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Gastrointestinal Week 2 2016/17 > 1: Anatomy - Jaundice 1 > Flashcards

1: Anatomy - Jaundice 1 Flashcards

1
Q

What is jaundice?

A

Yellowing of the sclera and skin

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2
Q

What causes jaundice?

A

Increase in blood concentration of bilirubin

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3
Q

What is a byproduct of red blood cell breakdown in the spleen?

A

Bilirubin

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4
Q

Where does red blood cell breakdown occur?

A

Spleen

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5
Q

What is bilirubin used to form in the liver?

A

Bile

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6
Q

Bilirubin is a major component of ___.

A

bile

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7
Q

What is the biliary tree?

A

Liver, gall bladder and the ducts connecting them to the duodenum

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8
Q

What does the gall bladder do?

A

Stores and concentrates bile

(This question comes up in the anatomy spot and you need to quote it verbatim to get the mark)

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9
Q

Bile is important in the absorption of (carbohydrate / protein / fat).

A

fat

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10
Q

Which organ excretes digestive enzymes into the duodenum?

A

Pancreas

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11
Q

The pancreas excretes digestive ___ into the duodenum.

A

enzymes

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12
Q

Which organ is the largest in the body?

A

Liver

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13
Q

The liver receives nutrients absorbed from the __ tract.

A

GI

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14
Q

Which energy storage molecule is held in the liver?

A

Glycogen

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15
Q

The liver is involved in the secretion of ___ into the duodenum.

A

bile

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16
Q

The ___ secretes ___ into the duodenum.

The ___ secretes ___ ___ into the duodenum.

(digestive enzymes , liver , pancreas , bile)

A

liver, bile

pancreas, digestive enzymes

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17
Q

In which quadrant is the liver found?

A

Right upper quadrant

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18
Q

Which ribs protect the liver?

A

Ribs 7-11

1 true rib, 3 false ribs and 1 floating rib

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19
Q

The liver moves inferiorly during ___.

A

inspiration

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20
Q

The liver moves superiorly during ___.

A

expiration

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21
Q

Where is the liver in relation to the gall bladder?

A

Anterior and superior

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22
Q

What is the hepatic flexure?

A

Sharp bend between:

ascending colon

transverse colon

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23
Q

Where is the liver in relation to the hepatic flexure?

A

Superior

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24
Q

Where is the liver in relation to the right kidney, right adrenal gland, inferior vena cava and abdominal aorta?

A

Anterior

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25
Q

How many anatomical lobes (i.e those visible to the naked eye) does the liver have?

A

4

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26
Q

What are the four anatomical lobes of the liver?

A

Right lobe

Left lobe

Caudate lobe

Quadrate lobe

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27
Q

Why is the caudate lobe named like that?

A

Looks like a tail

NOT inferior (caudal) as name suggests

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28
Q

The caudate lobe is found at the (superior / inferior) aspect of the (anterior / posterior) surface of the liver.

A

superior

posterior

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29
Q

The quadrate lobe is found at the (superior / inferior) aspect of the (anterior / posterior) surface of the liver.

A

inferior

posterior

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30
Q

Which ligament joins the right and left lobes of the liver?

A

Falciform ligament

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31
Q

Which ligament is found at the inferior aspect of the anterior surface of the liver?

A

Round ligament / Ligamentum teres

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32
Q

The round ligament of the liver is a remnant of which embryological structure?

A

Umbilical vein

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33
Q

What is found in the porta hepatis?

A

Everything except the hepatic veins draining deoxygenated blood from the liver, so the portal triad structures:

right and left hepatic ducts (for bile)

right and left hepatic arteries (oxygenated blood supply)

hepatic portal vein (from the portal system of the intestines, bringing absorbed stuff)

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34
Q

The porta hepatis carries the structures found within the omental foramen - the ___ ___ structures.

A

portal triad

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35
Q

What is the bare area of the liver?

A

Area with no peritoneal covering

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36
Q

What covers the bare area of the liver?

A

Right hemi-diaphragm

NOT peritoneum

37
Q

How many functional lobes does the liver have?

A

8

38
Q

The functional lobes of the liver are named in a (clockwise / anticlockwise) fashion.

A

clockwise

39
Q

What name is given to the procedure which removes a functional lobe of the liver?

A

Segmentectomy

or lobectomy, doesn’t really matter

40
Q

What vessels are found in each segment of liver?

A

Branch of hepatic artery

Branch of hepatic portal vein

Bile drainage to bile duct

Venous drainage to IVC

41
Q

Why does an increase in central venous pressure damage the liver?

A

IVC and hepatic veins have NO VALVES

42
Q

The hepatic veins draining deoxygenated blood from the functional lobes come together to form ___ veins which then enter the __ __ __.

A

three

inferior vena cava

43
Q

What imaging method can be used to visualise the three hepatic veins entering the inferior vena cava?

A

Ultrasound

44
Q

What three vessels are found in the portal triad?

