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MBBS 2: Gastrointestinal Tract Anatomy > Anatomy of Liver, Gallbladder and Pancreas > Flashcards

Anatomy of Liver, Gallbladder and Pancreas Flashcards

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1
Q

Name the 3 accessory digestive organs in the abdominal cavity that help in the chemical breakdown of food?

A
  1. liver 2. gall bladder 3. pancreas
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2
Q

Describe characteristics of the liver?

A
  1. reddish brown - great vascularity 2. stores glygogen + secretes bile 3. largest internal organ - 1.5 kg in adults
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3
Q

Where is the liver located?

A

beneath the diaphragm in the right upper quadrant - right hypochindriac + epigastric

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4
Q

Name the surfaces of the liver?

A
  1. diaphragmatic surface 2. visceral surface 3. bare area
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5
Q

Describe the diaphragmatic surface?

A
  1. diaphragm is anterior + superior + some posterior 2. smooth + dome-shaped
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6
Q

What seperates the diaphragmatic surface from the diaphragm?

A

left + right subphrenic recesses

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7
Q

What seperates the subphrenic recesses into left and right?

A

falciform ligament

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8
Q

Describe the bare area of liver?

A
  1. posterior to diaphragm

2. demarcated by reflections of upper & lower layers of coronary ligament

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9
Q

Describe the visceral surface?

A

covered by peritoneum except porta hepatis

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10
Q

What are the relations of the visceral surface?

A
  1. stomach + lesser omentum
  2. duodenum + right colic flexure
  3. gall bladder, right kidney + suprarenal gland
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11
Q

Describe the hepatorenal recess?

A

between right kidney and right lobe of liver

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12
Q

Describe the lobes of the liver?

A

has functionally independent right and left parts that are approximately equal in size

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13
Q

Each part of the liver has its own?

A
  1. blood supply - hepatic artery + portal vein

2. venous + biliary drainage

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14
Q

What seperates the 2 lobes on the visceral surface?

A

gall bladder + IVC fossae

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15
Q

The caudate and quadrate lobes function as part of which lobe?

A

left lobe

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16
Q

Why are the quadrate and caudate lobes part of the left lobe?

A

they are supplied by left hepatic artery, left branch of portal vein & deliver bile to left hepatic duct

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17
Q

The caudate and quadrate lobes are anatomically part of which lobe?

A

right lobe

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18
Q

What are the lobes of the liver?

A
  1. right 2. left 3. caudate 4. quadrate
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19
Q

Where is the caudate lobe?

A

between IVC and fissure for ligamentum venosum (ductus venosus)

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20
Q

Where is the quadrate lobe?

A

between the gall bladder fossa and ligamentum teres (umbilical vein)

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21
Q

Function of the falciform ligament?

A
  1. seperates right from left lobe anteriorly 2. attaches liver to anterior abdominal wall + diaphragm
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22
Q

Describe the ligamentum teres?

A
  1. continuous with falciform ligament to umbilicus 2. remnant of umbilical vein of fetus
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23
Q

What is the porta hepatis?

A

fissure on visceral surface between caudate and quadrate lobes

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24
Q

The porta hepatis gives passage to?

