100 - Abdominal Viscera 2 Flashcards
Quadrant occupied by the liver
Fills RUQ, extends into LUQ
*Anterior surface of the liver
Features of diaphragmatic surface of liver 1 2 3 4
1) Dome-shaped 2) Divided into two lobes by falciform ligament 3) Shiny, covered with peritoneum 4) Coronary ligament is where peritoneum reflects off liver to undersurface of diaphragm
Falciform ligament
Double layer of serous membrane that separates right and left lobes of liver. Attaches liver to anterior abdominal wall. Extends to ligamentum teres.
*Visceral surface of the liver
Landmarks of visceral surface of liver 1 2 3 4 5
1) Gastric impression on left lobe 2) Porta hepatis is the hilum where neurovascular bundle enters liver. 3) “H”-shaped fissure (porta hepatis, ligamentum teres, ligamentum venosum, gallbladder, IVC) 4) Kidney impression 5) Duodenal impression
Arrangement of vessels entering porta hepatis
Portal vein is behind. Artery to left. Bile duct to the right. Nerves and lymphatics are present, but not visible.
Lobes demarcated by ‘H’ shape on visceral liver
Caudate lobe is superior, quadrate lobe is inferior
How does the neurovascular portal triad reach the porta hepatis?
Travels through the lesser omentum, attaching to the lesser curvature of the stomach
Venous drainage of the liver
Drains into the IVC. Three hepatic veins drain into the IVC, which is intimately associated with the liver
Role of portal vein to liver
Delivers venous blood from the GIT into the liver
Biliary system structure 1 2 3
1) Hepatocytes produce bile, which enters duct system. 2) Ducts get progressively larger, right and left hepatic ducts join to form the common hepatic duct at the hilum 3) Common bile duct joins the pancreatic duct at ampulla.
How do the pancreatic duct and bile duct enter the duodenum?
Very complex sphincter. Sphincter is normally closed.
How does bile get stored in the gallbladder?
Sphincter into the duodenum is normally closed. Bile accumulates, backs up into the gallbladder where it is stored and concentrated.
*Gallbladder picture
Pancreas location 1 2 3 4
1) Head is in C-shaped curve of duodenum 2) Uncinate process is a wedge-shaped process coming off the head of the pancreas. Also within the C-shaped curve of the duodenum 3) Body is above the duodenaljejunal flexure 4) Tail of the pancreas points towards the hilum of the spleen
Over what does the pancreas lie?
Superior mesenteric vessels
Ducts within pancreas 1 2
1) One main duct that drains most of the pancreas. This drains into the major duodenal papilla. 2) An accessory duct that drains the head and uncinate process. This drains into the minor duodenal papilla
Important possible injury of the spleen
Break of the left ribs 9, 10, 11 can puncture spleen. Spleen is very vascular, so this can result in fatal bleeding.
Spleen
Oval mass of lymphoid tissue in the LUQ. Smooth diaphragmatic surface, visceral surface with hilum.
