Trans - Liver, Gallbladder, Stomach Flashcards
(107 cards)
1
Q
weight of the liver
A
male - 1400-1800g
female - 1200-1400g
2
Q
location of the liver
A
right upper quadrant - right hypochondriac, epigastric, part of the left hypochondriac
3
Q
connective tissue capsule of the liver
A
Glisson’s capsule
4
Q
the liver is deep to which ribs
A
7-11
5
Q
lower border of the liver
A
right 10th rib to left 5th intercostal space
6
Q
upper border of the liver
A
5th intercostal space on both right and left
7
Q
ligament extending from the umbilicus to the liver
A
falciform ligament
8
Q
the right leaflet of the falciform ligament becomes the:
A
coronary ligament
9
Q
the left leaflet of the falciform ligament becomes the:
A
left triangular ligament
10
Q
what structure is embedded within the falciform ligament
A
ligamentum teres hepatis
11
Q
the ligamentum teres hepatis is a remnant of what structure
A
umbilical vein
12
Q
the ligamentum venosum is a remnant of what structure
A
ductus venosus
13
Q
the superior layer of the coronary ligament is reflected onto the:
A
diaphragm
14
Q
the inferior layer of the coronary ligament becomes the
A
hepatorenal ligament
15
Q
what structure lies in the posterior right limb of the H fissure of the liver
A
IVC
16
Q
what structure lies in the anterior right limb of the H fissure of the liver
A
gallbladder
17
Q
what structure lies in the crossbar of the H fissure of the liver
A
porta hepatis
18
Q
what structure lies in the posterior left limb of the H fissure of the liver
A
ligamentum venosum
19
Q
what structure lies in the anterior left limb of the H fissure of the liver
A
falciform ligament
20
Q
the H fissure divides the liver into:
A
right, left, caudate, quadrate lobes
21
Q
the anterosuperior aspect of the liver fits into:
A
cupola of the diaphragm
22
Q
function of the liver
A
glycogen storage, bile secretion, other metabolic functions
23
Q
right triangular ligament is formed from the convergence of the __________
A
inferior and superior layers of coronary ligament
24
Q
divisions of the liver anteriorly
A
right lobe and left lobe
25
T/F: the quadrate lobe is more posterior to the caudate lobe
F
26
difference between anatomical and functional subdivisions of the liver
anatomical lobes - determined by fissures
| functional lobes - determined by distribution of blood vessels
27
the bare area of the liver is found in which surface
inferoposterior
28
subphrenic recess is divided into the left and the right subdivisions by the:
falciform ligament
29
the liver is covered by peritoneum except in these areas:
1. bare area
2. groove for IVC
3. gallbladder fossa
4. porta hepatis
30
simultaneous secondary branchings of the portal vein and hepatic artery within the liver
portal pedicles
31
T/F: the hepatic artery and portal vein independently supply all of the 8 surgically resectable hepatic segments
F, they only supply 7
32
hepatic artery is a branch of the :
celiac artery
33
hepatic portal vein is formed as a union of which two veins
1. superior mesenteric vein
| 2. splenic vein
34
3 major hepatic veins
1. right hepatic vein
2. central hepatic vein
3. peripheral hepatic vein
35
the hepatic artery supplies __% of the liver's blood
20-30%
36
the hepatic portal vein supplies ___% of the liver's blood
70-80%
37
difference of blood in hepatic artery and hepatic portal vein
1. hepatic artery - rich in oxygen, poor in nutrients
| 2. hepatic portal vein - rich in nutrients, poor in oxygen
38
hepatic veins drain into the
IVC
39
vein that connects the intestinal veins with the IVC and its retroperitoneal branches
vein of Retzius
40
most of the lymph coming from the liver is formed in the:
perisinusoidal space of Disse
41
space of Disse - function
area where non-bile products of the liver are secreted
42
lymph drainage of deep liver structures
hepatic lymph nodes
43
lymph drainage of superficial anterior aspect of liver
celiac lymph nodes
44
lymph drainage of superficial posterior aspect of liver
phrenic lymph nodes
45
lymph drainage of central diaphragmatic surface of liver
parasternal lymph nodes
46
lymph drainage along ligamentum teres
anterior abdominal wall lymph nodes
47
innervation of the liver
1. hepatic plexus
2. left and right vagus
3. right phrenic
48
components of the hepatic plexus of nerves
1. sympathetic - from celiac trunk
| 2. parasympathetic - from vagus
49
during a liver biopsy, the needle is directed through where
through the right 10th intercostal space in the midaxillary line
50
hepatic enlargment caused by congestive heart failure, tumors, and bacterial/viral diseases (e.g. hepatitis)
hepatomegaly
51
progressive destruction of hepatocytes and replacement by fat and fibrous tissue
cirrhosis
52
subphrenic abscesses often drain into the:
hepatorenal recess / pouch of Morison
53
difference of liver lobectomy and segmentectomy
lobectomy - entire left or right lobe removed, without excessive bleeding