A
  1. hepatic artery 2. portal vein 3. hepatic ducts 4. lymphatics 5. nerves
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25
What is the epiploic foramen?
opening where the lesser and greater sac communicate
26
What are the relations of the epiploic foramen?
1. anterior - hepatic artery, portal vein + bile duct 2. posterior - IVC
27
What are the peritoneal relations of the liver?
1. hepatogastric ligament - part of lesser omentum between liver and stomach 2. hepatoduodenal ligament - part of lesser omentum between liver and duodenum
28
Describe the arterial supply of the liver?
1. hepatic artery : oxygenated blood from aorta - 30% | 2. portal vein : poorly oxygenated blood from GIT
29
Describe the venous drainage?
1. hepatic veins draining into IVC
30
Describe the lymphatic drainage of the liver?
1. hepatic lymph node - celiac lymph node - cisterna chyli - thoracic duct 2. phrenic lymph node + mediastinal lymph node - right lymphatic + thoracic ducts
31
Describe the nerve supply?
hepatic nerve plexus
32
Describe the gall bladder?
7-10 cm pear shaped organ covered by the peritoneum
33
Where is the gall bladder?
in the gall bladder fossa - liver visceral surface
34
What are the parts of the gall bladder?
1. Fundus - located at tip of right 9th coastal cartilage – transpyloric plane 2. Body - related to liver, T colon, duodenum 3. Neck - narrow, has spiral valve & directed to porta hepatis
35
What is the arterial supply of the gall bladder?
1. cystic artery - branch of right hepatic artery 2. Small vessels from the visceral surface of the liver
36
What is the venous drainage?
cystic vein
37
What is the lymphatic drainage of the gallbladder?
cystic + hepatic lymph node - celiac lymph node
38
What is the nerve supply of the gallbladder?
1. celiac plexus 2. vagus 3. right phrenic nerves
39
What are bile canaliculi?
hepatocytes produce bile and secrete it into these thin channels
40
Describe the biliary tree?
1. bile canaliculi drain into small interlobular biliary ducts that drain into right and left hepatic ducts carrying bile away from liver 2. Hepatic ducts unite to form common hepatic (CH) duct 3. Cystic duct joins CH to form the bile duct - carrying bile to duodenum
41
Describe the arterial supply of the bile duct?
1. proximal - cystic artery 2. middle - right hepatic artery 3. retroduodenal - Post sup pancreaticoduodenal & gastroduodenal arts
42
Describe the venous drainage of the bile duct?
Post sup pancreaticoduodenal vein
43
Describe the lymphatic drainage?
cystic + hepatic lymph node + celiac lymph node
44
Things to note before doing a cholecystectomy?
1. Be aware of the many variations in the arterial supply to the gallbladder and the relationship of the vessels to the bile ducts 2. Hepatic and bile ducts commonly included in arterial ligation
45
Describe the pancreas?
elongated digestive gland
46
Where is the pancreas?
posterior to stomach
47
What is the exocrine component?
pancreatic juice - trypsin
48
What is the endocrine component?
glucagon + insulin
49
What are the parts of the pancreas?
1. head 2. neck 3. tail 4. body
50
Describe the head of the pancreas?
1. in the curve of the duodenum posterior to superior mesenteric vessesl 2. posterior relations include: IVC, right renal artery + vein, left renal vein, bile duct
51
Describe the neck?
posteriorly - superior mesenteric vein + splenic vein form portal vein
52
Describe the body?
1. Extend to left across aorta & L2 - posterior to omental bursa 2. lateral - splenic vessels 3. anterior - stomach 4. posterior - aorta, superior mesenteric artery, left kidney, suprarenal gland
53
Describe the tail?
1. passes between the splenorenal ligament layers 2. tip related to hilum of spleen
54
Describe the main pancreatic duct?
1. extends through length of gland 2. unites with bile duct to form hepatopancreatic ampullla (of Vater) that has hepatopancreatic sphincter (of Oddi) - Ampulla empties into duodenum thru major duodenal papilla
55
Describe the blood supply of the pancreas?
pancreatic arteries - branches of splenic, pancreaticoduodenal, SMA & gastroduodenal arts
56
Describe the venous drainage of the panreas?
1. pancreatic 2. splenic 3. superior mesenteric vein
57
Describe the lymphatic drainage of the pancreas?
pancreaticosplenic, celiac, SM LN
58
Describe the nerve supply of the pancreas?
vagus + thoracic splanchnic
59
What is hepatitis?
inflammation of the liver
60
What is cholecytitis?
inflammation of gall bladder due to cystic duct blockage - gall stones
61
What is jaundice?
if bile cannot leave gall bladder, enters blood
62
What is cirrhosis?
hepatocytes are destroyed & replaced with fibrous tissue
63
Describe liver support and surgery?
attachment of hepatic veins to the inferior vena cava; peritoneal ligaments and abdominal muscles for minor support
64
What causes trauma to the liver?
fractures of lower ribs
65
How do you do a liver biopsy?
needle inserted through the right 8th or 9th intercostal space in the midaxillary line passing through the diaphragm into the liver to get a small tissue for microscopy
66
Pain from the pancreas is referred to?
the back
67
Describe the spread of inflammation of the pancreas?
Inflammation of the pancreas can spread to the peritoneum forming the posterior wall of the lesser sac - this in turn can lead to adhesions and the closing off of the lesser sac to form a pseudocyst

MBBS 2: Gastrointestinal Tract Anatomy (7 decks)

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