A

Hepatic artery PROPER

Hepatic PORTAL vein

Bile duct

45
Q

Which ligament does the portal triad run within?

A

Hepatoduodenal ligament

46
Q

The coeliac trunk is the first midline branch of the ___.

A

abdominal aorta

47
Q

Is the coeliac trunk intraperitoneal or retroperitoneal?

A

retroperitoneal

48
Q

At which vertebral level does the coeliac trunk leave the aorta?

A

T12

49
Q

The coeliac trunk supplies the (foregut / midgut / hindgut).

A

foregut

50
Q

What are the three branches of the trifurcation of the coeliac trunk?

A

Left gastric artery

Splenic artery

Common hepatic artery

51
Q

Which artery, part of the portal triad, branches from the common hepatic artery?

A

Hepatic artery proper

52
Q

Which two arteries anastomose to supply the lesser curvature of the stomach?

A

Right gastric artery

Left gastric artery

53
Q

The course of the splenic artery is (straight / torturous).

A

torturous

54
Q

The splenic artery runs along the superior border of which organ?

A

Pancreas

55
Q

The splenic artery runs along the superior aspect of the ___.

A

pancreas

56
Q

In which abdominal region is the spleen found?

A

Left hypochondrium

57
Q

Is the spleen intraperitoneal or retroperitoneal?

A

Intraperitoneal

58
Q

Which bend in the large intestine is the spleen superior to?

Which aspects of the large intestine are connected by this bend?

A

Splenic flexure

Transverse colon to descending colon

59
Q

Which ribs protect the spleen?

A

Ribs 9-11

2 false ribs, 1 floating rib

60
Q

The spleen breaks down red blood cells to produce ___.

A

bilirubin

61
Q

Why may a rib fracture in the left hypochondrium cause massive internal bleeding?

A

Punctured spleen

62
Q

Apart from the liver, which other organ moves with the diaphragm during inspiration and expiration?

A

Spleen

63
Q

Which arteries supply the liver?

Which artery do these arteries originally branch from?

A

Right and left hepatic arteries

Hepatic artery proper

64
Q

The right and left hepatic arteries account for the (majority / minority) of hepatic blood supply.

A

minority

65
Q

Which structure accounts for most of the liver’s blood supply?

A

Hepatic portal vein

66
Q

The liver has a dual blood supply - which structures are responsible?

A

Hepatic portal vein (from the portal system carrying nutrients from the intestines)

Right and left hepatic arteries - branches of the hepatic artery proper, which carries blood from the coeliac trunk, which is a branch of the aorta

67
Q

What are the two recesses you stuck your hand in during the first dissections?

A

Subphrenic recess

Hepatorenal recess - behind the liver, towards the kidneys

68
Q

What can collect in the recesses of the abdominal cavity if a patient has peritonitis?

A

Pus

69
Q

What is an abscess?

A

A painful build-up of pus in the tissue

70
Q

Which abdominal recess will fluid drain into if a patient lies supine?

A

Hepatorenal recess

71
Q

The hepatic portal vein drains blood from which collections of abdominal organs?

A

Foregut

Midgut

Hindgut

i.e all of them

72
Q

What happens to blood in the liver?

A

First pass metabolism

“cleaned”

73
Q

Which vein drains the foregut?

A

Splenic vein

74
Q

Which vein drains the midgut?

A

Superior mesenteric vein

75
Q

Which vein drains the hindgut?

Which vein does it then merge with?

A

INFERIOR mesenteric vein

Drains into the splenic vein

76
Q

Which two veins form the hepatic portal vein?

A

Splenic vein (which the inferior mesenteric vein has already drained into)

Superior mesenteric vein

77
Q

Which vein drains blood from the hepatic veins into the right atrium?

A

Inferior vena cava

78
Q

The gall bladder lies on the (anterior / posterior) aspect of the liver.

A

posterior

79
Q

The gall bladder lies (anterior / posterior) to the duodenum.

A

anterior

80
Q

What can become stuck in the gall bladder?

A

Gallstones

81
Q

How does bile flow in and out of the gall bladder?

A

Cystic duct

82
Q

Which artery supplies the gall bladder?

In most people, this artery is a branch of the right ___ artery.

A

cystic artery

right hepatic artery

83
Q

In which “triangle” can the cystic artery and cystic duct be found?

A

Triangle of Calot

84
Q

What can cause inflammation of the gall bladder?

A

Gallstones

85
Q

Given that the gall bladder is a foregut organ, in which region of the abdomen does gall bladder pain present?

A

Epigastric region

also the hypochondrium

86
Q

Where is pain associated with gallbladder inflammation referred?

A

Right shoulder / neck

87
Q

Why does gall bladder pain sometimes refer to the right shoulder and neck?

A

If the diaphragm is irritated by the gall bladder, refers to the diaphraghm spinal nerves C345, dermatomes for C345 are found in the right shoulder / neck

88
Q

What is a cholecystectomy?

A

Removal of the gallbladder

Gastrointestinal Week 2 2016/17 (7 decks)

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