallbladder

A

Neck due to its narrow diameter

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24
Q

How does billiary colic present?

A

sharp pain in the epigastric and/or right hypochondrium region

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25
What is the biliary tree?
series of ducts which stem from the liver and gallbladder to move bile towards the duodenum
26
What does the biliary tree join with?
Main pandreatic duct to form the hepatopancreatic ampulla
27
What is the function of the hepatopancratic ampulla?
Combines bile and pancreatic enzymes which are then drained into the descending duodenum
28
Label this diagram of the porta hepatis
1. Hepatic duct 2. Bile duct 3. Portal artery 4. Portal vein
29
How does bile leave the liver?
through the right and left hepatic ducts, which merge to form the common hepatic duct
30
Which ducts transport bile out of the gallbladder?
Cystic duct
31
Which ducts form the common bile duct
Common hepatic duct and cystic duct
32
What is the pancreas?
Endocrine and exocrine digestive organ
33
Where is the pancreas located?
- epigastric region and upper left quadrant - transpyloric plane (L1-L2) behind stomach
34
Label 1-5
1. Left lobe 2. Hepatic portal vein 3. Right proper hepatic artery 4. Caudate lobe 5. Left proper hepatic artery
35
Label 6-10
6. Common hepatic duct 7. Fissure of round ligament 8. Gallbladder 9. Quadrate lobe 10. Right lobe
36
What is the hepatopancreatic duct?
Joining of the pancreatic and bile ducts
37
What does the hepatopancreatic duct drain into?
Duodenum via the major duodenal papilla
38
Is the pancreas retroperitoneal or intraperitoneal?
Retroperitoneal apart from tail
39
Label 1-5
1. Tail 2. Body 3. Neck 4. Head 5. Uncinate process
40
Label 6-10
6. Main pancreatic duct 7. Major duodenal papilla 8. Duodenum 9. Common bile duct 10. Main pancreatic duct
41
Label 11-14
11. Hepatopancreatic ampulla 12. Descending duodenum 13. Major duodenal papilla 14. Hepatopancreatic sphincter
42
What is the blood supply of the head of the pancreas?
Superior and inferior pancreaticoduodenal arteries
43
What are the features of pain from the pancreas?
- poorly localised - often referred to the back - often confused with pain from stomach or transverse colon
44
What can cancer at the head of the pancreas cause?
- obstructive jaundice - tumour can compress the bile duct, backing up the biliary tree
45
What is the spleen?
- lymphoid organ - not an accessory organ of the GIT (doesn't aid with digestion)
46
Where is the spleen located?
- left hypochondrium, posterior to stomach - in front of left ribs 9-11
47
Can you live without a spleen?
Yes, many of its functions are carried out by the liver
48
Is the spleen intraperitoneal or retroperitoneal?
Intraperitoneal
49
What is the spleen attached to and how?
- stomach and left kidney - gastrosplenic and splenorenal ligaments
50
Label the diagram
1. Superior border 2. Inferior border 3. Splenic artery 4. Splenic vein
51
Where does the blood supply to the abdominal organs come from?
- Abdominal aorta (continuation of thoracic aorta) - Inferior vena cava
52
Are the abdominal aorta and IVC intraperitoneal or retroperitoneal?
Retroperitoneal
53
Where are the abdominal aorta and IVC located?
- abdominal aorta is slightly left of the midline - IVC is slightly right of the midline
54
Where does the abdominal aorta enter the abdominal cavity?
T12, behind the diaphragm
55
What are the three main branches of the abdominal aorta?
- coeliac trunk (foregut) - superior mesenteric artery (midgut) - inferior mesenteric artery (hindgut)
56
What does the coeliac trunk divide into?
- left gastric artery - splenic artery - common hepatic artery - superior pancreaticoduoedenal artery
57
What does the common hepatic artery divide into?
- gastroduodenal artery - proper hepatic artery
58
What can a ruptured ulcer in the stomach or first part of the duodenum cause?
- can erode through the organ walls and rupture nearby gastroduodenal artery - leads to large amount of bleeding in the peritoneal cavity
