54. GI anatomy part 4

Question 1

Where is the gallbladder located?

How much bile can it handle?

Answer 1

At the inferior border of the liver and superiolaterally to the duodenum

30-50ml

Question 2

Describe the anatomical appearance of the gallbladder

What artery supplies the gall bladder?

Answer 2

Fundus- top

Body- middle

Neck- bit that leads into the cystic duct

cystic artery

Question 3

Describe the pathway of the biliary tree

What artery supplies the gall bladder?

Answer 3

(Right and left hepatic duct—> hepatic duct)

Common hepatic duct and cystic duct–> Common bile duct

Common bile duct and pancreatic duct–> hepatopancreatic ampulla of vater

Question 4

What are the range of diseases associated with the gall bladder

Answer 4

Cholelithiasis- uncomplicated gallstones

Biliary colic- right upper quadrant pain after a meal

Cholecystitis- inflammation of the gall bladder

Choledocholithiasis- gallstone within the common bile duct

Cholangitis- infection of the common bile duct (charcot’s triad)

Question 5

Where is a common site in the gallbladder where stones will lodge and cause an impaction?

Answer 5

Hartmann’s pouch- a mucosal fold located in the neck of the gallbladder

Question 6

Describe the positioning of the pancreas?

Answer 6

Lies centrally in the trans-pyloric plane (L1). Its head tucks into the curve of the duodenum

Question 7

The pancreas has some major landmarks in anantomy- explain them?

Answer 7

Aorta and IVC passes posteriorly to the head of the pancreas

Superior mesenteric artery lies behind the neck of the pancreas

Posterior to the neck of the pancreas the splenic and superior mesenteric veins unite

Question 8

Describe the five major regions of the pancreas?

Answer 8

Head- widesr part lies within c shaoed curve

Uncinate process- lies psoteriorally to the neck and medially to the head

Neck- located between the head and body

Body- major bit that sits centrally

Tail- near spleen

Question 9

What controls the release of substances through the ampulla of vater?

Answer 9

The sphincter of oddi

Question 10

How is the pancreas arterially supplied and drained?

Answer 10

branches of splenic artery

superior mesenteric branches of hepatic portal vein

Question 11

What ligaments anchor the spleen?

Answer 11

Gastrosplenic ligament- connects spleen to greater curvature of stomach

Splenorenal ligament- connects hilum of spleen to left kidney

Question 12

What covers the spleen?

Answer 12

Fibroelastic capsule

Question 13

Describe the shape and structure of the adrenal glands?

Answer 13

Left- semilunar shape
Right- pyramidal

Enclosed by renal fascia

Question 14

What are the two regions of the adrenal glands?

Answer 14

Medulla (outer)

Coretex (inner)

Question 15

Discuss the layer of the cortex and what hormones they secrete?

Answer 15

Zona glomerulosa – produces and secretes mineralocorticoids such as aldosterone.

Zona fasciculata – produces and secretes corticosteroids such as cortisol. It also secretes a small amount of androgens.

Zona reticularis – produces and secretes androgens such as dehydroepiandrosterone (DHES). It also secretes a small amount of corticosteroids.

Question 16

What does the medulla do?

Answer 16

Chromaffin cells which secrete catecholamines into the bloodstream

Question 17

Explain the blood supply of the adrenal glands

Answer 17

Superior adrenal artery – arises from the inferior phrenic artery

Middle adrenal artery – arises from the abdominal aorta.

Inferior adrenal artery – arises from the renal arteries.

Question 18

Discuss the positioning of the kidneys?

Answer 18

Retroperitoneal organs that lie from T12 to L3.

The adrenal glands sit atop it within a separate envelope renal fascia

Question 19

Describe the layers of kidneys from deep to superficial?

Answer 19

Kidney (in the middle)
Renal capsule
Perirenal fat
Renal fascia- encloses kidneys and adrenal glands
Pararenal fat- mainly located on the posterolateral aspect of the kidney

Question 20

Talk through the layers of the kidney

Answer 20

Encased in an outer cortex this cortex divides the medulla into triangular shapes known as the renal pyramids

apex of pyramids is the renal papilla- associated with a minor calyx. Minor calyx form major calyx. Major calyx form renal pelvis. Renal pelvis drains into ureter.

Question 21

The kidneys are supplied by the renal arteries. Which artery is longer and how does it cross the vena cava?

Answer 21

Right renal artery- crosses IVC posteriorly

Question 22

What is the line of brodel?

Answer 22

The line in the lateral and slightly posterior border of the kidney which delineates the segments supplied by anterior and posterior regions of the kidneys.

important for open and endoscopic surgeries

Question 23

Which renal vein is larger?

How does it travel in relation to the abdominal aorta

Answer 23

Left renal vein, travels anteriorly to the abdominal aorta

Question 24

What are the two most common developmental abnormalities of the kidneys?

Answer 24

Pelvic kidneys- kidney fails to ascend and remains in pelvis around common iliac artery

Horseshoe kidney- two developing kidneys fuse into a single horseshoe shaped kidney