Hepatobiliary System Flashcards
(16 cards)
hepatic ducts
*tube-like structures that carry bile from the liver
*left and right hepatic ducts join to form the common hepatic duct
*common hepatic duct merges with the cystic duct (from the gallbladder) to form the common bile duct
common bile duct (CBD)
*formed form the union of the common hepatic duct and the cystic duct
*carries bile to the small intestine
*joins the pancreatic duct to open into the 2nd portion of the duodenum at the ampulla of Vater; opening is regulated by the sphincter of Oddi
sphincter of Oddi
*located at the ampulla of Vater (2nd portion of duodenum)
*regulates the flow of bile and pancreatic juice
*relaxation occurs with CCK and vagal stimulation
*sympathetic stimulation causes increased pressure & sphincter contraction
gallbladder anatomy
*a pear-shaped, distensible reservoir structure with avg capacity of 30-50 mL
*inferior & lateral surfaces covered by peritoneum; superior surface associated with the hepatic fossa
*4 anatomic portions: fundus, body, infundibulum, and neck
*supplied by the cystic artery, which is usually a branch of the right hepatic artery
gallbladder physiology
*gallbladder absorbs water and solute from bile, thereby concentrating the solute components
*acts as a storage organ for bile
*secretes mucus and glycoproteins
*gallbladder contractility is controlled by enteric hormones and autonomic nervous system (CCK & vagal firing are stimulators)
hepatoduodenal ligament
*a peritoneal fold that forms the thickened R edge of the lesser omentum, connecting the liver to the duodenum
*forms the anterior border of the epiploic foramen
*contains the portal triad:
1. bile duct
2. hepatic artery
3. portal vein
epiploic foramen
*the space behind the hepatoduodenal ligament
*aka foramen of Winslow
*communicates directly with the lesser sac
*can be occluded to control the vascular inflow to the liver via the Pringle maneuver
vascular anatomy of the liver
*blood supply: unique dual blood supply via portal venous circulation (~80%) & hepatic arterial circulation (~20%)
*venous outflow: R, middle, and L hepatic veins, which drain directly into IVC
portal vein
*formed by the confluence of superior mesenteric vein & splenic vein
*organs that drain into portal vein include: stomach, intestines (small & large), spleen, pancreas, gallbladder
*bifurcates in the hepatic hilum into R and L portal veins
hepatic artery
*a branch of the celiac artery
*found in the hepatoduodenal ligament (part of the portal triad)
*branches into: proper hepatic artery & gastroduodenal artery
celiac trunk / axis
*a major branch of the abdominal aorta that supplies blood to the foregut organs
*gives rise to 3 main branches:
1. left gastric artery - supplies stomach, esophagus, diaphragm
2. common hepatic artery - gives off branches to liver, gallbladder, and pancreas
3. splenic artery - supplies spleen, pancreas, and stomach
superior mesenteric artery
*a major branch of the abdominal aorta that supplies blood to the midgut organs
*gives rise to several major branches:
1. inferior pancreaticoduodenal artery
2. jejunal & ileal arteries
3. right colic artery
4. ileocolic artery
5. middle colic artery
inferior mesenteric artery
*a major branch of the abdominal aorta that supplies blood to the hindgut organs
*gives rise to several major branches:
1. left colic artery
2. sigmoid arteries
3. superior rectal artery
foregut anatomy
*arises from endoderm
*extends from mouth to the proximal duodenum
*develops into esophagus, stomach, proximal duodenum, liver, gallbladder, and pancreas
*supplied by the celiac artery
midgut anatomy
*develops into distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, and proximal 2/3 of the transverse colon
*transition to hindgut occurs at the splenic flexure (left colic flexure)
*supplied by the SMA
hindgut anatomy
*develops into the distal 1/3 of the transverse colon, descending colon, sigmoid colon, rectum, and upper anal canal
*transition to hindgut occurs at the splenic flexure (left colic flexure)
*supplied by the IMA
