Accessory Organs Of Digestion

Question 1

What kind of saliva does the parotid gland secrete?

Answer 1

Serous saliva

Question 2

What is the name of the duct that secretes saliva from the parotid gland?

What is its pathway?

Answer 2

Stenston Duct

Arises from anterior surface of the gland, transverses the masseter muscle, turns into the buccal fat pad and pierces the buccinator, opens into the oral cavity near the 2nd upper molar

Question 3

What 3 important structures pass through the parotid gland?

What do they divide into? (Or are formed by?)

Answer 3

Facial nerve - divides into 5 terminal branches to innervate muscles of facial expression
External carotid artery - divides into maxillary and superficial temporal artery
Retromandibular vein - formed by convergence of superficial temporal and maxillary veins

Question 4

What is the parasympathetic innervation of the parotid gland?

Answer 4

Glossopharyngeal nerve, synapses with otic ganglion

Auriculotemporal nerve carries parasympathetic fibres from the otic ganglion

This results in an increase in saliva production

Question 5

What kind of secretion does the submandibular gland secrete?

Answer 5

Mixed serous and mucous secretion

Question 6

What is the name of the submandibular duct?

What is its pathway?

Answer 6

Wharton’s Duct

Emerges anteromedial from the deep arm of the gland, ascends on its course to open a the base of the lingual frenulum bilaterally

Question 7

What is the parasympathetic innervation of the submandibular and sublingual gland?

Answer 7

Chorda tympani synapses at the submandibular ganglion

Post ganglion innervation of the gland

This increases saliva secretion

Question 8

What kind of secretion do the sublingual glands secrete?

Answer 8

Mucous secretion

Question 9

What is the name of the sublingual duct?

Answer 9

Barholin duct

Question 10

What are the two functions of the pancreas?

Answer 10

Exocrine - secrete digestive juices

Endocrine - secrete hormones to control glucose levels

Question 11

What are the 5 anatomical parts of the pancreas?

Answer 11

Head - lies in C shaped curve created by duodenum
Uncinate process - projection from lower part of head
Neck - located between head and body
Body - centrally located
Tail - left end of pancreas that lies in close proximity to the spleen

Question 12

What is the only part of the pancreas that is intraperitoneal?

Answer 12

The tail

Question 13

Describe the course of the pancreatic duct?

Answer 13

Beings at the tail of the pancreas
Runs the length of the pancreas right through body into the head, turns inferiorly in the head
In the head it gives off the accessory pancreatic duct
In the lower head it combines with the common bile duct to form the hepatopancreatic ampulla (ampulla of vater)

Question 14

Where does the hepatopancreatic ampulla open into?

Answer 14

The major duodenal papilla

In the 2nd (descending)part of the duodenum

Question 15

How are the secretions at the major duodenal papilla controlled

Answer 15

By the sphincter of oddi - surrounds the ampulla of vater and acts as a valve

Question 16

Where does the accessory pancreatic duct open into?

Answer 16

The minor duodenal papilla

Question 17

What do the pancreatic duct and the bile duct combine to make?

Answer 17

The ampulla of vater

Question 18

What is the arterial supply to the pancreas?

Answer 18

Splenic artery - supplies the body and neck
Gastroduodenal artery - splits into the anterior superior and posterior superior pancreaticoduodenal artery to supply the head
Superior mesenteric artery - splits into the anterior inferior and posterior inferior pancreaticoduodenal artery to supply the head

Question 19

What is the venous drainage of the pancreas?

Answer 19

Superior mesenteric vein

Splenic vein

Question 20

What is the lymphatic drainage of the pancreas?

Answer 20

Pancreaticosplenal nodes

Pyloric nodes

Question 21

What are the two surfaces of the liver?

Answer 21

Diaphragmatic Surface - anterosuperior surface of the liver which is smooth and convex

Visceral Surface - posteroinferior surface of the liver, moulded by the shape of the surrounding organs

Question 22

What is the bare area of the liver?

What is it bounded by?

Answer 22

Part of the liver on the diaphragmatic surface where there is no intervening peritoneum between the liver and the diaphragm

Bounded by the anterior coronary and posterior coronary ligament

Question 23

What are the three hepatic recesses?

