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DM > L11 - Gastrointestinal System IV - Liver, Pancreas, and Spleen > Flashcards

L11 - Gastrointestinal System IV - Liver, Pancreas, and Spleen Flashcards

Feb 13, 2019

1
Q

In what two surface regions does the liver occupy on the abdomen?

A

1) right hypochondrium

2) epigastric region

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2
Q

What are some wounds that might cause liver trauma?

A

1) blunt abdominal trauma
2) fractured ribs
3) penetrating wounds of the thorax

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3
Q

What is the most frequent cause of portal HTN?

A

cirrhosis

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4
Q

Where is the needle placed for a percutaneous liver biopsy?

A

Between 9th and 10th R intercostal, mid axillary line

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5
Q

What are the two surfaces of the liver?

A

1) diaphragmatic

2) visceral

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6
Q

What two organs is the subphrenic space located between?

A

diaphragm and liver

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7
Q

Which lobe is larger? Right or left?

A

Right lobe is bigger.

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8
Q

Which two areas of the liver are not covered by peritoneum?

A

1) bare area

2) gallbladder fossa

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9
Q

The falciform ligament separates what from what?

A

The left from the right lobe of the liver

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10
Q

Where do the structures/vessels enter the liver?

A

Porta hepatis

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11
Q

The caudate and quadrate lobes belong to which lobe:

1) functionally?
2) anatomically?

A

Functionally caudate and quadrate lobes are part of the LEFT lobe. Anatomically they are part of the right lobe

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12
Q

Where is the IVC positioned with respect to the liver?

A

Superior and posterior

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13
Q

What do liver segments represent? How many are in the liver?

A

Each segment has their own arterial, venous, and biliary supply. Liver has 8 segments

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14
Q

What does the falciform ligament morph into? What embryological structure does this come from?

A

Ligament teres. Comes from obliterated umbilical vein

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15
Q

The ligamentum venosum is a remnant of what?

A

Ductus venosus

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16
Q

What are the four ligaments to the diaphragm from the liver?

A

Right and left triangular

Superior and inferior coronary

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17
Q

Where the coronary ligaments unite is called what?

A

Triangular ligaments

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18
Q

In terms of the mesentery, where is the location of the hepatoduodenal ligament?

A

right free margin of the lesser omentum

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19
Q

What two parts make up the lesser omentum?

A

Hepatogastric and hepatoduodenal

20
Q

What is the Pringle maneuver?

A

Clamping the hepatoduodenal ligament to prevent bleeding from the proper hepatic artery

21
Q

What percentage of bloody supply do the hepatic artery and portal vein contribute?

A

70% portal vein, 30% hepatic artery

22
Q

Where does the liver’s lymph flow to?

A

Celiac nodes

23
Q

The fundus of the gallbladder projects beyond the inferior margin of the liver. Where is this in terms of surface anatomy?

A

Right 9th costal cartilage mid-clavicular line

24
Q

Where does bile enter in the duodenum?

A

2nd part

25
Q

The right and left hepatic ducts merge and form the what? Which duct drains into this duct afterward?

A

1) form common hepatic duct

2) cystic duct then drains into this

26
Q

The bile duct passes ______ to the _____ part of the duodenum.

A

1) inferiorly

2) first

27
Q

What is the sphincter that controls gallbladder secretion? What type of control is it under? Approximately how long after a meal are there signals for gallbladder contraction?

A

1) Sphincter of Oddi
2) under autonomic and hormonal control
3) thirty minutes

28
Q

How does the biliary system empty into the duodenum?

A

Through the major duodenal papilla

29
Q

What are the four risk factors for gallstones?

A

1) fat
2) fertile
3) female
4) ~40 yrs old

30
Q

Where is referred pain from gallstones felt?

A

Right shoulder

31
Q

Why can a biliary obstruction cause pancreatitis?

A

Autolytic enzymes will start to digest the pancreas

32
Q

What is ERCP?

A

ERCP is the injection of dye into the biliary tree through an endoscope passed through the stomach and duodenum. XR fluoroscopy is used to visualize structures

33
Q

What is the triangle of Calot? What does it contain?

A

The triangle made by the liver and cystic and common hepatic ducts. It contains the cystic artery

34
Q

The mnemonic 1,3,5,7,9,11 is used to remember the spleen. What does this stand for?

A

Spleen is 1” by 3” by 5”. It weighs 7 oz. and spans the 9th to the 11th ribs.

35
Q

Where is the spleen found?

A

left hypochondrium

36
Q

What organ is associated with the hilum of the spleen?

A

Tail of the pancreas

37
Q

What is the most frequently injured organ in the abdomen?

A

The spleen

38
Q

What are the two major vessels that make up the portal vein?

A

Splenic vein and superior mesenteric vein

39
Q

What forms the esophageal porto-caval anastomosis?

A

Esophageal tributaries of the left gastrict vein (portal system) and esophageal tributaries of azygos and hemiazygos veins (caval system)

40
Q

What forms the rectal porto-caval anastomosis?

A

Superior rectal vein (drains into IMA of portal system) and inferior and middle rectal veins (drain into the internal iliacs

41
Q

What forms the caput medsae?

A

Para-umbilical veins of the portal system and the superior and inferior epigastric veins (specifically the superior)

42
Q

How does cirrhosis cause hepatic encephalopathy?

A

Cirrhosis causes portal HTN which causes ammonia to wash into the systemic circulation and will affect the brain

43
Q

What vessels constitute the anastomosis around the head of the pancreas?

A

Superior and inferior pancreaticoduodenal arteries (anterior and posterior branches)

44
Q

What type of organ is the pancreas?

A

retroperitoneal

45
Q

Why is pancreatic cancer so dangerous?

A

1) access to IVC, portal system, spleen, bile duct, and lymph; all are very close to pancreas and leads to cancer metastasis
2) retroperitoneal organ so symptoms are not always readily apparent
3) pancreatic tissue is very friable making surgical excision hard

DM (16 decks)

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