Hepatobiliary

Question 1

Epiploic foramen boundaries

Answer 1

Anterior - CBD , Hepatic Artery , Portal vein

Posterior - IVC , Right adrenal gland

Superior - caudate lobe of liver

Inferior - 1st part of duodenum

Question 2

Liver

Rt & Lt lobes are divided anatomically by

Answer 2

Anteriorly - Falciform ligament

Posteriorly - fissures of ligamentum venosum & ligamentum teres
H-shaped fossae

Question 3

Lobes of Liver

Answer 3

• Rt lobe
• Lt lobe
• Caudate lobe
• Quadrate lobe
• Base area ( between superior & inferior coronary ligament )
• Porta hepatis

Question 4

Lobes of Liver

Anatomically & Functionally

Answer 4

Anatomically

Rt Lobe ( Caudate + Quadrate ) > Lt Lobe

Functionally

Rt Lobe = Lt Lobe ( Caudate + Quadrate )

Question 5

Ligaments in Liver

Answer 5

• Falciform ligament
• Ligamentum teres
• Coronary ligaments
• Right triangular ligament
• Left triangular ligament
• Ligamentum venosum

Question 6

Lesser omentum

from - to ?
contains ?

Answer 6

• from ligamentum venosum & porta hepatis
• passes to lesser curve of stomach
• free edge of lesser omentum contains
  DAVE - CBD , Hepatic Artery , Portal vein , Epiploic foramen

Question 7

the area devoid of peritoneum in liver

Answer 7

Bare area
( in which IVC is embedded )
( between superior & inferior coronary ligaments )

Question 8

Right triangular ligament is formed by

Answer 8

Fusion of Upper & Lower leaves of coronary ligament

Question 9

Falciform ligament divides into

Answer 9

Left Triangular ligament & Coronary ligament

Question 10

Liver nerve supply is from

Answer 10

Coeliac plexuses

Question 11

What are Posteroinferior to Liver ?

Superior - Diaphragm

Answer 11

• abdominal oesophagus
• stomach
• doudenum
• hepatic flexure
• right kidney
• right suprarenal

Question 12

Liver inferior surface - Superior to inferior

Answer 12

IVC
Caudate lobe
Porta hepatis
Quadrate lobe

Question 13

Contents of Porta Hepatis

Answer 13

DAVE

• CBD
• Hepatic artery
• Portal vein
• Epiploic foramen
• Lymph node

Question 14

Blood supply of Liver

Answer 14

• Portal vein

- Hepatic artery

Question 15

Calot’s traingle borders

Answer 15

Superior - Inferior surface of liver
Inferior - Cystic duct
Medial - Common hepatic duct

Question 16

Contents of Calots triangle

Answer 16

• Right hepatic artery
• Cystic artery
• Lymph node of lund
• Lymphatics

Question 17

CBD is formed by ?

Answer 17

fusion of

• cystic duct from gallbladder &
• common hepatic duct from liver

Question 18

Blood supply of Gall bladder

Answer 18

Cystic artery ( from right hepatic artery )

Question 19

Gall bladder consists of

Answer 19

• Fundus
• Body
• Neck

( neck opens into cystic duct - which conveys bile to and from CBD )

Question 20

Hemorrhage during cholecystectomy or liver trauma can be controlled by

Answer 20

Pringles’s manoeuvre

compressing the hepatic artery & portal vein in the free edge of lesser omentum

Question 21

Pancreas is divide into

Answer 21

• Head
• Uncinate process
• Neck
• Body
• Tail

Question 22

Pancreas’s

• peritoneum ?
• plane ?

Answer 22

• Retroperitoneal

- Transpyloric plane ( L1 )

Question 23

Superior mesenteric vessels in relation to pancreas

Answer 23

• posterior to Head of pancreas

- anterior to uncinate process

Question 24

Head of Pancreas is anterior to

Answer 24

IVC
Renal vessels
Superior mesenteric vessels

Question 25

Which vessels ? join at Where ? - to form the portal vein

Answer 25

- SMV & Splenic vein - joins behind neck of pancreas To for the portal vein

Question 26

Where does splenic artery run along ?

Answer 26

Superior border of pancreas

Question 27

Where does splenic vein runs ?

Answer 27

Behind pancreas

Question 28

Where does main pancreatic duct ( of Wirsung ) enters into digestive system ?

Answer 28

Medial aspect of 2nd part of duodenum | - at the ampulla of Vater

Question 29

Blood supply of head & uncinate process of pancreas

Answer 29

- superior pancreaticoduodenal A ( gastroduodenal A ) | - inferior pancreaticoduodenal A ( SMA )

Question 30

Blood supply of pancreas | except head & uncinate process

Answer 30

From splenic artery | via arteria pancreatica magna

Question 31

Origin of pancreas | embroyamal development

Answer 31

Ventral & Dorsal endodermal outgrowths of the duodenum

Question 32

Posterior relations of pancreas

Answer 32

- Aorta - SMV - Portal vein - CBD - left crus of diaphragm - left suprarenal - left kidney

Question 33

Rule of odds of Spleen

Answer 33

1 3 5 inches 7 ounces ( 150g ) 9 - 11 ribs ( site )

Question 34

Gastrosplenic ligaments - contents - connects

Answer 34

Left Gastroepiploic artery + Short Gastric arteries - connects spleen to greater curve of stomach

Question 35

Lieonrenal ligament - contents - connects

Answer 35

Splenic Artery + Tail of pancreas - connects spleen to posterior abdominal wall

Question 36

Relations of the spleen

Answer 36

Anterior - stomach Posterior - left lung - left part of diaphragm ( seperate it from pleura ) - 9,10,11 ribs Inferiorly - splenic flexure of colon Medially - left kidney - tail of pancreas

Question 37

Blood supply of spleen

Answer 37

- Splenic artery | - Hilum contains splenic vessels

Question 38

Spleen - red pulps & white pulps function

Answer 38

Red pulps - vessels White pulps - immune

Question 39

Where are accessory spleen found ? Splenunculi

Answer 39

- near hilum - tail of pancreas - gonads - omentum - small bowel mesentery - splenorenal ligament

Question 40

Division of what will be necessary during a splenectomy

Answer 40

Short gastric vessels | splenic flexure may need to be mobilises but not divided

Question 41

Most superficial structure at L1 right of rectus sheath

Answer 41

Fundus of GB

Question 42

Identify a large vessel passing inferiorly over the anterior aspect of the pancreatic head

Answer 42

SMA

Question 43

Blood supply of CBD

Answer 43

Hepatic artery

Question 44

Blood supply of pancreatic head & tail

Answer 44

Head - Pancreaticoduodenal artery Tail - branches of splenic artery

Question 45

Granulomata arise from which type of cells

Answer 45

Macrophageso

Question 46

Mobilisation of left lobe of liver will facilitate surgical access to ?

Answer 46

Abdominal oesophagus