Accessory Organs Flashcards

1
Q

Largest gland in the body

A

Liver

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2
Q

Specific regions the liver occupies

A

Right hypochondruim, across the epigastrium, into left hypochondrium

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3
Q

Connects the stomach and the liver

A

Lesser Omentum

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4
Q

What ligaments make up the lesser omentum?

A

heptaogastric and hepatoduodenal ligaments

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5
Q

What does the hepatoduodenal ligament contain?

A

Common bile duct, proper hepatic artery, hepatic portal vein

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6
Q

Is a reflection of the peritoneum from the liver to the diaphragm

A

Coronary ligament

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7
Q

What encircles the bare area of the liver, but is considered intraperitoneal?

A

Coronary and triangluar ligaments

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8
Q

What ligaments split the liver into lobes?

A

The ligamentum teres hepatic is enclosed by the falciform ligament

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9
Q

What is the falciform ligament continuous with?

A

Coronary ligament on the superior surface and the lesser omentum at the porta hepatis

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10
Q

Lies between the anterior part of the liver and the diaphragm

A

Subphrenic recess

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11
Q

Deep recess on the right side between the liver anteriorly and the kidney

A

Hepatorenal recess aka Morison’s pouch

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12
Q

Where does the fliud draining from the omental bursa flow into?

A

Morison’s recess

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13
Q

Between the left lobe of the lliver and the diaphragm

A

Superior recess of omental bursa (lesser sac)

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14
Q

In the middle of the visceral surface of the liver

A

Porta hepatis

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15
Q

Elongated smooth area that runs from the inferior margin of the liver towards the IVC

A

Fossa for gallbladder

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16
Q

Posterior aspect of the liver in the bare area contains a space near the midline for a major structure

A

Groove for IVC

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17
Q

From the inferior border of the liver to the porta hepatis

A

Fissure for ligamentum teres hepatis

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18
Q

Deep fissure passing from the porta hepatis to the posterior surface of the liver

A

Fissure for ligamentum venosum

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19
Q

Organs superiorly related to the liver

A

Base of right lung, pericardium/heart, base of left lung

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20
Q

Anterior relations to the liver

A

Costal margin, xiphoid process, abdominal wall

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21
Q

Posterior relationships to the liver

A

Direct contact with the diaphragm, IVC, right suprarenal gland, small portion of the right kidney

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22
Q

Inferior relationships to the liver to the right of the gallbladder

A

Duodenum, right kidney, right flexure of colon, transverse colon

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23
Q

Inferior relationships to the liver to the left of the gallbladder

A

Lesser omentum, stomach, esophagus

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24
Q

Lobe between the gallbladder and the fissure of the ligamentum teres anterior to the porta hepatis

A

Quadrate lobe

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25
Q

Passes to the right between the porta hepatis and the IVC

A

Caudate process of the caudate lobe

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26
Q

Caudate lobe/process hypertrophy seen with occlusion of hepatic veins

A

Budd-Chiari syndrome

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27
Q

Inferior projection off of the caudate lobe that may be confused for a pancreatic mass or enlarged lymph node

A

Papillary process

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28
Q

Functional lobes of the liver

A

Right, left, caudate

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29
Q

What supplies blood to the right and left lobes?

A

Separate primary branches of hepatic artery

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30
Q

Blood supply/drainage to the caudate lobe

A

Both right and left primary branches, drained by it’s own hepatic vein

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31
Q

Provides 75% of the blood to the liver

A

Portal vein

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32
Q

Provides 25% of blood to the liver

A

Hepatic arteries

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33
Q

Where is the portal vein formed?

A

Posterior to neck of the pancrease where the splenic and superior mesenteric ceins join

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34
Q

Path of the splenic vein

A

Formed in the hilum of the spleen, passes in the splenorenal ligament, passes inferiorly to the splenic artery, posterior to the tail/body of the pancrease

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35
Q

Tributaries to the splenic vein

A

Short gastric veins, left gastro-omental vein, pancreatic veins, inferior mesenteric vein

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36
Q

Pathway of superior mesenteric vein

A

Crosses anterior 1/3 of the duodenum/uncinate process of the pancrease, terminates posterior to the neck of the pancreas, help form portal vein

37
Q

Tributaries of the superior mesenteric vein

A

Jejuna, ileale, ileocolic, right/middle colic, right gasto-omental, anterior/posterior inferior pancreatico-duodenal VEINS

38
Q

Tributaries to the portal vein

A

Right/left gasteric veins, posterior superior pancreaticoduodenal vein, cystic veins, paraumbilical veins

39
Q

Portaal vein’s course/location

A

Ascends posterior to the 1st part of the duodenum, lies in free margin of lesser omentum, posterior to bile duct/hepatic artery

40
Q

Proper hepatic artery branching coursing

A

Left: left of the common hepatic duct, right:posterior to the common hepatic duct

41
Q

Where does the lymph of the liver/gall bladder drain to primarily?

