Why Might my Patient be Jaundiced ? Part 2

Question 1

Where is the main site of break down of red blood cells?

Answer 1

The spleen

Question 2

What is a normal by-product of the breakdown of red blood cells

Answer 2

Bilirubin

Question 3

What is bilirubin used to form ? Where does this occur?

Answer 3

Bile in the liver

Question 4

Describe the biliary tree

Answer 4

A set of tubes connecting the liver tot the 2nd part of the duodenum

Question 5

What 3 structures make up the interlobular portal triad?

Answer 5

branch of the Hepatic vein, branch of the hepatic artery and a biliary duct

Question 6

What is the biliary tree made up of? What do they do?

Answer 6

A number of ducts which transport bile

Question 7

What forms the common hepatic duct

Answer 7

Right and left hepatic ducts

Question 8

What unite to form the bile duct

Answer 8

Common hepatic duct and the cystic duct

Question 9

Where does the bile duct drain into?

Answer 9

The second part of the duodenum

Question 10

Where is the location of the bile duct?

Answer 10

Descends posteriorly to the 1st part of the duodenum

Question 11

Where does the bile duct travel into?

Answer 11

A groove on the posterior aspect of the pancreas where it then joins with the main pancreatic duct to form the ampulla

Question 12

Where does the bile duct and the main pancreatic duct drain into?

Answer 12

The 2nd part of the duodenum through the major duodenal papilla

Question 13

Name the 3 sphincters related to the bile duct

Answer 13

Bile duct sphincter, pancreatic duct sphincter and the sphincter of Oddi

Question 14

What investigation is used to study the biliary tree and the pancreas?

Answer 14

ERCP (Endoscopic Retrograde Cholangiopancreatography)

Question 15

What could happen to the levels of bilirubin if there was an abstruction somewhere in the biliary tree?

Answer 15

Backflow of bile up to the liver.

Overspill of bile into the blood including bilirubin

Question 16

What can cause an obstruction of the biliary tree?

Answer 16

Gallstones and carinoma at head of pancreas

Question 17

Describe the panceras

Answer 17

Head with uncinate process
Neck 
Body 
Tail
Retroperitoneal organ which lies transversely across the posterior abdomen

Question 18

What surrounds the head of the pancreas?

Answer 18

The duodenum

Question 19

What is the endocrine function of the pancreas?

Answer 19

Islets of Lannerghans (insulin and glucagon into the bloodstream)

Question 20

What is the exocrine function of the pancreas?

Answer 20

Acinar cell (pancreatic digestive enzymes into main pancreatic duct)

Question 21

Where does the pancreas branch from?

Answer 21

Mainly from the splenic artery (pancreatic branches)

Question 22

What is the most common cause of pain in the pancreas?

Answer 22

Pancreatitis

Question 23

What is a cause of pancreatitis

Answer 23

Blockage of the ampulla by a gallstone causing bile to to be diverted into the pancreas leading to irritation and inflammation

Question 24

Describe the type of organ the pancreas is

Answer 24

Foregut and midgut organ

Question 25

Where can pancreatic pain present?

Answer 25

In the epigastric region / umbilical region | Radiate through to the back

Question 26

What parts of the duodenum are foregut organs?

Answer 26

1st and 2nd parts of the duodenum

Question 27

What are the rest of the small intestines?

Answer 27

Midgut organs

Question 28

What are the 4 parts of the duodenum?

Answer 28

Superior Descending Horizontal Ascending

Question 29

What sphincter does the duodenum begin at?

Answer 29

Pyloric sphincter

Question 30

What does the pyloric sphincter control?

Answer 30

The flow of chyme from the stomach to the duodenum

Question 31

What is secreted by the duodenum

Answer 31

A number of peptide hormones into the blood (gastrin and CCK)

Question 32

Where does pain from a duodenal ulcer tend to present?

Answer 32

Epigastric region

Question 33

What does the close relationship between the pancreas and the duodenum cause?

Answer 33

Similarities in the blood supply

Question 34

What is one of the branches of the gastroduodenal artery?

Answer 34

Superior pancreaticoduodenal

Question 35

What is one of the brances of the superior mesenteric artery?

Answer 35

Inferior pancreaticodudoenal

Question 36

What makes up most of the small intestines?

Answer 36

Jejunum and the ileum

Question 37

Where does the jejunum begin?

Answer 37

At the duodenaljejunal flexure

Question 38

Where does the ileum end?

Answer 38

At the ileocacal junction

Question 39

Describe the folds in the jejunum?

Answer 39

Mucosa is highly folded The folds are called plicae circularis Slightly rough in texture

Question 40

Is the mucosa of distal ileum smoother or rougher than the proximal end?

Answer 40

Smoother

Question 41

What does bile help with?

Answer 41

The absorption of fats form the GI tract lumen into the intestinal cells

Question 42

Where are fats absorbed from and where do they go?

Answer 42

From the intestinal cells and into specialised lymphatic vessels of the small intestine called lacteals

Question 43

Where do fats eventually drain into the venous system at?

Answer 43

At the left venous angle

Question 44

Where do lymph vessels lie in the abdomen?

Answer 44

Alongside arteries

Question 45

What are the main 4 groups of lymph nodes drainign abdominal organs?

Answer 45

Celiac (foregut) Superior mesenteric (midgut) Inferior mesentric (hinf Lumbar (kidneys, pelvis)

Question 46

Where does the right lymphatic duct drain into?

Answer 46

DeeThe right venous angle (angle between the right subclavian and right internal jugular veins

Question 47

Where does the thoracic duct drain lymph into?

Answer 47

Into the left venous angle (angle between the left subclavian and left interanal jugual veins