Foregut (liver and gall bladder)

Question 1

what are the 4 lobes of the liver

Answer 1

left
right
caudate
quadrate

Question 2

what 2 lobes can be seen from the anterior view of the liver

Answer 2

right and left

Question 3

the peritoneum of the abdominal wall reflects over the surface of the liver to create what

Answer 3

falciform ligament

Question 4

the ligamentum teres is a fibrous remnant of what

Answer 4

umbilical vein

Question 5

where does the caudate lobe sit

Answer 5

between the IVC and left lobe

Question 6

where does the quadrate lobe sit

Answer 6

between the left lobe and the gall bladder

Question 7

what is the bare area of the liver

Answer 7

area that is not covered in peritoneum

Question 8

where is the bare area

Answer 8

superior surface of right lobe

Question 9

what is the hilum of the liver called

Answer 9

porta hepatis

Question 10

what attaches to the porta hepatis

Answer 10

lesser omentum free edge

Question 11

what does the free edge of the lesser omentum carry

Answer 11

hepatic artery and hepatic portal vein to the liver
bile duct away from liver

Question 12

what structures are present at the porta hepatis

Answer 12

right and left hepatic ducts
hepatic arteries
hepatic portal vein
ANS fibres
lymph nodes

Question 13

where are the hepatic veins found

Answer 13

drain directly into the IVC as it passes along posterior surface of liver - NOT found in porta hepatis

Question 14

the hepatic arteries and bile duct lie _____ to the portal vein

Answer 14

anterior

Question 15

what regions does the liver lie in

Answer 15

fills right hypochondrium and crosses through the epigastric region

Question 16

anterior surface of the liver is covered by what

Answer 16

lower ribs on right side

Question 17

superior surface of liver covered by what

Answer 17

diaphragm

Question 18

the liver reaches up to what ribs

Answer 18

ribs 5-6

Question 19

what is the surface marking of the gall bladder

Answer 19

right 9th costal cartilage at mid-clavicular line

Question 20

what are the relations of the posterior surface of the liver

Answer 20

oesophagus
stomach
duodenum
right colic flexure
right kidney
supra-renal gland
gall bladder

Question 21

where does the falciform ligament lie

Answer 21

between right and left lobes

Question 22

what does the right layer of the falciform ligament create

Answer 22

coronary ligament over the right lobe and then the right triangular ligament

Question 23

what does the left layer of the falciform ligament create

Answer 23

left triangular ligament

Question 24

the liver is covered in visceral peritoneum except for

Answer 24

bare area - area attached to diaphragm

Question 25

where does the falciform ligament pass

Answer 25

to umbilicus

Question 26

the falciform ligament passes to the umbilicus and contains the remnants of waht

Answer 26

umbilical vein (ligamentum teres)

Question 27

what is the ligamentum venosum

Answer 27

remnant of fetal ductus venosus which shunted blood from the umbilical vein to the IVC - oxygenated blood to IVC

Question 28

what is the purpose of the falciform ligament

Answer 28

attaches liver to anterior abdominal wall

Question 29

describe the blood supply of the liver

Answer 29

30% blood from hepatic artery 70% from portal vein

Question 30

what supplies the liver with oxygenated blood

Answer 30

hepatic artery

Question 31

what supplies the liver with blood rich in nutrients

Answer 31

portal vein

Question 32

the hepatic artery is a branch of what

Answer 32

coeliac axis

Question 33

after processing by the hepatocytes, the blood passes into what

Answer 33

hepatic veins and is drained directly into the inferior vena cava

Question 34

arterial and venous blood is conducted to the central vein of each liver lobule by

Answer 34

sinusoids

Question 35

the central veins drain into where

Answer 35

left and right hepatic veins (4 in total) and directly into vena cava

Question 36

lymph from the liver drains where

Answer 36

local nodes at porta hepatis and then to nodes clustered at coeliac axis (pre-aortic T12)

Question 37

small amount of lymph can also pass where

Answer 37

into the thoracic lymphatic system via diaphragm

Question 38

pain from liver is referred where

Answer 38

mainly body wall within epigastric region but if liver irritates diaphragm pain may be felt in right shoulder

Question 39

why can pain be felt in right shoulder if liver irritates diaphragm

Answer 39

phrenic nerve - C345 - same dermatomes as right shoulder

Question 40

Autonomic nerves to liver are from

Answer 40

hepatic plexus derived from coeliac plexus sympathetic from celiac plexus parasympathetic from vagus nerves

Question 41

bile made by the liver is needed to what

Answer 41

emulsify fats when fatty food is eaten

Question 42

bile is secreted by what

Answer 42

liver

Question 43

bile is stored where

Answer 43

gall bladder

Question 44

the bile duct is _cm long

Answer 44

8cm

Question 45

the bile duct ends where

Answer 45

pierces medial wall of 2nd part of duodenum

Question 46

the bile duct is joined by what and opens into where

Answer 46

bile duct joined by main pancreatic duct and opens into hepatopancreatic ampulla (of vater)

Question 47

hepatopancreatic ampulla opens into duodenum via what

Answer 47

major duodenal papilla (sphincter of Oddi)

Question 48

what branches join to form the bile duct

Answer 48

right and left hepatic ducts unite and then join to cystic duct to form bile duct

Question 49

what happens when fat is present in the duodenum

Answer 49

the sphincer of Oddi opens and gall bladder contracts causing the bile that has been stored and concentrated in the gall bladder to be released into the 2nd part of duodenum

Question 50

what are the 3 divisions of the gall bladder

Answer 50

fundus body neck

Question 51

where is the fundus of the gall bladder found

Answer 51

hands below liver

Question 52

where is the body of the gall bladder found

Answer 52

contacts visceral surface of liver

Question 53

where is the neck of the gall bladder found

Answer 53

joints cystic duct

Question 54

describe the surfaces of the gall bladder

Answer 54

external surface is smooth due to visceral peritoneum internal surface has many folds (rugae and microvilli)

Question 55

what is the purpose of the rugae and microvilli of gall bladder

Answer 55

increase surface area for absorption of water during bile concentration

Question 56

what causes the gall bladder to contract

Answer 56

fat in duodenum causes the release of cholecystokinin from small intestine mucosa

Question 57

when the gall bladder contracts what happens to the smooth muscle at the end of the bile duct and the ampulla

Answer 57

relax

Question 58

what is the arterial supply of the gall bladder

Answer 58

cystic artery from right hepatic artery

Question 59

the cystic vein drains where

Answer 59

into portal vein

Question 60

where does lymph from the gall bladder go

Answer 60

to cystic node then hepatic then coeliac

Question 61

nerves to gall bladder come from where

Answer 61

coeliac plexus

Question 62

pain from gall bladder referred where

Answer 62

epigastric region

Question 63

gallstones are formed from what

Answer 63

crystalline bodies made from pigment and cholesterol components of bile

Question 64

gall stones cause pain when

Answer 64

if they lodge into biliary tree

Question 65

if the gall stones are made from cholesterol what colour are they

Answer 65

green or yellow/white

Question 66

if the gall stones are made from pigment stones (bilirubin and calcium salts)

Answer 66

usually small and dark