segmentectomy - removal of severely injured segments using cauterizing scalpel or laser surgery
54
rupture of the liver is often caused by:
broken ribs perforating the liver
55
maximum capacity of gallbladder
50ml of bile
56
parts of the gallbladder
1. fundus
2. body
3. infundibulum
4. neck
57
tapering transitional area between gallbladder body and neck
infundibulum
58
attaches the infundibulum of the gallbladder to the duodenum
cholecystoduodenal ligament
59
bulging interior surface of gallbladder infundibulum
Hartman's pouch
60
valve formed by gallbladder neck mucosa
spiral valve of Heister
61
function of spiral valve of Heister
1. keeps cystic duct open to divert bile into gallbladder when hepatopancreatic sphincter is closed
2. provides additional resistance to sudden release of bile due to increased intraabdominal pressure
62
clinical importance of proximiity of gallbladder to right colon and hepatic flexure
easy spread of malignancies
63
arterial supply of gallbladder
cystic artery
64
venous drainage of gallbladder
no major cystic vein, venous drainage is accomplished by small veins that drain into the portal capillary system
65
lymph drainage of gallbladder
hepatic lymph nodes
66
innervation of gallbladder
1. celiac plexus - sympathetic
2. vagus nerve - parasympathetic
3. right phrenic nerve - sensory
67
pain in the gallbladder is referred to:
ipsilateral shoulder and neck (dermatomes of C3 C4 C5)
68
2 perihepatic spaces
1. suprahepatic - between liver and diaphragm
| 2. infrahepatic - between visceral surface of liver and transverse colon
69
gallbadder inflammation
cholecystitis
70
location of the stomach
epigastric, umbilicial, left hypochondriac regions
71
anterior relations of the stomach
diaphragm, left lobe of liver, anterior abdominal wall
72
posterior relations of the stomach
omental bursa, pancreas
73
wide part of the pylorus
pyloric antrum
74
narrow part of the pylorus
pyloric canal
75
pyloric region is divided into smaller subregions by:
sulcus intermedius
76
pyloric canal and sphincter lie in what level
L1 L2
77
temporary longitudinal folds formed when gastric mucosa is contracted
rugae
78
T/F: rugae are formed when the stomach is distended
F
79
structure temporarily formed during swallowing between the longitudinal gastric folds of the mucosa of the lesser curvature
gastric canal
80
clinical significance of proximity of heart and stomach
sharp objects swallowed may perforate the stomach wall and the adjacent pericardium and ventricle
81
blood supply of lesser curvature
left gastric artery and right gastric artery
82
origin of left gastric and right gastric arteries
1. left gastric - from celiac trunk
| 2. right gastric - from gastroduodenal artery
83
blood supply of greater curvature
left gastroepiploic and right gastroepiploic
84
origin of left gastroepiploic and right gastroepiploic arteries
1. left gastroepiploic - from splenic artery
| 2. right gastroepiploic - from superior pancreaticoduodenal
85
3 primary branches of the celiac trunk
1. left gastric artery
2. splenic artery
3. common hepatic artery
86
main draining vein of the stomach
portal vein
87
the short gastric and left gastroomental veins drain into the
splenic vein
88
the right gastroepiploic vein drains into
superior mesenteric vein
89
vein that ascends over the pylorus to drain into the right gastric vein
prepyloric vein
90
arterial supply of the fundus
1. short gastric artery
| 2. posterior gastric artery
91
lymph drainage of superior 2/3 of stomach
gastric lymph nodes
92
lymph drainage of fundus and superior part of the body
pancreaticosplenic lymph nodes
93
lymph drainage of right 2/3 of the inferior 1/3 of the stomach
pyloric lymph nodes
94
lymph drainage of left 1/3 of the greater curvature
pancreaticoduodenal lymph nodes
95
anterior vagal trunk is derived from:
left vagus
96
posterior vagal trunk is derived from:
right vagus
97
anterior vagal trunk supplies:
liver and duodenum
98
posterior vagal trunk supplies:
anterior and posterior surfaces of the stomach, celiac plexus
99
referred pain in epigastric region indicates a problem in the:
stomach
100
referred pain in umbilicus indicates a problem in the:
small intestine
101
referred pain in the right upper quadrant + neck + shoulder + scapula indicates a problem in the:
gallbladder
102
referred pain in the right lower quadrant indicates a problem in the:
appendix
103
how do abdominal muscles respond to abnormal stimuli in viscera
they become rigid and shield the abdominal wall and parietal peritoneum from painful movement
104
ulcers of the anterior wall of the stomach may perforate into the:
greater sac
105
ulcers of the posterior wall of the stomach may perforate into the:
omental bursa
106
the parietal peritoneum and skin in the area of the umbilicus is sensorily innervated by the
10th intercostal nerve
107
sharp pain that is well-localized in the epigastric region would involve which nerves
6th to 9th intercostal nerves
