Accessory Organs Flashcards
(178 cards)
1
Q
Supplies the gall bladder and cystic duct
A
Cystic artery
2
Q
Cystic artery Arises from the Right Hepatic Artery in the
A
Cystic Triangle of Calot
3
Q
Drains directly into portal vein or may also directly drain to the liver
A
Cystic veins
4
Q
Connects the neck of the gallbladder to the common hepatic duct
A
cystic duct
5
Q
- cystic duct : proximal part
- cystic duct : distal part
A
Spiral valve (of Heister)/ spiral fold Smooth part (Pars Glabra)
6
Q
Contains mucosal duplications within the initial portion of cystic duct that regulated gallbladder filling and emptying; offers additional resistance to sudden bile dumping
A
Spiral valve (of Heister)/ spiral fold
7
Q
cystic duct drainage is through the ________ -> __________ -> _____________
A
cystic lymph nodes (located in neck area) hepatic lymph nodes celiac lymph nodes
8
Q
- Shape of gallbladder
- capacity of gallbladder
- gallbladder attached to
- functions to
A
- pear shape
- 30-50mL
- inferior surface of liver
- store and concentrate bile
9
Q
Gallbladder is anteriorly to the _____ and the _____
A
- inferior/visceral surfaces of the liver
- anterior abdominal wall below subcostal margin
10
Q
are either circumscribed tenderness in the gallbladder region or colicky pain (pain due to gas in stomach and unable to pin point)
A
Biliary tracts pains
11
Q
cuboidal to columnar in shape
A
Mucous cells
12
Q
usually pyramidal in shape, with a broad base
A
Serous cells
13
Q
Where secretory end pieces empty into
A
Intercalated ducts
14
Q
Intercalated ducts, Lined by
A
simple cuboidal epithelial cells, with
presence of striations
15
Q
Characterized by radial striations that extend to form the bases of the cells to the level of the central nuclei
A
Striated ducts
initially lined with pseudostratified or stratified cuboidal epithelium, distally lined with stratified columnar epithelium
16
Q
present in basal lamina of glands or ducts which function to propel secretions upon contraction
A
Myoepithelial cells
17
Q
Secrete only 10% of the total volume of saliva, but account for approximately 70% of the mucous secreted
A
Minor salivary glands
18
Q
Secrete in response to parasympathetic activity induced by physical, chemical, and psychological stimuli
A
Major salivary glands
19
Q
Largest of the salivary glands
A
Parotid Glands - Wedge-shaped
20
Q
emerges from the anterior border of the gland, runs toward the lateral surface of the masseter muscle, pierces the buccinator muscle, opens opposite the upper 2nd molar tooth, into the parotid papilla of the oral cavity
A
Stensen’s/Parotid duct
21
Q
Submandibular/Submaxillary glands secretes
A
lyzozyme
22
Q
Parotid Gland Arterial supply
A
External carotid artery (ECA) and its superficial terminal branches (Superficial temporal and maxillary aa.)
23
Q
Parotid Gland Venous drainage
A
Retromandibular v.
24
Q
Parotid Gland Lymphatic drainage
A
Parotid and Deep cervical nodes
25
Parotid Gland Nerve supply
Parasympathetic: Secretomotor supply from the glossopharyngeal nerve (via the tympanic branch, the Lesser Petrosal nerve, the Otic ganglion, and the Auriculotemporal nerve)
Sympathetic: Plexus around ECA
26
Submandibular/Submaxillary glands Arterial Supply and Venous drainage
Facial & Lingual (artery & vein)
27
Submandibular/Submaxillary glands Lymphatic drainage
Retromandibular and Deep cervical nodes
28
Submandibular/Submaxillary glands Nerve supply
o Parasympathetic: secretomotor supply is from the
facial nerve via the chorda tympani & the
submandibular ganglion (Superior Salivary nucleus of
CN VII)
o Sympathetic: Plexus around facial and lingual a.
29
Seen on the floor of mouth, beneath mucus membrane,
| close to the midline
Sublingual glands - smallest
- Secretes 5% of the total saliva
30
Largest mass of glandular tissue in the body
LIVER
FUNCTIONS
Production and secretion of bile
Involved in many metabolic activities related to carbohydrate, fat and protein metabolism
Filtration of blood – removes bacteria and other foreign particles
Synthesizes heparin and other important proteins
Produces bile pigments from hemoglobin of worn-out RBC’s
31
SURFACES OF THE LIVER
1. Diaphragmatic
2. Anterior aspect
3. Posterior aspect
4. Visceral or posteroinferior surface
32
Liver Visceral Surface, From the left to right:
```
fundus of the stomach
abdominal esophagus
gallbladder duodenum
right kidney with right suprarenal gland
right colic (hepatic) flexure
```
33
Right liver's impressions?
