The Liver, Gallbladder, Duodenum and Pancreas (GI)

Question 1

What are the two surfaces of the Liver?

Answer 1

Diaphragmatic surface and Visceral surface

Question 2

What positions do the Diaphragmatic and Visceral surfaces lay?

Answer 2

Diaphragmatic- Anterosuperior
Visceral- Posteroinferior

Question 3

Which three regions of the liver are not covered by peritoneum?

Answer 3

Base area of liver
Area where gallbladder lies in contact with liver
Region of Porta hepatis

Question 4

What is the base area of the liver?

Answer 4

Region of posterior surface that lies in contact with diaphragm

Question 5

What is the porta hepatis?

Answer 5

Where hepatic blood vessels and ducts of biliary system enter and exit the liver. The hepatic vein is not one of them

Question 6

What is the liver split into?
What separates them from one another?

Answer 6

Large right lobe and small left lobe
Separated by falciform ligament

Question 7

What does Falciform ligament connect?

Answer 7

Anterior surface of liver to anterior abdominal wall

Question 8

Two accessory lobes oft the liver and where they are located?

Answer 8

Caudate and quadrate
Located on the Posteroinferior surface

Question 9

How many segments is the liver split into internally? What does each segment have its own of?

Answer 9

8
Each segments has its own hepatic artery, portal vein and hepatic duct

Question 10

What connects the Liver to the Diaphragm?

Answer 10

Coronary and triangular ligaments

Question 11

What does the portal triad consist of and where do they run together?

Answer 11

Hepatic artery, Hepatic portal vein and bile duct
Free edge of the lesser omentum

Question 12

What do the Portal triad and the free edge of the lesser omentum form? What is this the entrance to?

Answer 12

Form the anterior boundary of the epiploic foramen
Entrance to lesser sac

Question 13

What are the three recesses related to the liver?

Answer 13

Hepatorenal recess
Right and left Sub phrenic recesses

Question 14

Where does the hepatorenal recess lie?

Answer 14

Between the right kidney and the posterior surface of the right side of the liver

Question 15

Where do the subphrenic recesses lie?

Answer 15

Each side of the falciform ligament, between the anterosuperior surface of the liver and diaphragm

Question 16

Where does the Liver develop from? Where does it develop?

Answer 16

Foregut
Ventral mesentry

Question 17

What is the Ventral mesentry?

Answer 17

Peritoneal fold in upper abdomen that connects the stomach to the anterior abdominal wall in Embryos

Question 18

What does the Ventral mesentery develop into as the Liver is pulled to the right?

Answer 18

Lesser omentum and falciform ligament

Question 19

What does the free edge of the falciform ligament contain? What is it a remnant of?

Answer 19

Round ligament of liver
Remnant of the umbilical vein

Question 20

What is the Ligamentum Venosum a remnant of? Where does it lie?

Answer 20

Remnant of ductus venosus
Lies on posterior surface of liver, groove between caudate lobe and left lobe of liver

Question 21

What is the function of the Ductus venous in a foetus?

Answer 21

Diverts blood from the umbilical vein to the IVC, bypassing the liver

Question 22

What branch of the coeliac trunk supplies the liver? What does this branch further branch into? Where do these arteries enter the liver?

Answer 22

Common Hepatic
Becomes the Hepatic artery proper then branches into the left and right hepatic arteries
Enters the liver at the porta hepatis

Question 23

What veins does Blood exit the liver from? What do they unite with? and what position to the liver do they unite with this vein?

Answer 23

Two or three hepatic veins (Not externally visible)
Unite with the Inferior Vena Cava as it passes posterior to liver

Question 24

Where does the hepatic portal vein receives blood from?

Answer 24

From superior and inferior mesentric veins and splenic vein

Question 25

What nervous system supplies the liver? Where do the parasympathetic fibers arise from?

Answer 25

Hepatic plexus Vagus nerve

Question 26

Where is pain from the liver referred to? Why?

Answer 26

Epigastric region It is a foregut derivative

Question 27

What is the Function of the Gallbladder?

Answer 27

Stores and contracts bile

Question 28

Where does the Gallbladder lie?

Answer 28

Visceral surface of the liver and close to the duodenum

Question 29

What are the three parts of the Gallbladder?

Answer 29

Fundus, body and neck

Question 30

Where does the body of the gallbladder sit?

Answer 30

Gallbladder fossa of the visceral surface of the liver

Question 31

What does the neck of the gallbladder communicate with?

Answer 31

The cystic duct

Question 32

Where is the surface marking of the fundus of the gallbladder at?

Answer 32

9th costal cartilage Where the midclavicular line intersects the right costal margin

Question 33

Which cells produce Bile and where is it first excreted into?

Answer 33

Produced by Hepatocytes (In the liver) First excreted into small channels called bile canaliculi

Question 34

Where do the Bile canaliculi drain bile into? and where do these bile ducts leave the liver?

Answer 34

Right and left hepatic ducts Leave the liver at the porta hepatis

Question 35

What do the left and right hepatic ducts converge into? Which duct is received to this duct from the Gallbladder?

Answer 35

Common Hepatic duct Which receives the cystic duct from the gallbladder

Question 36

What is the duct called after the common hepatic duct receives from the cystic duct?

Answer 36

Common bile duct

Question 37

Where does the bile duct run? and where does it descend

Answer 37

Free edge of the lesser omentum Descends posterior to the superior part of duodenum and posterior to the head of the pancreas

Question 38

What is the valve that lies at the junction between the gallbladder neck and cystic duct?

