Clinical Antomy of Jaundice - 2 Flashcards
(29 cards)
what is jaundice
yellowing of the sclera (white of the eyes)/ skin
caused by an increase in the blood levels of bilirubin
what is bilirubin
normal by product of break down of red blood cells
breakdown of red blood cells mainly occurs in the spleen
used to form bile in the liver
bile then travels through the ‘biliary tree’ (set of tubes connecting liver to 2nd part of the duodenum)
what makes up the interlobular portal triad
branch of the HPV
branch of the HA
bilary duct (bile formed in hepatocytes drain here)
what does the central vein in the liver do?
collects ‘cleaned’ blood and drains into hepatic vein
what is a hepatocyte
liver cell
describe the path of the ducts of the biliary tree
right and left hepatic ducts
unite to form COMMOM hepatic duct
unites with CYSTIC duct to form
BILE DUCT
4 parts of the duodenum
superior
descending
horizontal
ascending
where does the duodenum begin
at pyloric sphincter
–Anatomical sphincter controlling the flow of chyme from stomach to duodenum
Smooth muscle – autonomic nerves, (Symp) contraction, (ParaSymp) relaxation
where does the duodenum end
duodenojejunal flexure
what does Retroperitoneal mean
situated or occurring behind the peritoneum
where does the pancreas lie
transversely across the posterior abdomen
The head of the pancreas is described as being surrounded by the “C-shape” formed by the duodenum
what are the parts of the pancreas
head (with uncinate process)
neck
body
tail
anatomical relations of the pancreas
anteriorly lies the stomach
duodenum surrounds the head
superoposteriorly - the splenic vessels
functions of the pancreas
exocrine - pancreatic digestive enzymes into main pancreatic duct
endocrine - insulin and glucagon into bloodstream
drainage of the biliary system
The Bile Duct descends posteriorly to the 1st (superior) part of the duodenum
Then travels into a groove on the posterior aspect of the pancreas
It then joins with the main pancreatic duct
- Forms the ampulla of Vater / hepatopancreatic ampulla
- Widened part
Both then drain into the 2nd part of the duodenum
what are anatomical sphincters
discrete areas where muscle completely encircles the lumen of the tract
what is used to investigate the biliary tree and pancreas
and how does it work
ERCP - endoscopre retrograde cholangiopancreatogrephy
endoscope inserted through oral cavity, oesophagus, stomach and into duodem
cannula placed into major duodenal papilla and radio-opaque dye injected back into the bilary tree
Radiographic images are taken of the dye-filled biliary tree
obstructive causes and process of jaundice
obstruction of the biliary tree by: gall stones, carcinoma at head of pancreas
flow of bile back up to the liver
overspill into the blood, of its constituents (including bilirubin)
These are extra hepatic (outside the liver) obstructive causes of jaundice
Post-hepatic jaundice
what makes up the small intestine
duodenum
jejunum
ileum
where does the jejunmun begin and where does the ileum end
duodenaljejunal flaxure
ilecaecal junction
differences in the jejunum and the ileum
colour:
Jejunum is deep red
Ileum is lighter pink
Wall
Jejunum is thicker and heavy
Ileum is thinner and lighter
Vascularity
Jejunum is more vascular
Ileum is less vascular
Mesenteric Fat
Jejunum has less
Ileum has more
Circular Folds (L. plicae circularis)
Jejunum has large, tall and closely packed fold
Ileum has low and sparse folds (absent distally)
Lymphoid Tissue (Peyer’s Patches) - Present in ileum
Blood Supply of Jejunum and Ileum: arterial blood from
superior mesenteric artery
via jejunal and ileal arteries
Blood Supply of Jejunum and Ileum: venous drainage from
jejunal and ileal veins
to superior mesenteric vein
to hepatic portal vein
Blood Supply of Jejunum and Ileum: where do the vessels all travel
within the mesentery