Renal Impression
- right kidney
Colic/Hepatic Impression
- right colic/ hepatic flexure
- below kidney
Suprarenal impression
- suprarenal gland
- above the kidney
34
Left liver's impressions?
```
o Esophageal impression
- esophagus
- upper portion
o Gastric impression
- fundus of the stomach
```
35
Liver's H-shaped pattern that made up by the IVC (above) and the gallbladder (below)
Right Limb
36
In the H-shaped pattern of the liver, the left limb is made up superiorly by ___ and inferiorly by_____
- ligamentum venosum (Remnant of ductus arteriosus)
| - fissure of ligamentum teres hepatis (Remnant of the left umbilical vein)
37
The transverse limb is occupied by the ____
porta hepatis
38
The transverse fissure of the liver
Transverse limb
39
The transverse limb contains the _____
portal triad
- Bile duct (right)
- Proper hepatic artery (left)
- Hepatic portal vein (posterior; biggest structure)
40
Important clinically because it is the only portion of the liver that can be accessed during physical examination
Inferior Margin of the Liver
41
In infants and about 3 years of age, the inferior margin of the liver can be palpated around ____
2 finger breadths below the right costal margin.
42
In adults, he inferior margin of the liver can be palpated ____
1 finger breadth below the right costal margin.
43
Normally the Inferior Margin of the Liver is ____
If the blunted, ___
If hard, _____
If it has nodules, _____
- smooth, sharp and pliable.
- may have congestion of the heart (CHF) or liver
- may have carcinoma.
- may be cirrhosis
44
Attaches to the undersurface of the liver
Lesser Omentum
45
thick portion of the lesser omentum that attaches to the margins of the porta hepatis.
Hepatoduodenal ligament
46
Hepatoduodenal ligament is the portion of lesser omentum to be dissected to see the ____
portal triad
47
thin portion of the lesser omentum that attaches around the fissure of ligamentum venosum
Hepatogastric ligament
48
Space between the anterior surface of the liver and the diaphragm and the anterior abdominal wall
Subphrenic recess
49
Space ro portion that extends upwards between the visceral surface of the liver and the right kidney
Subhepatic space - Hepatorenal recess / Morison’s pouch
50
Subhepatic space is immediately below the ____
inferior surface of the liver
51
Formed by the anterior and posterior layers of the coronary ligament which are wide apart
Bare area
52
portions of the liver that are devoid of peritoneum
- bare area
- Portion where the IVC lies
- Gallbladder bed
- Porta hepatis
53
attaches the anterior and superior portions of the liver to the anterior and superior surfaces of the abdominal wall, respectively
Falciform ligament
54
attaches the liver to diaphragm
Coronary ligament
55
double-layered fold of peritoneum that extends from the umbilicus to the diaphragm
Falciform ligament
56
Part of Coronary ligament formed when the anterior and posterior layers meet on the right side
Right triangular ligament
57
Left triangular ligament merges with the left tip of the liver called the
appendix fibrosa hepatis
58
Part of Coronary ligament formed when the anterior and posterior layers meet on the left side
Left triangular ligament
59
Hepatic Segments
I - Posterior/Caudate V - Right anterior medial
II - Left posterior lateral VI - Right anterior lateral
III - Left anterior lateral VII - Right posterior lateral
IV - Left medial VIII - Right posterior medial
P L- PAM RAM/L RPL/M
60
What consist the portal trial?
