9.2 Organs of the Peritoneal Cavity-- Accessory Organs of the GI Tract

Question 1

Answer 1

Question 2

site of hematopoiesis in fetus, and in adults

Answer 2

fetus; liver and spleen

adult; bone marrow

Question 3

4 lobes of the liver

Answer 3

Externally, ligaments and fissures divide the liver into four anatomic (topographic) lobes: the right, left, caudate, and quadrate lobes

Question 4

what is the liver bare area

Answer 4

The liver’s diaphragmatic surface conforms to the shape of the diaphragm and is marked by the bare area, which lacks peritoneum and is in direct contact with the diaphragm

Question 5

3 prominent fissures of the liver

Answer 5

The left sagittal fissure accommodates:

a. the round ligament (ligamentum teres) of the liver anteriorly between the left and quadrate lobes. The round ligament is a remnant of the fetal umbilical vein.
b. the ligamentum venosum posteriorly between the left and caudate lobes. The ligamentum venosum is a remnant of the fetal ductus venosus.

The right sagittal fissure accommodates:

a. the gallbladder anteriorly between the right and quadrate lobes and
b. the inferior vena cava posteriorly between the right and caudate lobes.

The transverse fissure accommodates

the porta hepatis, or hilum of the liver. Structures of the portal triad [proper hepatic artery, portal vein, and (common) bile duct] enter or exit here.

Question 6

Answer 6

Question 7

the liver is ___ (retroperitoneal, secondary, intraperitoneal)

Answer 7

intraperitoneal, covered by peritoneum except at the bare area, gall bladder fossa and porta hepatis.

Question 8

a subperitoneal fibrous capsule known as ____ covers the sruface of the liver

Answer 8

glissons capsule

Question 9

Peritoneal reflections of the liver include

the ____ AND _____ ligaments, single-layered reflections between the liver and diaphragm that surround the bare area;

the ___ ligament, a double layer of peritoneum, which attaches the liver to the anterior abdominal wall and contains the round ligament in its free edge; and

the ____ and ____ ligaments (both parts of the lesser omentum), which attach the liver to the stomach and proximal duodenum

Answer 9

Peritoneal reflections include

the coronary and triangular ligaments, single-layered reflections between the liver and diaphragm that surround the bare area;

the falciform ligament, a double layer of peritoneum, which attaches the liver to the anterior abdominal wall and contains the round ligament in its free edge; and

the hepatogastric and hepatoduodenal ligaments (both parts of the lesser omentum), which attach the liver to the stomach and proximal duodenum

Question 10

nternally, branching of the intrahepatic blood vessels divides the liver into eight functional segments (designated as I through VIII) (Figs. 9.17, Table 9.1). This segmental arrangement of the blood supply facilitates the resection of individual diseased segments. Outline

Answer 10

Question 11

outline the dual blood supply of the liver

Answer 11

The liver has a dual blood supply: the portal vein and the proper hepatic artery (see Fig. 8.11). Both vessels divide to form primary and secondary branches that supply the liver segments.

The portal vein, carrying nutrient-rich blood from the digestive tract, provides 75 to 80% of the blood volume to the liver.

The proper hepatic artery, supplied by the celiac trunk via the common hepatic artery, contributes 20 to 25% of the blood volume to the liver.

Question 12

explain the lymph system of the liver

Answer 12

The liver has superficial and deep lymphatic drainages.

The superficial lymphatic plexus, found within the fibrous capsule, drains the anterior liver surfaces to hepatic nodes (and eventually into the celiac nodes) and drains the posterior surfaces toward the bare area, which flow into phrenic or posterior mediastinal nodes.

The deep plexus, which accompanies vessels within the liver segments, drains most of the liver, flowing first into the hepatic nodes in the porta hepatis and lesser omentum, before draining to the celiac nodes.

Question 13

which nerve plexus innervates the liver and what is it a division of?

Answer 13

The hepatic nerve plexus, a division of the celiac plexus, travels along the vessels of the portal triad to innervate the liver (se

Question 14

Answer 14

Question 15

The gallbladder is a pear-shaped sac that lies in a fossa on the visceral surface of the liver . It stores the bile produced and secreted by the liver and concentrates it by absorbing salts and water. Hormonal or neural stimulation causes the gallbladder to release bile into the ____ ____ ____.