Answer 23

Subphrenic space (left and right) - located between the diaphragm and the liver
Subheptic space - located between inferior surface of liver and transverse colon
Hepatorenal recess - located between the right side of liver and the right kidney

Question 24

What is another name for the hepatorenal recess?

Answer 24

Morison’s Pouch

Question 25

What is the falciform ligament? What is it a remnant of?

Answer 25

Ligament attached to the anterior surface of the liver to the anterior abdominal wall, divides the left and right lobes Free edge contains the ligamentum teres - remnant of the umbilical vein

Question 26

What is the fibrous layer that covers the liver called?

Answer 26

Glisson's capsule

Question 27

What are the four lobes of the liver?

Answer 27

Right Left Caudate Quadrate

Question 28

What is the ligamentum venosum a remnant of?

Answer 28

The fetal ductus venousus

Question 29

What is the portal triad composed of?

Answer 29

Branch of hepatic artery entering the liver Branch of hepatic portal vein entering the liver Branch of bile duct leaving the liver

Question 30

Which two veins combine to make the portal vein? Where does this occur?

Answer 30

Splenic vein and Superior mesenteric Occurs at the level of L2 posterior to the neck of the pancreas

Question 31

What is the blood supply to the liver

Answer 31

Hepatic artery proper (25%) | Hepatic portal vein (75%)

Question 32

What is the venous drainage of the liver?

Answer 32

Left and right hepatic veins - drain into the inferior vena cava

Question 33

What is the purpose of portacaval anastomoses?

Answer 33

If portal circulation to the liver is obstructed, then blood can return to the heart via the systemic circulation

Question 34

What are the four site of portacaval anastomoses?

Answer 34

Inferior oesophagus Upper anal canal Secondary retroperitoneal structures Paraumbillical area of anterior abdominal wall

Question 35

Describe the portacaval anastomoses at the inferior oesophagus

Answer 35

Portal drainage - left gastric vein into portal vein | Systemic drainage - azygos vein into IVC

Question 36

Describe the portacaval anastomoses at the upper anal canal

Answer 36

Portal drainage - superior rectal veins drain into portal system Systemic drainage - middle and inferior rectal veins drain int internal iliac and internal pudendal which drain into IVC

Question 37

Describe the portacaval anastomoses at the umbilicus

Answer 37

Portal drainage - paraumbilical veins drain into portal system System drainage - superficial epigastric veins drain into axillary or femoral veins which drain into IVC

Question 38

What is the lymphatic drainage from the liver

Answer 38

``` Hepatic lymph nodes (lie in the lesser omentum) Drain into coeliac lymph nodes Drain into intestinal trunk Drain into cysterna chyli Drain into thoracic duct ```

Question 39

What is the storage capacity of the gall bladder?

Answer 39

30-50mL

Question 40

Where does the gall bladder lie?

Answer 40

On the visceral surface of the right lobe of the liver in a fossa between the right and quadrate lobes

Question 41

What are the three parts of the gall bladder?

Answer 41

Fundus Body Neck

Question 42

What is Hartmann's pouch?

Answer 42

A mucosal fold located in the neck of the gall bladder, where gallstones commonly become lodged

Question 43

Describe the route of bile through the Biliary tree

Answer 43

Begins at the left and right hepatic ducts Unite to form common hepatic duct Unite with cystic duct from gall bladder to form common bile duct Combine with pancreatic duct to form ampulla of vater Empties into duodenum at major duodenal papilla

Question 44

How is secretion of bile controlled?

Answer 44

By CCK release from enteroendocrine cells in duodenum - which is triggered by presence of fat in duodenum This causes sphincter of oddi to relax It also causes gall bladder to contract

Question 45

What is the arterial supply of the gall bladder

Answer 45

Cystic artery - branch of right hepatic artery

Question 46

What is the venous drainage of the gall bladder?

Answer 46

Dependant on area of the gall bladder: Fundus and body - drain into hepatic sinusoids Neck and cystic duct - drain into cystic vein

Question 47

What is the lymphatic drainage of the gall bladder?

Answer 47

Cystic node

Question 48

Where is the quadrate lobe found?

Answer 48

In between the left lobe and the gall bladder