POrtal vein
Hepatic artery
Bile duct
61
Caudate does not really occupy a caudal position but it is thus named because it has a tail called the ___
papillary process
62
caudate process extends to the right and the rest of the right lobe of the liver and is located between _____
the IVC and the gallbladder
63
liver is divided by a major lobar fissure demarcated by the____
inferior vena cava and the gallbladder
Functional Part of Liver
o Functional right lobe
o Functional left lobe
64
areas demarcated by the (right and left) branches of the portal triad
Transverse hepatic plane (T)
65
divides the left lobe into left medial and left lateral lobe
Umbilical Fissure
delineated by the left hepatic vein
66
divides the right lobe into right medial and right lateral lobe
Right portal fissure (R)
delineated by the right hepatic vein
67
Main portal fissure (M)
delineated by the middle hepatic vein
68
Thin CT capsule in stroma
Glisson’s Capsule
69
In between sinusoids and hepatocyte, where exchange of nutrients and waste products occur
Perisinusoidal Space (Space of Disse)
70
mononuclear phagocyte system
| degrade worn out rbc for the reuse of heme
Kupffer’s cells
71
INTRAHEPATIC VASCULAR SYSTEM: BLOOD SUPPLY
o Hepatic artery
| o Portal vein
72
Hepatic Artery
Supply 20% of blood flow
Branch of celiac plexus
O2 rich
Ramifies parallel with portal vein branches (run side by side)
73
Sends inlet arteriole to sinusoids to allow mixing of venous and arterial in sinusoids
Interlobular artery - Branch of hepatic artery
74
Supply 80% of blood flow to liver
portal vein
75
Splenic vein receives many tributaries:
o Short gastric v – drains fundus of stomach
o Left gastro-epiploic vein – upper/left portion of greater curvature of stomach
o Pancreatic branches
o Inferior mesenteric vein
76
Inferior mesenteric vein ascends on posterior abdominal wall and receives:
o Superior rectal veins
o Sigmoid veins
o Left colic vein
77
Inferior mesenteric vein then goes up to join the splenic vein behind the
body of the pancreas
78
drains the left/upper portion of lesser curvature of stomach, communicates with the esophageal plexus (drains the esophagus)
Left gastric vein
79
drains the right/lower portion of lesser curvature of stomach
Right gastric vein
80
Liver Acinus shape
diamond or rhomboai shape
81
Smallest functional unit of hepatic parenchyma
Liver Acinus
82
Disc shaped and lies in the concavity of the duodenum
head of pancreas
83
head of pancreas rests posteriorly on the
IVC, right renal artery and vein, and left renal vein
84
Origin of the superior mesenteric artery from the aorta
neck of pancreas
Important in being a landmark for the origin of vessels
85
Lies in front of the beginning of the portal vein behind the neck (splenic and mesenteric vein unite)
neck of pancreas
86
Lies to the left of the superior mesenteric vessels, passing over the aorta and the l2 vertebra
body of pancreas
87
Part of the pancreas that is Anterior to the left kidney and passes forward in the splenicorenal ligament
Tail
88
Drains the upper portion of the head of the Pancreas and opens into the duodenum about 2 cm above the main duct on the minor duodenal papilla
Accessory Pancreatic Duct (of Santorini)
89
Functions to contract the Ampulla of Vater to prevent the throw of bile during the basal state
Sphincter of Oddi
90
Arterial blood supply of the pancreas is dervide from the
Splenic artery
91
Pancreas is Drained via these pancreatic veins
o splenic vein o superior mesenteric vein
92
Lymphatic drainage, the pancreas drains into
celiac group of nodes and the superior mesenteric group of nodes
93
Sympathetic nerve supply of pancreas
greater sympathetic (T5-T9) to lesser splanchnic (T10-T11)
Parasympathetic o Vagus nerve
94
Polygonal clusters of cells arranged in short irregular
cords and profusely invested with fenestrated
capillaries because of endocrine function
Islets of Langerhans
Constitute about 1-2% of pancreatic volume
Most numerous in tail of pancreas
95
cuboidal to columnar in shape
Mucous cells
96
usually pyramidal in shape, with a broad base
Serous cells
97
Where secretory end pieces empty into
Intercalated ducts
98
Intercalated ducts, Lined by
simple cuboidal epithelial cells, with
| presence of striations
99
Characterized by radial striations that extend to form the bases of the cells to the level of the central nuclei
Striated ducts
initially lined with pseudostratified or stratified cuboidal epithelium, distally lined with stratified columnar epithelium
100
present in basal lamina of glands or ducts which function to propel secretions upon contraction
Myoepithelial cells
101
Secrete only 10% of the total volume of saliva, but account for approximately 70% of the mucous secreted
Minor salivary glands
102
Secrete in response to parasympathetic activity induced by physical, chemical, and psychological stimuli
Major salivary glands
103
Largest of the salivary glands
Parotid Glands - Wedge-shaped
104
emerges from the anterior border of the gland, runs toward the lateral surface of the masseter muscle, pierces the buccinator muscle, opens opposite the upper 2nd molar tooth, into the parotid papilla of the oral cavity
Stensen’s/Parotid duct
105
Submandibular/Submaxillary glands secretes
lyzozyme
106
Parotid Gland Arterial supply
External carotid artery (ECA) and its superficial terminal branches (Superficial temporal and maxillary aa.)
107
Parotid Gland Venous drainage
Retromandibular v.
