Clinical anatomy of jaundice 2 Flashcards Preview

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Flashcards in Clinical anatomy of jaundice 2 Deck (31):
1

Explain the anatomy of the Biliary Tree

Made up of a number of ducts which transport bile

  • Right + left hepatic duct = Common hepatic duct 
  • Common hepatic duct + common bile duct = Common bile duct 

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2

How many parts does the doudenum have and where does bil drain into 

4 parts 

Bile drains into 2nd part 

3

Where is the cystic artery found 

triangle for callot - between the common heptatic duct and the cystic duct 

4

Where does the doudenum begin and end 

Begins - pyloric sphincter

Ends - Doudenojejunal fleture 

5

Which parts of the doudenum are retroperitoneal and intraperitoneal

  • Superior doudenal cap = Intraperitoneal 
  • Descending = retroperitoneal 
  • Horizontal = retroperitoneal 
  • Asceding = Retroperitoneal 

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6

What are the secretions of the doudenum 

  • Gastrin 
  • CCK 

7

Where does pain form doudenum present 

Epigastric region 

8

Describe the anatomy of the pacreas 

  • Locations = right side - lies transversly across poterior abdomen
  • Retroperitoneal organ 

​Parts

  • Head - has an uncinate process 
  • Neck 
  • Body 
  • Tail - lies closely to the hilum of the spleen 

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9

What are the anatomical relations of the pancreas 

       Posterioly lies

  • Abdominal aorta
  • Right and left kidney and adrenal glands
  • IVC 
  • Bile duct 
  • Superior Mesenteric vessesl 
  • Part of the portal system 

Anteirorly  - lies Stomach 

Doudenum - surrounds heads 

Superior-posterioly - splenic vessels 

 

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10

 

what do these structure look like on a CT

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11

What are the functions of the pancrea 

  • Excorine function: Acinar cells - release pancratic digestive enzymes into main pancreatic duct 
  • Endocrine functions: Islets of langerhands - Releases insulin and glucagon into the blood stream

12

 

What is the autonomic supply to the pancreas

Vagus nerve (all glands are supplied by parasympathetics

13

How does drainage from the biliary system occur 

  • Bile duct descends posteriorly to the 1st part of doudenum 
  • Then travels into a groove on the posterior aspect of the pancreas
  • Bile duct joins with the main prancreatic duct to form the ampulla of vater- wider duct 
  • both drain Into the major doudenal papilla in 2nd part of doudenum 

 

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14

there are 2 papillas in the 2nd part of the doudenum what are they and what do they drain

  • Major papilla - drains ampulla of vater 
  • Minor papilla - drains accessory pancreatic duct 

15

What are anatomical sphicter 

areas of lumen where smooth muscle encircles the lumen of the tract 

16

What are the sphincters related to secretion into the doudenum 

  • Dile duct sphincter 
  • Sphincter of oddi 
  • pancreatic sphincter 

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17

What do the ducts look like on ERCP 

procedure to looks at the different ducts - Biliary tree and pancreas to treat pathologies within it 

  1. Endocope intersted into oral cavity into doudenum 
  2. Cannula placed into major doudenal papilla and radio-opaque due is injected back into biliary tree 
  3. Radiographic images are then taken 

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18

What are the causes post-heptic jaundice 

  • Gallstones 
  • Carcinoma of head of pancreas 
  • causes flow of bile and bilirubin back into liver 

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19

What is the blood supply to the doudenum and pancreas 

  • Superior peancreatic doudenal artery - branch of gastrodoudenal artery 
  • and inferior panctreatic doudenal artery - branch of superior mesenteric artery 
  • Anastomosis at head of pancreas 

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20

At what level does the superior mesenteric artery branch come off the aorta 

 

L1

21

What is pancreatic pain and where is it felt 

  • Pancreatitis due to Gallstone blockage of ampulla- Bile diverted to pancrea - irritation and inflammation 
  • Midgut and foregut structure  
  • Epigastric region 
  • Umbillicul region 
  • Back radiation 

22

What us acute pancreatitis 

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23

is the small intestine a foregut or mid-gut structures

  • 1st and second part of doudenum - foregut 
  • Rest of small intestine - midgut 

24

Describe the anatomy of the jejunum and ileum 

  • Most of the small intestines
  • Found in all 4 quadrants 

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25

Where does jejunum begin and ileum end 

  • jejunum begins - Doudenaljejunal flexure - Intraperitoneal
  • Illeum ends at - Ileocaecal junction 

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26

What is the difference in jejunum and ileum

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27

What is the blood supply to the jejunum and ileum 

Aterial blood supply

  • Suprior mesenteric artery branches 
  • Jejunal and ileal arteries 

Venous drainage

  • Jejunal and ileal veins
  • to supeiror mesenteric veins 
  • To hepatic veins 

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28

Describe the anatomy of the superior mesenteric vessels

  • leave aorta at L1 
  • Posterior to the neck of pancreas 
  • Travels inferior, anerior to the uncinate process of the pancrease to enster the mesentery proper 

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29

How is absorption of fat carried out 

  • Bile help to absorb fat from GI lumen into the intestinal cells
  • Fat with chylomicrons are then absorbed from the intestinal cell into specialised lymphatic vessels of the small intestine called lacteals 
  • They travels via the lymphatic system to eventually drain into the venous system at left venous angle 

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30

Describe the lympahtics of the abdomen 

  • Lie along side arteries

Main groups drianing abdominal organs: 

  • Celiac nodes - foregut 
  • Superior mesenteric nodes - Midgut
  • Inferior mesenteric nodes - hindgut 
  • Lumbar nodes - kidney, posterior abdominal wall, pelvis and lower limbs

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31

What is the venous angle

junction between Sub-clavian and internal jugular veins

  • Left venous angle - thoracic duct drainage
  • Right venous angle - right lymphatic duct drainage 

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