3.b) The liver, biliary apparatus and spleen Flashcards

1
Q

What ligaments can the lesser omentum be divided into?

A

Hepatoduodenal Ligament

Gastrohepatic Ligament

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2
Q

Which ligaments suspend the spleen?

A
Splenorenal ligament (posterior)
Gastrosplenic ligament (anterior)
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3
Q

In which mesentery does the liver develop?

A

Ventral foregut mesentery

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4
Q

What connects the liver to the anterior abdominal wall?

A

Falciform Ligament

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5
Q

What connects the liver to the lesser curvature of the stomach?

A

Lesser Omentum

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6
Q

What is the region of the liver that makes direct contact with the diaphragm called?

A

Bare area of the liver

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7
Q

Which ribs are the liver deep to?

A

Deep to ribs 7-11

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8
Q

Which abdominal regions do the liver extend across?

A

The top 3:
right hypochondriac
epigastric
left hypochondriac

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9
Q

What is the structure at the end of the falciform ligament called and how did it originate?

A

Ligamentum Teres

It is a remnant of the umbilical vein

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10
Q

What are the ligaments on the superior surface of the liver called?

A
Coronary Ligament (anterior and posterior) 
Left and Right Triangular Ligaments
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11
Q

What defines the anatomical boundary (dividing the liver into anatomical lobes)?

A

The fissures of the foetal veins

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12
Q

What are the 2 accessory lobes of the liver and where are they located?

A

Quadrate: located between the gallbladder and the fissure of the ligamentum teres
Caudate: located between the IVC and the fissure of the ligamentum venosum
Porta hepatis divides the caudate and quadrate lobes.

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13
Q

What is the ligament on the posterior end of the inferior aspect of the liver?

A

Ligamentum venosum: remnant of the ductus venosum

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14
Q

What divides the liver into right and left functional lobes?

A

A line between the gallbladder and the IVC

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15
Q

What is special about the caudate lobe?

A

It is functionally separate from the right and left lobes.

It is supplied by right and left hepatic arteries

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16
Q

What vessels make up porta hepatis?

A

Common bile duct and lymphatics
Hepatic artery
Hepatic portal vein

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17
Q

What are the 2 parts of the coronary ligament?

A

Anterior and Posterior

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18
Q

Describe the anatomical relations of the liver

A

Covered by costal margin except in upper epigastrium
Convex diaphragmatic surface
Complex visceral surface in contact with stomach, duodenum, right kidney and colon

19
Q

Where is the liver palpated?

A

right hypochondriac region

20
Q

Blood supply to functional right and left vascular lobes of the liver

A

Right hepatic artery: Right lobe

Left hepatic artery: Left lobe, Caudate lobe, Quadrate lobe

21
Q

How many segments is the liver comprised of?

A

8

Each has its own blood supply, drainage and bile duct

22
Q

How many divisions of the celiac trunk? What are they?

A

3
Splenic artery
Left gastric artery
Common hepatic artery

23
Q

What does the common hepatic artery split into?

A

Gastroduodenal artery
Right gastric artery
Hepatic artery proper

24
Q

What does the Hepatic artery proper divide into?

A

Right and left hepatic arteries

25
Q

What join to form the hepatic portal vein?

A

Splenic vein

Superior mesenteric vein

26
Q

What connects the venous drainage of the liver to the IVC?

A

3 short hepatic veins

27
Q

What are the 4 sites of portal-systemic anastomosis? (systemic : portal)

A

Oesophageal Veins : Left Gastric Vein
Inferior Rectal Vein : Superior Rectal Vein
Epigastric Veins : Paraumbilical Vein
Retroperitoneal Veins : Visceral Veins

28
Q

What is the significance of these portal-systemic anastomosis?

A

If there is a blockage causing hepatic portal tension, these sites of porto-systemic anastomoses could dilate, rupture and bleed heavily

29
Q

At which of the portal-systemic anastomoses is haemorrhage common?

A

Oesophagus

Rectum

30
Q

Describe the structure of the biliary tree.

A

Cystic duct from the gallbladder joins the hepatic duct (from the right and left hepatic ducts) to form the common bile duct

31
Q

Where does the common bile duct and pancreatic duct join and where do they enter into the duodenum?

A

Join at Ampulla of Vater

Enter duodenum at Major Duodenal Papilla

32
Q

What sphincter guards the ampulla of vater?

A

Sphincter of oddi

33
Q

Presence of sphincters in pancreatic and bile duct

A

There are separate sphincters for the bile duct and pancreatic duct

34
Q

What do neoplasms of the head of the pancreas result in?

A

Obstruction of pancreatic and bile duct exits

35
Q

What forms the common hepatic duct?

A

Left and right hepatic ducts

36
Q

What forms the common bile duct?

A
Common hepatic duct
Cystic duct (from gall bladder)
37
Q

What is the clinical significance of the proximity of the gallbladder to the first part of the duodenum?

A

Gallstones can press on the duodenum and ulcerate causing a cholecystoduodenal fistula (gall stone will enter duodenum)

38
Q

What is the largest lymphoid organ in the body?

A

Spleen

39
Q

The spleen lies on the underside of which ribs?

A

9-11

left ribs

40
Q

What does traumatic rupture of the spleen cause?

A

Severe haemorrhage

Can’t be repaired, must be removed

41
Q

Describe the appearance of the superior border of the spleen

A

Knuckled

42
Q

What lies in the splenorenal ligament?

A

Tail of pancreas and splenic artery

43
Q

What does the gastrosplenic ligament carry?

A

Blood vessels from splenic artery (short gastric vessels) to the left side of the stomach