108
Parotid Gland Lymphatic drainage
Parotid and Deep cervical nodes
109
Parotid Gland Nerve supply
Parasympathetic: Secretomotor supply from the glossopharyngeal nerve (via the tympanic branch, the Lesser Petrosal nerve, the Otic ganglion, and the Auriculotemporal nerve)
Sympathetic: Plexus around ECA
110
Submandibular/Submaxillary glands Arterial Supply and Venous drainage
Facial & Lingual (artery & vein)
111
Submandibular/Submaxillary glands Lymphatic drainage
Retromandibular and Deep cervical nodes
112
Submandibular/Submaxillary glands Nerve supply
o Parasympathetic: secretomotor supply is from the
facial nerve via the chorda tympani & the
submandibular ganglion (Superior Salivary nucleus of
CN VII)
o Sympathetic: Plexus around facial and lingual a.
113
Seen on the floor of mouth, beneath mucus membrane,
| close to the midline
Sublingual glands - smallest
- Secretes 5% of the total saliva
114
Largest mass of glandular tissue in the body
LIVER
FUNCTIONS
Production and secretion of bile
Involved in many metabolic activities related to carbohydrate, fat and protein metabolism
Filtration of blood – removes bacteria and other foreign particles
Synthesizes heparin and other important proteins
Produces bile pigments from hemoglobin of worn-out RBC’s
115
SURFACES OF THE LIVER
1. Diaphragmatic
2. Anterior aspect
3. Posterior aspect
4. Visceral or posteroinferior surface
116
Liver Visceral Surface, From the left to right:
```
fundus of the stomach
abdominal esophagus
gallbladder duodenum
right kidney with right suprarenal gland
right colic (hepatic) flexure
```
117
Right liver's impressions?
Renal Impression
- right kidney
Colic/Hepatic Impression
- right colic/ hepatic flexure
- below kidney
Suprarenal impression
- suprarenal gland
- above the kidney
118
Left liver's impressions?
```
o Esophageal impression
- esophagus
- upper portion
o Gastric impression
- fundus of the stomach
```
119
Liver's H-shaped pattern that made up by the IVC (above) and the gallbladder (below)
Right Limb
120
In the H-shaped pattern of the liver, the left limb is made up superiorly by ___ and inferiorly by_____
- ligamentum venosum (Remnant of ductus arteriosus)
| - fissure of ligamentum teres hepatis (Remnant of the left umbilical vein)
121
The transverse limb is occupied by the ____
porta hepatis
122
The transverse fissure of the liver
Transverse limb
123
The transverse limb contains the _____
portal triad
- Bile duct (right)
- Proper hepatic artery (left)
- Hepatic portal vein (posterior; biggest structure)
124
Important clinically because it is the only portion of the liver that can be accessed during physical examination
Inferior Margin of the Liver
125
In infants and about 3 years of age, the inferior margin of the liver can be palpated around ____
2 finger breadths below the right costal margin.
126
In adults, he inferior margin of the liver can be palpated ____
1 finger breadth below the right costal margin.
127
Normally the Inferior Margin of the Liver is ____
If the blunted, ___
If hard, _____
If it has nodules, _____
- smooth, sharp and pliable.
- may have congestion of the heart (CHF) or liver
- may have carcinoma.
- may be cirrhosis
128
Attaches to the undersurface of the liver
Lesser Omentum
129
thick portion of the lesser omentum that attaches to the margins of the porta hepatis.
Hepatoduodenal ligament
130
Hepatoduodenal ligament is the portion of lesser omentum to be dissected to see the ____
portal triad
131
thin portion of the lesser omentum that attaches around the fissure of ligamentum venosum
Hepatogastric ligament
132
Space between the anterior surface of the liver and the diaphragm and the anterior abdominal wall
Subphrenic recess
133
Space ro portion that extends upwards between the visceral surface of the liver and the right kidney
Subhepatic space - Hepatorenal recess / Morison’s pouch
134
Subhepatic space is immediately below the ____
inferior surface of the liver
135
Formed by the anterior and posterior layers of the coronary ligament which are wide apart
Bare area
136
portions of the liver that are devoid of peritoneum
- bare area
- Portion where the IVC lies
- Gallbladder bed
- Porta hepatis
137
attaches the anterior and superior portions of the liver to the anterior and superior surfaces of the abdominal wall, respectively
Falciform ligament
138
attaches the liver to diaphragm
Coronary ligament
139
double-layered fold of peritoneum that extends from the umbilicus to the diaphragm
Falciform ligament
140
Part of Coronary ligament formed when the anterior and posterior layers meet on the right side
Right triangular ligament
141
Left triangular ligament merges with the left tip of the liver called the
appendix fibrosa hepatis
142
Part of Coronary ligament formed when the anterior and posterior layers meet on the left side
Left triangular ligament
143
Hepatic Segments
I - Posterior/Caudate V - Right anterior medial
II - Left posterior lateral VI - Right anterior lateral
III - Left anterior lateral VII - Right posterior lateral
IV - Left medial VIII - Right posterior medial
P L- PAM RAM/L RPL/M
144
What consist the portal trial?