Answer 38

Spiral fold

Question 39

Artery that supplies Gallbladder? Where does it arise from?

Answer 39

Cystic artery Arises from the right hepatic artery

Question 40

What vein drains the gallbladder and what does it join?

Answer 40

Drained by cystic veins Either pass directly into the liver or join hepatic portal vein

Question 41

What sympathetic fibers supply the Gallbladder?

Answer 41

T5-T9 Greater splanchnic nerves

Question 42

Where can pain be felt in association with the gallbladder?

Answer 42

Epigastrium (Due to nerves t5-t9) Right shoulder

Question 43

Why can inflammation of the gallbladder cause pain in the right shoulder?

Answer 43

inflammation of gallbladder can irritate diaphragm which is innervated by nerves C3-C5 Nerves C3-C5 also receives somatic sensory information from skin over the shoulder

Question 44

What level does the coeliac trunk leave the aorta? Which structures does each branch supply?

Answer 44

Leaves at T12 LGA- Distal Oesophagus and lesser curvature of the stomach Common hepatic artery- Liver, Stomach and Duodenum Splenic artery- Stomach, pancreas and spleen

Question 45

# Duodenum What are Four regions of the duodenum in order?

Answer 45

1. Supeiror 2. Descending 3. Inferior 4. Ascending

Question 46

# Duodenum What lies posterior to the superior part of the duodenum

Answer 46

1. Common bile duct 2. Gastroduodenal artery 3. Hepatic portal vein

Question 47

# Duodenum What artery lies anterior to the third part of the duodenum?

Answer 47

Superior Mesentric artery

Question 48

# Duodenum Where does the ascending duodenum meet the Jejenum?

Answer 48

Duodenojejunal flexure

Question 49

# Duodenum Where does bile and pancretaic secretions enter the Duodenum?

Answer 49

Major duodenal papilla

Question 50

# Duodenum blood supply What arteries supply the First and second half of the duodenum respectively?

Answer 50

1. First half- Gastroduodenal (from coeliac trunk) 2. Second half- Inferior pancreaticoduodenal (from SMA)

Question 51

# Duodenum blood supply What vein drains the duodenum?

Answer 51

First half- Gastroduodenal vein then Second half-

Question 52

# Pancreas What position does the Pancreas lie in? on what structure?

Answer 52

Lies Horizontally on the posterior abdominal wall

Question 53

# Pancreas What level does the pancreas lie on? Is it retro or intra peritoneal?

Answer 53

L1 Retroperitoneal

Question 54

# Pancreas What are the four parts of the pancreas?

Answer 54

Head, neck, body and tail

Question 55

# Pancreas What does the pancreas form from?

Answer 55

Dorsal and ventral pancreatic buds which fuse during development

Question 56

# Pancreas What is the Hook-like projection of the head of the pancreas called?

Answer 56

Uncinate process

Question 57

# Pancreas Where does the tail of the Pancreas extend to?

Answer 57

The hilum of the spleen

Question 58

# Pancreas What does the Pancreas form part of?

Answer 58

Posterior wall of the lesser sac

Question 59

# Pancreas What is the lesser sac?

Answer 59

Potential space between the stomach and the pancreas

Question 60

# Pancreas What runs within the substance of the pancreas?

Answer 60

Main pancreatic duct and accessory pancreatic duct

Question 61

# Pancreas Two functions of pancreas

Answer 61

Exocrine and Endocrine functions

Question 62

# Pancreas What does the Pancreas synthesise and secrete?

Answer 62

Insulin and Glucagon

Question 63

# Pancreas What does the pancreas produce that is released into the duodenum? How does it get there?

Answer 63

Pancreatic juice Via main pancreatic duct and accessory pancreatic duct

Question 64

# Pancreas Where do the Common bile duct and main pancreatic duct merge?

Answer 64

Hepatopancraeatic ampulla

Question 65

# Pancreatic duct Where does the hepatopancreatic ampulla open up into? what does its wall contain to stop reflux of duodenal contents?

Answer 65

Major duodenal papilla Hepatopancreatic sphincter

Question 66

# Pancreatic duct Where does the accessory pancreatic duct open its contents into?

Answer 66

Minor Duodenal papilla

Question 67

# Blood supply of pancreas What three arteries supply the Pancreas? What are they branches of?

Answer 67

1. Pancreatic arteries- branches of splenic artery 2. Superior pancreaticoduodenal arteries- Branch of the Gastroduodenal artery 3. Inferior pancreaticoduodenal arteries- Branch of superior Mesentric artery

Question 68

# Blood supply of pancreas Venous system of the Pancreas

Answer 68

Splenic vein drains pancreas unites with the superior mesentric vein to form the hepatic portal vein

Question 69

# Spleen What type of organ is the spleen? What protects it?

Answer 69

Haematopoietic and lymphoid organ Ribs 9-11

Question 70

# Spleen Is the spleen intra or retroperitoneal? What quadrant does it lie in?

Answer 70

Intraperitoneal Left upper quadrant

Question 71

# Spleen Two surfaces of the spleen? What do they come into contact with?

Answer 71

1. Diaphragmatic surface- adjacent to diaphragm 2. Visceral surface-contact with stomach, left kidney and colon

Question 72

# Spleen Difference between anterior and superior borders and the posterior and inferior borders

Answer 72

Anterior and superior-notched Posterior and inferior are smooth

Question 73

# Blood supply of spleen What artery supplies the spleen? Where does it enter the spleen? How many branches does it split into?

Answer 73

1. Splenic artery 2. Hilum on visceral surface 3. five branches