Why might my patient be jaundice

Question 1

What links the liver, spleen, gallbladder, pancreas and small intestine

Answer 1

The formation of bilirubin, then bile and the clinical condition of jaundice

Question 2

What is jaundice

Answer 2

a yellowing of the sclera (whites of eyes) and skin due to excess bilirubin in the blood

Question 3

What is bilirubin

Answer 3

A normal product from the breakdown of red blood cells which mainly occurs in the spleen
Used to form bile in the liver

Question 4

What is the ‘Biliary Tree’

Answer 4

Tubes connecting the liver to the second half of the duodenum allowing bile to travel through

Question 5

Where is bile formed

Answer 5

In the liver (from bilirubin)

Question 6

what role does the Gallbladder play

Answer 6

stores and concentrates bile

Question 7

Why is bile important

Answer 7

Is important in allowing the normal absorption of fats from the small intestine

Question 8

What other organ excretes digestive enzymes into the 2nd hald of the duodenum

Answer 8

The pancreas (necessary for food digestion)

Question 9

What organ is the largest in the body

Answer 9

The liver

Question 10

What are the main functions of the liver

Answer 10

Receives nutrients absorbed from GI tract
Glycogen storage
Bile secretion
Other metabolic functions

Question 11

What is the location of the liver

Answer 11

Right Upper Quadrant
Protected by ribs 7-11
Location changes with breathing

Question 12

What are the 4 anatomical lobes of the liver

Answer 12

Right Lobe
Left Lobe
Caudate Lobe (next to IVC)
Quadrate Lobe (next to gallbladder)

Question 13

What is the Porta Hepatis

Answer 13

site of entrance for portal triad structures

Question 14

how many functional segments are there in the liver

Answer 14

8

Question 15

what does each functional liver segment contain

Answer 15

A branch of the hepatic artery
A branch of a hepatic portal vein
Bile drainage (to bile duct)
Venous drainage (to IVC)

Question 16

Why is an increase in central venous pressure directed to the liver

Answer 16

IVC and hepatic veins lack valves

Question 17

Describe the pathway of the hepatic veins

Answer 17

The hepatic veins carrying deoxygenated blood from the liver come together to form three veins, before joining the vena cava

Question 18

What does the Portal Triad contain

Answer 18

Hepatic portal vein
Hepatic artery proper
Bile duct
(main structures entering/leaving the liver)

Question 19

What are the two ligaments from the liver in the lesser omentum

Answer 19

Hepatoduodenal

Hepatogastric

Question 20

What is the coeliac trunk

Answer 20

First of three midline branches of the aorta, leaves the aorta at T12 vertebral level supplying the organs of the foregut

Question 21

What 3 branches does the coeliac trunk split into

Answer 21

Splenic artery
Left gastric artery
Common hepatic artery

Question 22

The splenic artery has a torturous course true/false

Answer 22

True - splenic artery is an end artery so if it ruptures the spleen will become neurotic, torturous course attempts to increase flexibility and reduce the chance of rupture

Question 23

What anatomical area contains the spleen

Answer 23

Left hypochondrium

Protected by ribs 9-11

Question 24

What is the function of the spleen

Answer 24

Breaks down read blood cells to produce bilirubin

Question 25

How do you palpate the spleen

Answer 25

Time it with the patients breathing as both the liver and the spleen are diaphragm so move with anatomically related to the respiration

Question 26

What are the major blood supplies to the stomach

Answer 26

RIGHT AND LEFT GASTRIC ARTERIES (along the junction of the lesser curvature and the lesser omentum, they also anastomose together) RIGHT AND LEFT GASTRO-OMENTAL ARTERIES (along junction of greater curvature and greater omentum, also anastomose together)

Question 27

What are the minor blood supplies to the stomach

Answer 27

Posterior gastric artery (from splenic) | Short gastric arteries (from splenic)

Question 28

Where does the blood supply to the liver come from

Answer 28

Right and left hepatic arteries Rest is from the hepatic portal vein Liver has a dual blood supply

Question 29

What are the two clinically important areas of the peritoneal cavity related to the liver

Answer 29

Hepatorenal recess Sub-phrenic recess (both within greater sac, peritonitis results in a collection of pus in these recesses)

Question 30

What is the lowest part of the peritoneal cavity when patient is supine (pus often collects here)

Answer 30

Hepatorenal recess

Question 31

What is the role of the Hepatic Portal Vein

Answer 31

Drains blood from foregut, midgut and hindgut to the liver for first pass metabolism (cleaning)

Question 32

What vessels from the hepatic portal vein

Answer 32

Splenic vein (drains foregut) Superior mesenteric vein (midgut) Inferior mesenteric vein (hindgut) - comes off splenic

Question 33

What vessel drains cleaned blood from liver back to the right atrium

Answer 33

Inferior vena cava

Question 34

What is the function of the Gallbladder

Answer 34

Stores and concentrated bile between meals

Question 35

What supplies blood to the gallbladder

Answer 35

The cystic artery (branch of right hepatic artery) located in triangle of calot

Question 36

What vessels allows bile to flow out of the gallbladder

Answer 36

The cystic duct

Question 37

What causes gallbladder pain

Answer 37

Inflammation of the gallbladder or cystic duct following irritation from gallstone

Question 38

Where will gallbladder pain present

Answer 38

The epigastric region as visceral afferents entre the spinal cord between T6-T9 for the foregut

Question 39

What is the name of the surgical removal of the gallbladder

Answer 39

Cholecysectomy