POrtal vein
Hepatic artery
Bile duct
145
Caudate does not really occupy a caudal position but it is thus named because it has a tail called the ___
papillary process
146
caudate process extends to the right and the rest of the right lobe of the liver and is located between _____
the IVC and the gallbladder
147
liver is divided by a major lobar fissure demarcated by the____
inferior vena cava and the gallbladder
Functional Part of Liver
o Functional right lobe
o Functional left lobe
148
areas demarcated by the (right and left) branches of the portal triad
Transverse hepatic plane (T)
149
divides the left lobe into left medial and left lateral lobe
Umbilical Fissure
delineated by the left hepatic vein
150
divides the right lobe into right medial and right lateral lobe
Right portal fissure (R)
delineated by the right hepatic vein
151
Main portal fissure (M)
delineated by the middle hepatic vein
152
Thin CT capsule in stroma
Glisson’s Capsule
153
In between sinusoids and hepatocyte, where exchange of nutrients and waste products occur
Perisinusoidal Space (Space of Disse)
154
mononuclear phagocyte system
| degrade worn out rbc for the reuse of heme
Kupffer’s cells
155
INTRAHEPATIC VASCULAR SYSTEM: BLOOD SUPPLY
o Hepatic artery
| o Portal vein
156
Hepatic Artery
Supply 20% of blood flow
Branch of celiac plexus
O2 rich
Ramifies parallel with portal vein branches (run side by side)
157
Sends inlet arteriole to sinusoids to allow mixing of venous and arterial in sinusoids
Interlobular artery - Branch of hepatic artery
158
Supply 80% of blood flow to liver
portal vein
159
Splenic vein receives many tributaries:
o Short gastric v – drains fundus of stomach
o Left gastro-epiploic vein – upper/left portion of greater curvature of stomach
o Pancreatic branches
o Inferior mesenteric vein
160
Inferior mesenteric vein ascends on posterior abdominal wall and receives:
o Superior rectal veins
o Sigmoid veins
o Left colic vein
161
Inferior mesenteric vein then goes up to join the splenic vein behind the
body of the pancreas
162
drains the left/upper portion of lesser curvature of stomach, communicates with the esophageal plexus (drains the esophagus)
Left gastric vein
163
drains the right/lower portion of lesser curvature of stomach
Right gastric vein
164
Liver Acinus shape
diamond or rhomboai shape
165
Smallest functional unit of hepatic parenchyma
Liver Acinus
166
Disc shaped and lies in the concavity of the duodenum
head of pancreas
167
head of pancreas rests posteriorly on the
IVC, right renal artery and vein, and left renal vein
168
Origin of the superior mesenteric artery from the aorta
neck of pancreas
Important in being a landmark for the origin of vessels
169
Lies in front of the beginning of the portal vein behind the neck (splenic and mesenteric vein unite)
neck of pancreas
170
Lies to the left of the superior mesenteric vessels, passing over the aorta and the l2 vertebra
body of pancreas
171
Part of the pancreas that is Anterior to the left kidney and passes forward in the splenicorenal ligament
Tail
172
Drains the upper portion of the head of the Pancreas and opens into the duodenum about 2 cm above the main duct on the minor duodenal papilla
Accessory Pancreatic Duct (of Santorini)
173
Functions to contract the Ampulla of Vater to prevent the throw of bile during the basal state
Sphincter of Oddi
174
Arterial blood supply of the pancreas is dervide from the
Splenic artery
175
Pancreas is Drained via these pancreatic veins
o splenic vein o superior mesenteric vein
176
Lymphatic drainage, the pancreas drains into
celiac group of nodes and the superior mesenteric group of nodes
177
Sympathetic nerve supply of pancreas
greater sympathetic (T5-T9) to lesser splanchnic (T10-T11)
Parasympathetic o Vagus nerve
178
Polygonal clusters of cells arranged in short irregular
cords and profusely invested with fenestrated
capillaries because of endocrine function
Islets of Langerhans
Constitute about 1-2% of pancreatic volume
Most numerous in tail of pancreas