59
What level does the coeliac trunk arise from?
T12
60
What does the superior mesenteric artery branch into?
- inferior pancreaticoduodenal artery - jejunal and ileal arteries - right colic artery - middle colic artery
61
What does the inferior pancreaticoduodenal artery supply?
- head of pancreas - duodenum
62
What does the right colic artery supply?
Ascending colon
63
What does the middle colic artery supply?
Transverse colon
64
What do the ileal and jejunal arteries give rise to?
- arterial arcades - anastamose with each other - lie within the mesentery of the small intestine
65
Where does the superior mesenteric artery arise from?
L1
66
What does the inferior mesenteric artery branch into?
- left colic artey - sigmoid artery - superior rectal artery
67
Where does the inferior mesenteric artery arise from?
L3
68
What is the marginal artery?
- anastomosis of superior and inferior mesenteric artery - blood supply for watershed area of transverse colon
69
Which branch of the abdominal artery is largest?
Superior mesenteric artery
70
What are the two venous drainage pathways for the abdominal organs?
Portal venous system and systemic venous system
71
What is the hepatic portal venous system?
- Drains blood from GIT and associated organs - Drains into liver at porta hepatis and then into inferior vena cava
72
Which veins drain foregut, midgut and hindgut organs?
- foregut = splenic vein - midgut = superior mesenteric vein - hindgut = inferior mesenteric vein
73
What is the layout of the portal venous system?
- splenic vein and superior mesenteric vein join behind neck of pancreas to form hepatic portal vein - inferior mesenteric vein drains into splenic vein behind neck of pancreas
74
What is the systemic venous system?
- Venous drainage for kidneys, adrenal glands and gonads - Drains straight into inferior vena cava
75
Why does blood from the systemic venous system not need to be processed by the liver?
- kidney filters blood - adrenal glands and gonads need the hormones they produce to enter systemic circulation in order to reach their target organs
76
What are portosystemic anastomoses?
- sites of communication between portal and systemic venous systems - provide alternate route for venous drainage if there is a blockage in the portal venous system - allows blood to still be returned to the heart via the IVC
77
What is the danger of portosystemic anastomoses?
- blood from the GIT needs to processed by the liver to remove harmful/waste substances - anastomoses allow these substances to enter heart and systemic circulation
78
Label 1-4
1. Left adrenal vein 2. Left renal vein 3. Left testicular vein 4. Left common iliac vein
79
Which lymphatic nodes drain abdominal organs?
Pre-aortic lymph nodes
80
Label this diagram
1. peritoneum 2. stomach 3. gastrospenic ligament 4. spleen 5. splenorenal ligament 6. left kidney
81
Label this diagram
1. left gastric artery 2. coeliac trunk 3. common hepatic artery 4. splenic artery
82
Label this diagram
1. superior mesenteric artery 2. jejunal and ileal arteries 3. middle colic artery 4. right colic artery 5. ileocolic artery
83
Label this diagram
1. marginal artery 2. left colic artery 3. sigmoid artery 4. middle colic artery 5. right colic artery 6. ileocolic artery
84
Label this diagram
1. splenic vein 2. inferior mesenteric vein 3. portal vein 4. superior mesenteric vein All with tributaries
85
Label this diagram
1. left adrenal vein 2. left renal vein 3. left testicular vein 4. left common iliac vein 5. hepatic veins 6. inferior vena cava 7. right renal vein 8. right testicular vein
86
Label 1-10
1. falciform ligament 2. caudate lobe 3. inferior vena cava 4. suprarenal impression 5. bare area 6. anterior coronary ligament 7. posterior coronary ligament 8. right triangular ligament 9. renal impression 10. right lobe of liver
87
Label 11-21
11. neck 12. body 13. fundus 14. gallbladder 15. colic impression 16. quadrate lobe 17. porta hepatis 18. oesophageal impression 19. left lobe 20. gastric impression 21. left triangular ligament