The alimentary sytem-the liver Flashcards Preview

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Flashcards in The alimentary sytem-the liver Deck (31):
1

what is topography

The appearance/location of something

2

What is the topography of the liver?

Below the diaphragm
From t4/5 -right stomach
above colon
has a left lobe and larger right lobe
Falciform ligament

3

What are the 4 main functions of the liver

1-Detoxification
2-Prosynthesis/ metabolism-portal system
3- bile production-GI organ
4-Glycogen storage

4

Describe topography posteriorly

Inferior vena cava seen laterally, and gall bladder
2 add lobes- Quadrate and caudate lobe

5

What is the lesser omentum and functions

Ligament from liver to stomach
Encloses: Hepatic artery, portal vein, bile duct, lymph nodes
Its medial
origins- lesser curvature- Porta hepatis

6

What's the porta hepatis

The porta hepatis is a deep fissure in the inferior surface of the liver through which all the neurovascular structures
right and left hepatic ducts
right and left branches of hepatic artery
portal vein
Inferiorly- divides caudate and quadrate lobe

7

whats the bare area

No peritoneum- matt and opaque

8

Falciform ligament

Links diaphragm and abdominal wall to upper liver
Teres @ lower end

9

What is the round ligament

extends to umbilicus

10

Coronary ligament

to inferior surface of diaphragm

11

Blood supply

As its in foregut
Coelic artery supplies a lot- divides into- hepatic, splenic and left gastric
@t12/L1

12

Porta hepatis -topography

@hilum of liver- visceral surface

13

What are the entries and exit to porta hapatis

Hepatic portal vein- deoxy blood, nutrients, drugs and toxins-from intestines

Hepatic artery proper- brings O2 blood

Common hepatic duct

lymph and nerves

14

Liver lobules-

according to how the hepatic portal veins and artey divide liver

15

Coinauds segments

Hepatic vein and artery subdivide liver

16

Portal triad

Hepatic artery
Portal vein
Bile duct

17

What does central vein drain

THe portal triads contents

18

Functions of hepatic cells

Synthesis & release plasma proteins into blood albumin, ie clotting factors

De-aminates amino acids-urea in blood

Bilirubin- Bile pigment & breakdown of the haemoglobin

Bile salts- Emulsification of fats

19

Venous drainage: ( portal vein next to hepatic artery)

Liver sinusoid- (disc epitheium and fenestrated)- serves as a location for mixing of blood from hepatic artery and portal vein
These drain into central veins
@ centre of hepatic lobule
These drain into sublobular- hepatic- IVC

20

Portal system anastomoses

Communications between some branches of portal and systemic systems- portocaval anastomosis

Allows collateral return of blood to heart

21

Portal hypertension

Portal vein blocked- varicoses and caput medusa- oesophageal varices

22

Name some vessel anstamoses

• Abdominal part of oesophagus: branches from the azygos vein (which is systemic) around the oesophagus link with some from the left gastric (portal)
• Upper abdomen: veins draining the kidneys (renal), diaphragm (phrenic) and lumbar area (lumbar) join with some from the colon, duodenum, pancreas and liver (portal)
• Umbilicus: epigastric veins (systemic) draining this area of the anterior wall join the paraumbilical veins (portal)
• In the anal canal region: the middle and inferior rectal veins (systemic) link with the superior rectal (portal)

23

Portacaval shunt- functions

Reduce hypertension
-Diverting blood from portal to systemic system
-From portal to IVC

24

Portal vein converys what % to liver

70

25

Bile secreted by

Hepatocytes to canaliculi

26

Bile from canaliculi to

Bile is initially secreted from hepatocytes and drains from both lobes of the liver via canaliculi, intralobular ducts and collecting ducts into the left and right hepatic ducts. These ducts amalgamate to form the common hepatic duct- join onto the cystic duct to form common bile duct and joins pancreatic duct
ampulla of vater
closed sphincter oddi
- duodenum and then to gall bladder

27

Right and left hepatic ducts supply

Relevant lobes and emerge from porta hepatis to form common hepatic ducts

28

Lymphatic drainage- where are lymph nodes

In porta hepatis

29

Where does lymph pass to from porta hepatis

to coelic nodes

30

Where does lymph drain to from coelic nodes

Cisterna chyli

31

Liver trauma- caused by what & solution & similar cases

Fractured ribs/penetrating wounds
bleeding exacerbated by- High vascularisation of liver-leading to severe haemorrhage

Resolve by- Removing segmental portions

Similar cases- liver biopsies, metastases, cirrhosis