A

Phrenic nodes near diaphragm, and secondarily to hepatic nodes near porta hepatis

42
Q

Sympathetic innervation of liver/gall bladder

A

T6-T9, greater splanic nerves synapse with celiac ganglion

43
Q

Parasympathetic innervtion of liver/gall bladder

A

From vagus, hitch-hike on sympathetic

44
Q

What nerve provides afferent fibers to the liver/gall baldder area?

A

Phrenic nerve

45
Q

What liver lobes surround the gallbladder?

A

Right and quadrate lobe

46
Q

External locators for gall bladder

A

Tip of right 9th costal cartilage and midclavicular line

47
Q

Contacts of the gall bladder

A

Visceral surface of the liver, transverse colon, superior part of duodenum

48
Q

Parts of the gall bladder

A

Fundus, body, neck

49
Q

What keeps the gall bladder lumen patent?

A

Spiral valve

50
Q

Connects neck of gall bladder to common hepatic duct,

A

Cystic duct

51
Q

Formed by joining the right and left hepatic ducts

A

Common hepatic duct

52
Q

Formed by joining the common hepatic duct to the cystic duct at an acute angle

A

Bile duct

53
Q

Path of the bile duct

A

Descends in the free border of lesser omentum, passes posterior to the duodenum/head of pancreas, becomes embedded in pancreas, merges with main pancreatic duct

54
Q

Which portion of the duodenum does the main pancreatic duct/bile duct pass thru?

A

posteriomedial wall of the 2nd part of the duodenum

55
Q

Landmarks of Cystohepatic triangle of Calot

A

Cystic duct, common hepatic duct, liver

56
Q

What does the triangle of calot contain?

A

Normally right hepatic artery and cystic artery

57
Q

Where do cystic veins drain to?

A

Portal veins

58
Q

Exocrine products of pancreas

A

Digestive enzymes

59
Q

Endocrine products of pancreas

A

Insulin and glucagon

60
Q

Vertebral level of the pancreas

A

L1-L3

61
Q

Uncinate process of the pancreas

A

Hook-like extension from lower left part of the head that lies posterior to the superior mesenteric vessels

62
Q

What part of the pancreas forms part of the bed of the stomach?

A

Body

63
Q

Where do loops of bowel contact anterior surface of the pancreas?

A

inferior to the attachment of the transverse mesocolon

64
Q

What is posterior to the pancreas?

A

aorta, renal arteries, left kidney, renal veins, IVC, portal vein

65
Q

Location of the main pancreatic duct

A

Length of pancreas, coursing from left to right, in the middle of the organ

66
Q

Where does the main pancreatic duct end?

A

Major duodenal papilla

67
Q

The dilation of pancreatic/bile ducts with in the major duodenal papilla

A

Hepatopancreatic ampulla of Vater

68
Q

Funnel-shaped muscular sheath that surrounds the bile duct just proximal to its passage thru the duodenal wall

A

Sphinctor of the bile duct

69
Q

Musculr sheath that encloses and constricts the ampulla of Vater

A

Hepatopancreatic sphincter of Odi

70
Q

Blood supply to pancreas

A

Branches of celiac trunk and superior mesenteric artery

71
Q

Arteries that arise from the gastroduodenal artery

A

Anterior/posterior superior pancreaticoduodenal arteries

72
Q

Arteries that arise from the superior mesenteric artery

A

Anterior/posterior inferior pancreaticoduodenal arteries

73
Q

Atery that arises from the proximal portion of the splenic artery

A

Dorsal pancreatic artery, great pancreatic artery (largest)

74
Q

Venous draingage of the pancreas

A

Splenic vein, superior mesenteric vein, portal vein

75
Q

Lymph drainage of pancreas superior to attachment site of transverse mesocolon

A

Towards the celiac nodes

76
Q

Lymph drainage of pancreas inferior to attachment site of transverse mesocolon

A

Towards the superior mesenteric nodes

77
Q

Area where spleen lies

A

Left hypochondrium

78
Q

What ribs cover the spleen?

A

9 thru 11

79
Q

What organs does the spleen contact?

A

Stomach, left kidney, left colic flexure, tail of pancreas

80
Q

What ligament supports the spleen?

A

Phrenicocolic ligament

81
Q

What ligament contains the splenic artery/vein?

A

Splenorenal ligament

82
Q

Site of structures entering and kidneys

A

hilum

83
Q

Anterior to posterior location of structures

A

Renal vein, renal artery, renal pelvis

84
Q

Outer zone of the kidney

A

Cortex

85
Q

Inner zone of kidney

A

Medulla

86
Q

Medulla composition

A

Columns, pyramids, papilla

87
Q

Where do the papilla drain to?

A

Calyx (minor and major)

88
Q

Difference between the shapes of the suprarenal glands

A

Right: pyramind shape, Left: flat and semilunar

89
Q

Where are the suprerenal glands found?

A

Inside the renal fascia, above the kidneys