Lecture 9 Flashcards
(25 cards)
What are the surfaces and recesses of the liver?
Anteriorly, posteriorly, and superiorly = diaphragmatic surface
Suphrenic recess - separates liver from diaphragm
Hepatorenal recess - between liver and right kidney/adrenal gland
The _____ lobe of the liver is the largest and is separated from the ____ by the _____ ______.
This lobe arises from the posterior part of the visceral surface on the right lobe.
This lobe is on the anterior part of the visceral surface.
Right, left, falciform ligament
Caudate
Quadrate
What is the caudate lobe bound by on the right and left sides?
What is the quadrate lobe bound by on the right and left sides?
What lobe is functionally similar to the left lobe and why?
Caudate - fissure for ligamentum venosum (left), and groove for IVC (right)
Quadrate - ligamentum teres (left) and fossa of gallbladder (right)
The quadrate lobe is similar to the left because it arises from there.
The gallbladder is located between the ____ and ____ lobes of the liver. Its function is to ______.
caudate, quadrate, store bile
Where does bile exit the liver through?
After exiting, it travels through the COMMON HEPATIC DUCT, which runs with what structures in the lesser omentum?
It then joins with the CYSTIC DUCT, to form the ____ ___, which descends to meet the ____ _____ ___ and empties into the _____ ____ ____ at the ampulla of hepatopancreatic ampulla).
Right and left hepatic ducts
proper hepatic artery and the portal vein
bile duct, main pancreatic duct, major duodenal papilla
Lipids are sitting in the duodenum after eating a particularly fatty meal. How will bile be released to emulsify these fats?
Presence of fats in the duodenum will stimulate release of cholecystokinin, which causes contraction of the gallbladder to release bile from the cystic duct.
The liver receives blood from which arteries? Where do these branch from?
The gallbladder receives blood from which arteries? Where do these branch from?
Liver is supplied by the right and left hepatic arteries, which branch from the hepatic artery proper - supplied by the celiac trunk.
The gallbladder is supplied by the cystic artery, which is a small branch of the right hepatic artery.
Where is the pancreas located?
What organ is the tail, neck, and head of the pancreas close to?
Posterior to the stomach and in between the spleen and the duodenum
Head - nestled in curve of duodenum
Neck - over the IVC and SMA, behind and near the pyloric antrum of the stomach
Body - underneath the splenic artery, behind the body of the stomach, and over part of the left kidney
Tail - over left kidney
The major/main pancreatic duct empties into the _____ ____ while the accessory pancreatic duct empties into the ____ ____.
The major pancreatic duct forms which structure, just right before entering the duodenum?
The major duodenal papilla is surrounded by which structure?
major/main empties into the major duodenal papilla
minor empties into the minor duodenal papilla, which is more superior
Ampulla of vater
Sphincter of Oddi
The following arteries all supply the pancreas - describe where each arise from and what it branches into.
The gastroduodenal artery arises from the ____, and branches to give which two arteries?
The inferior pancreaticoduodenal artery arises from the ____, and branches to give which two arteries?
Where are the dorsal and greater pancreatic arteries found?
GASTRODUODENAL - Arises from the common hepatic artery from the celiac trunk, branches to anterior superior PD and the posterior superior PD
INFERIOR PD - arises from SMA, branches to give anterior inferior PD and the posterior inferior PD
Dorsal - branches from splenic vein and closer to the the celiac trunk; over top of the neck
Greater - branches from splenic vein and closer to the tail region
The spleen is found in the left hypochondrium and lies against the _____ near ribs ___ and ___.
How is it connected to the greater curvature of the stomach and the left kidney? Each ligament that connect the spleen is a part of which omentum?
diaphragm, 9 and 10.
Stomach - gastrosplenic ligament
Kidney - splenorenal ligament
Both ligaments are part of the greater omentum
The splenic hilum is the entry and exit point for which vessels?
entry - splenic artery, which branches off the celiac trunk
exit - splenic vein
REVIEW
Composition of the foregut, midgut, and the hindgut?
Foregut - esophagus to duodenum (up to major duodenal papilla), liver pancreas, gallbladder, and the spleen
Midgut - Duodenum (after MDP), small intestine, large intestine, up to 2/3 of transverse colon
Hindgut - distal 1/3 of transverse, through superior portion of the rectum
Because the superior mesenteric artery and its vein travels on top of the duodenum, what can occur if enlargement of either the artery or the duodenum occurs?
If the artery enlarges, the duodenum will be compressed against and will affect digestion.
If the duodenum enlarges, blood flow is impeded at the SMA and causes SMA syndrome.
Which organs travel through the portal circulation before entering the IVC?
Digestive tract (abdominal esophagus up to superior rectum), pancreas, spleen, and the gall bladder. Everything is filtered through the liver first, through the hepatic portal vein.
Arterial blood from digestive organs will travel through the first capillary bed, then travels via the ____ _____ ____ to the liver sinusoids. Once the blood is here, it gets ______ and travels out via the _____ ____ and to the IVC.
Hepatic portal vein, detoxified, hepatic vein
The hepatic portal vein divides into _____ in the liver.
sinusoids, or the secondary capillary plexus
The portal vein receives drainage by a number of other veins from nearby organs. List and describe each.
Left gastric from the lesser curvature of the stomach is the first drainage point.
Splenic vein - contains the short gastrics, left gastro omental, and the pancreatic veins
Inferior mesenteric veins - left colic, sigmoid, and superior rectal
SMA - jejunal, ileal, iliocolic, right colic, middle colic, right gastro-omental, anterior and posterior PD
Blood can directly enter systemic circulation instead of passing through the portal system. Where can the portal circulation form anastomoses with the systemic circulation ?
Esophagus - azygous system
Inferior rectum/anus - middle and inferior rectal veins
Paraumbilical area - veins on anterior abdominal wall
What are the lymph nodes (IN FRONT OF THE AORTA) that drain the abdominal region?
Celiac, super mesenteric, and inferior mesenteric lymph nodes; all drain into the cisterns chyli.
T/F? The myenteric and submucosal plexuses are completely independent and not affected by the CNS.
FALSE - it is modulated by input from the CNS.
The anterior superior PD branches from the ______ and travels anteriorly, on the ____ of the pancreas. The posterior superior PD will be behind it.
Gastroduodenal artery, anterior
What structures are drained by the portal system of the liver before going to the IVC?
abdominal esophagus to superior rectum, spleen, pancreas, gallbladder
The inferior mesenteric vein goes to the portal vein for drainage into the IVC. However, due to its positioning in the body - it cannot drain directly into the portal vein, as seen with the left gastric and superior mesenteric vein. What major vein will it drain into in order to access the portal vein?
Splenic vein
