Chapter 8 The Liver, Gall Bladder, and Gastrointestinal Tract

Question 1

Which fissure divides the liver anatomically?

Answer 1

Falciform ligament, ligamentum teres, ligamentum venosum

Question 2

Which structures divide the liver functionally?

Answer 2

The line between fossa for gall bladder to the fossa with inferior vena cava behind it.

Question 3

What remnant is the ligamentum venosum for?

Answer 3

Ductus venosus - which used to shunt oxygenated blood from umblical vein past liver and into inferior vena cava before birth.

Question 4

What remnant is the ligamentum teres of?

Answer 4

left umbilical vein

Question 5

Where does the lesser omentum merge with?

Answer 5

Visceral peritoneum of liver in floor of the fissure formed by the ligamentum venosum and ligamentum teres.

Question 6

Which lobe is found between the fissure for the ligamentum venosum and the fossa for inferior vena cava?

Answer 6

Caudate lobe

Question 7

Which lobe is located between fossa for gall bladder and anterior part of ligamentum teres fissure?

Answer 7

Quadrate lobe

Question 8

Which ligaments enclose the bare area?

Answer 8

Anterior coronary ligament and posterior coronary ligament.

Question 9

What are the triangular ligaments?

Answer 9

The right triangular ligament occurs when the anterior and posterior coronary ligament meet and run together in a straight line for a while. The left triangular ligament runs as double layer to the left of the falciform ligament.

Question 10

Where does the right and left subphernic pockets lie between?

Answer 10

Between diaphragm and liver on either side of falciform ligament.

Question 11

Where is the subhepatic pouch (hepatorenal space)?

Answer 11

Between inferior visceral surface of the liver and the right kidney.

Question 12

Which structures is the liver in contact with?

Answer 12

Oesophegus, stomach, duodenum, right hepatic flexure of colon and right kidney, right suprarenal gland.

Question 13

What fossa does the gall bladder lie on?

Answer 13

Cystic fossa

Question 14

What are the parts of the gall bladder?

Answer 14

Fundus, Body, Neck, Cystic duct

Question 15

Cystic duct joins the _?

Answer 15

Common hepatic duct

Question 16

Left and right hepatic duct joins the _?

Answer 16

Common hepatic duct

Question 17

Cystic duct and Common hepatic duct join to form the _?

Answer 17

Common bile duct

Question 18

Common bile duct joins with pancreatic duct at the _?

Answer 18

Hepatopancreatic ampulla

Question 19

Hepatopancreatic ampulla opens into the duodenum at the _?

Answer 19

Duodenal papilla in wall of second part of the duodenum

Question 20

Which main artery supplies liver and gall bladder?

Answer 20

Coeliac trunk

Question 21

Which branches do coeliac trunk sprout?

Answer 21

Left gastric artery, common hepatic artery, splenic artery

Question 22

What does the common hepatic artery give off?

Answer 22

Right gastric artery
gastroduodenal artery
Then proceeds to give off the right and left hepatic arteries.

Question 23

Which arteries pass close to porta hepatis?

Answer 23

Right and left hepatic arteries (right behind the common hepatic duct)

Question 24

How does the right hepatic artery branch off to supply the gall bladder?

Answer 24

It gives off a cystic artery to supply the gall bladder

Question 25

Which part of the stomach is seen to contain swallowed air on radiographs?

Answer 25

Fundus

Question 26

What is the incisura angularis?

Answer 26

Notch on the lesser curvature that marks the junction of the body with the antrum

Question 27

Difference between pyloric and cardiac sphincter?

Answer 27

Pyloric sphincter is thickened by circular smooth muscles.

Question 28

What is surface marking point of cardiac sphincter?

Answer 28

Just to the left of the 6th costal cartilage in the midline

Question 29

What is surface marking point of pyloric sphincter?

Answer 29

Just to the right of the midline in the transpyloric plane

Question 30

What does the stomach relate to anteriorly?

Answer 30

Liver, diaphragm and abdominal wall

Question 31

What does the stomach relate to posteriorly?

Answer 31

Suprarenal gland, left kidney, transverse colon, spleen, pancreas, left crus of the diaphragm

Question 32

What arterial blood supplies the stomach?

Answer 32

Coeliac trunk

Question 33

Where do the left and right gastric arteries branch off from?

Answer 33

Left gastric artery branches directly off the coeliac trunk hilst the right gastric artery is one of the branches of common hepatic artery.

Question 34

What level does the first part of the duodenum lie?

Answer 34

L1

Question 35

Where is the lesser omentum attached?

Answer 35

Upper surface of the first part of the duodenum

Question 36

Why is the duodenum after the first part immobile?

Answer 36

It becomes retroperitoneal

Question 37

Which part is the 2nd part of duodenum?

Answer 37

The part that descends and crosses over hilum of right kidney

Question 38

Which part of the duodenum is the duodenal papilla located?

Answer 38

2nd part

Question 39

Which part is the 3rd part of the duodenum? Which level is it at?

Answer 39

As it levels the horizontal part of the curve. It lies just above umbilicus at level L3.

Question 40

Which veins and arteries lie behind the 3rd part of the duodenum?

Answer 40

IVC, Aorta, Right and left gonadal vein and artery

Question 41

Which muscle does the right ureter lie on?

Answer 41

Right psoas muscle

Question 42

Which vessel passes anteriorly in front of the 3rd part of duodenum?

Answer 42

Superior mesenterric artery

Question 43

What two structures do the duodenojejunal junction link?

Answer 43

4th part of the duodenum and the jejunum

Question 44

What is the suspensory ligament of the duodenum (ligament of Treitz)?

Answer 44

This is a ligament that may have muscle fibres in it, and it joins the 4th part of the duodenum to the right crus.

Question 45

Where are the superior and inferior fossae?

Answer 45

The pouches that form as the 4th part of the duodenum enters the peritoneal cavity formed by the peritoneum.

Question 46

4 parts of the pancreas

Answer 46

Head, neck, body, tail (urinate process)

Question 47

Which parts of the pancreas is retriperitoneal?

Answer 47

All parts but the tail

Question 48

Which artery queezes out from behind the pancreas to run ontop of the front of the 3rd part of the duodenum?

Answer 48

Superior mesenteric artery

Question 49

Where is the urinate process in relation to the superior mesenteric artery?

Answer 49

It hooks behind the superior mesenteric artery as it is developed in the ventral mesentery.

Question 50

Which ligament does the tail of the pancreas run behind?

Answer 50

Lienorenal ligament

Question 51

Which rib does the spleen lie on?

Answer 51

10th rib

Question 52

When enlarged, which levels of ribs can the spleen be felt?

Answer 52

9th, 10th, 11th ribs on deep inspiration

Question 53

What are the 3 regions created by the Y shaped central region on the spleen?

Answer 53

Kidney lies against it posteriorly Splenic fixure of colon lies anteriorly Stomach lies above it

Question 54

Describe path of splenic artery

Answer 54

Direct branch of coeliac trunk that runs along upper border of pancreas an dthen within lineorenal ligament to the spleen.

Question 55

What is the ligament attaching the stomach and the spleen?

Answer 55

Gastrosplenic ligament

Question 56

What does the gastrosplenic ligament contain?

Answer 56

Short gastric arteries that run from splenic artery to fundus of the stomach.

Question 57

Which parts make up the small intestine

Answer 57

Jejunum and ilieum