Lecture 10: Anatomy

Question 1

What are the spiral folds?

Answer 1

Folds found in the cystic duct

Makes endoscope cannulation of the gallbladder difficult

Question 2

What is the capacity of the gallbladder?

Answer 2

Approx. 50mL

Question 3

What is the function of the gallbladder>

Answer 3

Stores and concentrates bile between meals.

Concentrates the bile by absorbing the water

Question 4

What are the 3 parts of the gallbladder?

Answer 4

Neck

Body

Fundus

Question 5

What part of the gallbladder can be seen anteriorly?

Answer 5

The fundus

This part projects beyond the undersurface of the liver

Question 6

What is the other name for the hepatopancreatic ampulla?

Answer 6

ampulla of vater

Question 7

What is the hepatopancreatic duct?

Answer 7

Formed from the union of the pancreatic duct and the common bile duct

Question 8

What is the greater duodenal papilla?

Answer 8

Also known as the major duodenal papilla

Rounded projection at the opening of the hepatopancreatic ampulla to the duodenum

Question 9

What is the name of the Sphincter that surrounds the hepatopancreatic ampulla?

Answer 9

Sphincter of Oddi

Question 10

What is the function of the sphincter of Oddi?

Answer 10

Controls the release of bile

Question 11

Is the sphincter of oddi an anatomical sphincter or a physiological sphincter?

Answer 11

Anatomicaly

Rings of smooth muscle that surround the end of the bile duct

Question 12

What part of the small intestine does the greater duodenal papilla open into?

Answer 12

2/3rd show the descending part of the duodenum

Question 13

Does the common bile duct go behind or in front of the head of the pancreas?

Answer 13

Behind

Question 14

What seperates the left and right lobes of the liver?

Answer 14

Falciform ligament

Question 15

What ligament is the reminiscent of the umbilical vein?

Answer 15

Ligamentum teres

Also known as the roung ligament of the liver

Question 16

Which major blood vessel is embedded in the posterior side of the liver?

Answer 16

IVC

Inferior vena cava

Question 17

What are the hepatic recesses?

Answer 17

Anatomical spaces between the liver and surrounding structures

Question 18

Name the 3 types of hepatic recesses?

Answer 18

Subphrenic space

Subhepatic space

Morison’s pouch

Question 19

Describe the subphrenic space?

Answer 19

Translated to below the diaphragm i.e. above the liver

Located between the diaphragm and the superior aspect of the liver.

2 types: Left and right

Left above the left lobe of the liver

Right above the right lobe of the liver

Question 20

Describe the subhepatic space?

Answer 20

Translates to below the liver

Peritoneal space between the inferior aspect of the liver and the transverse colon

Part of the supracolic space in the greater sac of the peritoneal cavity

Question 21

What is the peritoneal cavity?

Answer 21

Potential space between the visceral and parietal peritoneum

It is the potential space for fluid to accumulate resulting in ascites

Question 22

What are the two divisions of the peritoneal cavity?

Answer 22

Greater and lesser peritoneal sacs

Question 23

Describe the greater sac of the peritoneal cavity?

Answer 23

2 subdivisions: supracolic and infracolic

Divided by the transverse colon

Supracolic: contains the liver, stomach, spleen

Infracolic: small intestine, ascending and descending colon

Question 24

Which peritoneum surrounds the abdominal wall?

Answer 24

Parietal peritoneum

Question 25

Which peritoneum surrounds the internal organs?

Answer 25

Visceral peritoneum

Question 26

The subhepatic space is part of which sac of the peritoneal cavity?

Answer 26

Greater sac of the peritoneal cavity (in the supracolic space)

Question 27

Name these parts of the abdomen

Answer 27

Question 28

Describe the Morison's pouch?

Answer 28

Potential space !! Between the visceral surface of the **liver** and the **right** **kidney**

Question 29

What is the clinical significance of Morison's pouch?

Answer 29

Most posterior part of the peritoneal cavity when lying down. Therefore, clinical its signficant as fluid, e.g. pus, will most likely accumulated in this potential space in a bedridden patient.

Question 30

Which is more superior the quadate or the caudate lobe?

Answer 30

Caudate superior (C is first in the alphabet) Quadate is inferior

Question 31

Which lobes are drained from the left hepatic duct and left portal vein?

Answer 31

Left lobe Caudate lobe Quadate lobe

Question 32

Which lobe is the caudate and quadrate apart of?

Answer 32

Anatomically: Right lobe Physiologically: Left lobe, as all 3 are drained by the left hepatic duct and left portal vein

Question 33

Describe the bare's area of the liver?

Answer 33

This is a region on the posterior diaphragmatic surface of the liver Not covered by peritoneum (unlike the rest of the liver) In direct contact with the diaphragm

Question 34

Does the bile duct come in front or behind the duondeum?

Answer 34

Behind the duodenum and enters at the ampulla of Vater (2/3rd down the descending part of the duodenum)

Question 35

What does the term "common" mean when refering to vessels such as the "common hepatic duct"?

Answer 35

Means shared the same as if you shared a fence with a neighbour that would be their common fence.

Question 36

What is the blood supply to the gallbladder?

Answer 36

Very variable Mostly the Cystic artery, a branch of the right hepatic artery

Question 37

What is the venous drainage for the gallbladder?

Answer 37

Cystic veins, that drains directly into the portal vein

Question 38

Describe the Pringle maneuver

Answer 38

It is a surgical maeuver used during abdominal surgeries. Clamping the hepatoduodenal ligament interrupts the flow of blood in the hepatic artery and portal vein. Thus controlling bleeding from the liver

Question 39

Name these different parts?

Answer 39

Question 40

What is the difference between the porta hepatis and the hepatoduodenal ligament?

Answer 40

_Porta_ _hepatis_: Part where major structures and ducts leave and enter the liver. _Hepatoduodenal_ _ligament_: Tube of peritoneum that extends from the porta hepatis to the superior porition of the duodenum. Contains the common bile duct, hepatic artery and portal vein

Question 41

Name these different parts?

Answer 41