11. Foregut 2

Question 1

Name the lobes of the liver (4)

Answer 1

Left
Right
Caudate
Quadrate

Question 2

What are the ligaments of the liver?

Answer 2

Falciform ligament
Triangular ligaments (R and L)
Coronary ligament
Ligamentum teres (string of tissue that hangs down from falciform ligament)

Question 3

What is the function of the falciform ligament of the liver?

Answer 3

Holds the liver to the body wall

Question 4

What is the ligamentum teres an embryological remnant of?

Answer 4

Umbilical vein

Question 5

What makes up the porta hepatis?

Answer 5

Bile duct (most anterior)
Hepatic artery 
Portal vein (most posterior)

NOT hepatic veins - these are within the liver itself

Question 6

What ducts form the bile duct?

Answer 6

Right and left hepatic ducts form common bile duct

Which joins with cystic duct

Question 7

Which important structure attaches to the porta hepatis?

Answer 7

Free edge of lesser omentum

Question 8

What type of peritoneum covers the liver?

Answer 8

Visceral

**except the part of the liver attached to the diaphragm - it is bare here

Question 9

What do the layers of falciform ligament of the liver form?

Answer 9

R –> coronary ligament

L –> left triangular ligament

Question 10

Describe the blood supply of the liver.

Answer 10

30% - oxygenated blood from hepatic artery

70% - deoxygenated, nutrient rich blood from portal vein

Question 11

Where does blood from the liver drain to?

Answer 11

Central veins –>
R and L hepatic veins (4 in total) –>
IVC

Question 12

Where does lymph from the liver drain?

Answer 12

Nodes at porta hepatis

Then coeliac nodes

Question 13

Where can pain from the liver refer to?

Answer 13

Epigastric region
R shoulder (via diaphragm)

Question 14

Where is bile secreted?

Answer 14

Liver

Question 15

Where is bile stored?

Answer 15

Gall bladder

Question 16

Where does the bile duct pierce the duodenum?

Answer 16

In second part of duodenum

via sphincter of Oddi (major duodenal papilla)

Question 17

What makes up the ampulla of Vater? Aka the hepatopancreatic ampulla

Answer 17

Bile duct + main pancreatic duct

Question 18

What is released from the small intestine when there is fat in the duodenum?

Answer 18

Cholecystokinin

Question 19

What effect does cholecystokinin have on the gall bladder?

Answer 19

Causes contraction

Question 20

What artery is the cystic artery a branch of?

Answer 20

Right hepatic artery

Question 21

Where does the cystic vein drain?

Answer 21

Into portal vein

Question 22

Where does lymph from the gall bladder drain?

Answer 22

Cystic node –>
Hepatic node –>
Coeliac ndoes

Question 23

Where does pain from the gall bladder refer?

Answer 23

Epigastric region

because nerve supply from coeliac plexus

Question 24

Which organs are anterior to the pancreas? (2)

Answer 24

Transverse colon

Stomach

Question 25

Which organs/ vessels/ structures are posterior to the pancreas? (10)

Answer 25

``` Bile duct Portal vein Splenic vein IVC Aorta Superior mesenteric artery L psoas L supra-renal gland L kidney Spleen ```

Question 26

What arteries supply the pancreas? (3)

Answer 26

Superior pancreaticoduodenal Inferior pancreaticoduodenal Dorsal

Question 27

Which artery is the dorsal pancreatic artery a branch of?

Answer 27

Splenic

Question 28

Which artery is the superior pancreaticoduodenal artery a branch of?

Answer 28

Gastroduodenal

Question 29

Which artery is the inferior pancreaticoduodenal artery a branch of?

Answer 29

Superior mesenteric

Question 30

Into which veins does blood from the pancreas drain?

Answer 30

Splenic vein Superior mesenteric vein (then into portal system)

Question 31

Where does lymph from the pancreas drain to?

Answer 31

Coeliac nodes at T12 | Superior mesenteric nodes at L1

Question 32

What is the nerve supply of the pancreas?

Answer 32

Coeliac and superior mesenteric plexuses

Question 33

Where does pain from the pancreas refer?

Answer 33

Epigastric region

Question 34

Where in the abdominal cavity does the spleen lie?

Answer 34

Left hypochondrium Inferior to ribs 9 - 11 Posterior to stomach

Question 35

What ligament connects the greater omentum and the hilum of the spleen?

Answer 35

Gastrosplenic ligament

Question 36

What vessels does the gastrosplenic ligament contain?

Answer 36

Short gastric | Gastro-epiploic

Question 37

What ligament connects the left kidney and the spleen?

Answer 37

Lienorenal ligament

Question 38

What does the lienorenal ligament contain?

Answer 38

Splenic vessels | Tail of pancreas

Question 39

What artery supplies the spleen?

Answer 39

Splenic artery (largest branch of coeliac)

Question 40

Where does blood from the spleen drain?

Answer 40

Splenic vein

Question 41

What vein drains into the splenic vein?

Answer 41

Inferior mesenteric vein | also smaller branches from stomach and pancreas

Question 42

What veins make up the portal vein?

Answer 42

Splenic vein | Superior mesenteric vein

Question 43

Where does lymph from the spleen drain?

Answer 43

Pancreaticosplenic nodes

Question 44

What is the nerve supply of the spleen?

Answer 44

Coeliac plexus