Why Might my Patient be Jaundiced?

Question 1

What are 3 symptoms/ signs of jaundice?

Answer 1

Yellowing of the sclera/ skin

Caused by an increase in the blood levels of bilirubin

Question 2

What is bilirubin

Answer 2

A normal by-product of the break down of red blood cells

Question 3

Where does the breakdown of red blood cells mainly occur?

Answer 3

Spleen

Question 4

What is bilirubin used to form and where?

Answer 4

Bile in the liver

Question 5

What is the bilary tree and what does it do?

Answer 5

It transports bile

It is a set of tubes connecting the liver to the 2nd part of the duodenum

Question 6

What is the role of the gallbladder?

Answer 6

Storage and concentration of bile

Question 7

What is the main function of bile?

Answer 7

Normal absorption of fats from the small intestine

Question 8

What does the pancreas do? and why is this necessary?

Answer 8

It excretes digestive enzymes into the 2nd part of the duodenum.
Necessary for digestion of food

Question 9

Where is the portal triad found?

Answer 9

In the free edge of the lesser omentum

Question 10

What does the portal triad consist of?

Answer 10

Hepatic artery, Heaptic portal vein and the common bile duct

Question 11

What do the 3 tubes supply?

Answer 11

Blood supply to and drainage to the liver

Question 12

What else is found in the portal triad?

Answer 12

Nerves and lymphatics

Question 13

What is the first of the three midline branches of the abdominal aorta called?

Answer 13

The celiac trunk

Question 14

The celiac trunk is retroperitoneal, define this

Answer 14

Situated or occuring behind the peritoneum

Question 15

Where does the celiac trunk arise?

Answer 15

T12

Question 16

What organs do the celiac trunk supply

Answer 16

All of the organs of the foregut

Question 17

The celiac trunk trifurcates into what 3 branches?

Answer 17

Splenic artery, hepatic artery and the left gastric artery

Question 18

Describe the course of the splenic artery

Answer 18

Very tortuous course

Question 19

Where does the splenic artery run?

Answer 19

Along the superior border of the pancreas

Question 20

What type of organ is the spleen?

Answer 20

Intraperitoneal organ within the hypochondrium

Question 21

What is the main function of the spleen?

Answer 21

Break down red blood cells to produce bilirubin

Question 22

What ribs protect the spleen?

Answer 22

Ribs 9-11

Question 23

Where does the blood supply to the stomach come from?

Answer 23

RIght and left gastric arteries and the right and left gastro-omental arteries

Question 24

Where do the gastric arteries run?

Answer 24

Along the lesser curvature

Question 25

Where do the gastro-omental arteries run?

Answer 25

Along the greater curvature

Question 26

What would happen if one of the blood supplies was cut off?

Answer 26

Blood would still be delivered from the other supply

Question 27

Where does the blood supplying the liver come from?

Answer 27

Hepatic Artery

Question 28

How much blood arrives from the hepatic artery?

Answer 28

20-25%

Question 29

What other vessel delivers the rest of the blood to the liver?

Answer 29

Hepatic Portal Vein

Question 30

What type of blood does the hepatic portal vein carry

Answer 30

Nutrient rich, oxygen poor blood

Question 31

Where does the liver lie?

Answer 31

Upper right quadrant

Question 32

What is the main function of the liver

Answer 32

Major metabolic organ which converts bilirubin to bile

Question 33

What ribs protect the liver?

Answer 33

Ribs 7-11

Question 34

What are the 4 anatomical segments of the liver?

Answer 34

Right and Left lobes, Caudate lobe and Quadrate lobe

Question 35

How many functional segments does the liver have?

Answer 35

8

Question 36

What does each segment possess?

Answer 36

Its own portal triad

Question 37

How many veins drain blood from the liver?

Answer 37

3 Hepatic Veins

Question 38

A rise in Central Venous Pressure would result in what?

Answer 38

Hepatomegaly as the liver would engorge in blood and the change in pressure is directly transmitted to the liver

Question 39

What is the function of the sinusoids?

Answer 39

To clean the blood (nutrients are removed)

Question 40

What is being produced in the hepatocytes?

Answer 40

Bile

Question 41

Name the 2 clinically important areas of the peritoneal cavitiy related to the liver

Answer 41

``` Hepatorenal recess (Morrison's Pouch Subphrenic recess ```

Question 42

Where are the recesses of the liver located?

Answer 42

Within the greater sac

Question 43

What could a collection of puss in the recess lead to?

Answer 43

Abscess formation

Question 44

Where does the hepatic portal vein act?

Answer 44

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

Question 45

What does the inferior mesenteric vein drain blod

Answer 45

Drains the blood from the hindgut to the splenic vein

Question 46

What does the splenic vein do?

Answer 46

drains the blood From the foregut to the hepatic portal vein

Question 47

What does the superior mesenteric vein do?

Answer 47

Drains the blood from the midgut to the hepatic portal vein

Question 48

What does the IVC do?

Answer 48

Drains the cleaned blood from the hepatic veins into the right atrium

Question 49

What ligaments attach the liver to the diaphragm?

Answer 49

Coronary ligaments

Question 50

What ligaments attach the liver to the anterior abdominal wall?

Answer 50

Falciform ligament

Question 51

What is the name of the remnant of the embryological umbilical vein?

Answer 51

Ligamentum teres / round ligament

Question 52

What does the gallbladder do?

Answer 52

Stores and concentrates bile in between meals

Question 53

What is the name of the narrowing of the gall bladder/?

Answer 53

Cystic duct

Question 54

What is the narrowing a potential site for

Answer 54

Gallstone impaction

Question 55

How does the blood reach the gallbladder?

Answer 55

Through tthe cystic artery which is a branch of the right hepatic artery

Question 56

What can cause gallbladder pain

Answer 56

Inflammation of the gallbladder or cystic duct following irritations from or ompaction of a gallstone

Question 57

What type of organ is the gallbladder?

Answer 57

A foregut organ

Question 58

Visceral afferents enters the spinal cord between which 2 verticbrae?

Answer 58

T6 and T9

Question 59

Where else can pain be found form the gall bladder?

Answer 59

``` Hypochondriium Right shoulder (as a result of diaphrmatic irritation) ```

Question 60

What is a cholescystectomy

Answer 60

Surgical removal of a gall bladder