Answer 15

The gallbladder is a pear-shaped sac that lies in a fossa on the visceral surface of the liver (Figs. 9.18 and 9.19). It stores the bile produced and secreted by the liver and concentrates it by absorbing salts and water. Hormonal or neural stimulation causes the gallbladder to release bile into the extrahepatic biliary ducts.

Question 16

Answer 16

Question 17

4 parts of the gall bladder

Answer 17

The fundus, the expanded distal end that is in contact with the anterior abdominal wall

The body, the main portion

The infundibulum between the body and neck

The neck, the narrow distal segment that joins with the cystic duct

Question 18

components of the extrahepatic biliary system

Answer 18

1. common hepatic duct
2. cystic duct which ddrais the gall bladder
3. bile duct: formed by the junction of the common hepatic duct and cystic duct

Question 19

The bile duct passes posterior to the first part of the duodenum and posterior to, or through, the head of the pancreas. It ends at the ___ ____), a dilation of the distal end of the duct, where it joins with the main ___ duct of the ____

Answer 19

The bile duct passes posterior to the first part of the duodenum and posterior to, or through, the head of the pancreas. It ends at the hepatopancreatic ampulla (of Vater), a dilation of the distal end of the duct, where it joins with the main pancreatic duct of the pancreas

Question 20

A muscular sphincter ____ ___ surrounds the _____ ampulla as it traverses the medial wall of the duodenum through the major duodenal papilla and opens into the descending part of the duodenum

Answer 20

A muscular sphincter (of Oddi) surrounds the hepatopancreatic ampulla as it traverses the medial wall of the duodenum through the major duodenal papilla and opens into the descending part of the duodenum

Question 21

what artery supplies the gall bladder

Answer 21

the cystic artery which is a branch of the right hepatic artery which is a branch of the proper hepatic artery which is a branch of the common hepatic artery which is a branch of the celiac trunk

(proper hepatic artery (PHA), is the continuation of the common hepatic artery after it gives off the gastroduodenal artery. Just prior to the porta hepatis it divides into the left and right hepatic arteries.)

Question 22

Answer 22

Question 23

outline the venous drainage of the gall baldder

Answer 23

drains into the hepatic veins inthe liver, which drain into the inferior vena cava.

Question 24

which plexus innervates the gall bladder?

Answer 24

hepatic plexus.

Sympathetic stimulation inhibits bile secretion.

Parasympathetic stimulation causes the gallbladder to contract and release bile.

Question 25

is the pancreas secondary or primary retroperitoneal

Answer 25

secondary retroperitoneal

Question 26

four parts of the pancreas

Answer 26

head and uncinate process, the neck, the body, and the tail

Question 27

The main pancreatic duct (of Wirsung) traverses the length of the gland to join with the ___ ____ duct at the hepatopancreatic ampulla. Together they drain into the descending part of the duodenum at the ___ ____ ____

Answer 27

The main pancreatic duct (of Wirsung) traverses the length of the gland to join with the common bile duct at the hepatopancreatic ampulla. Together they drain into the descending part of the duodenum at the major duodenal papilla

Question 28

outline the blood supply of the pancreas

Answer 28

Branches of the celiac trunk and superior mesenteric artery supply the pancreas (see Fig. 8.11).

Pancreaticoduodenal branches of the gastroduodenal artery (from the celiac trunk) and superior mesenteric artery supply the head.

Branches of the splenic artery supply the neck, body, and tail.

Question 29

Answer 29

Question 30

Answer 30

Question 31

outline the venous and lymph drainage of the pancreas.

Answer 31

Venous blood drains into the splenic and superior mesenteric veins, which merge to form the hepatic portal system

Lymphatic drainage is as varied as its blood supply but generally follows arterial pathways, ultimately draining into celiac and superior mesenteric nodes

Question 32

what is the inneravation of the pancreas

Answer 32

The celiac and superior mesenteric plexuses innervate the pancreas

Question 33

Answer 33

Question 34

Answer 34

Question 35

is the spleen retro or intra peritoneal

Answer 35

intraperitoneal

Question 36

The spleen is an intraperitoneal organ located in the ____ region of the left upper quadrant (Figs. 9.25, 9.26, 9.27). It functions as a _____ gland and as a ____ for old or abnormal red blood cells.

Answer 36

The spleen is an intraperitoneal organ located in the hypochondriac region of the left upper quadrant (Figs. 9.25, 9.26, 9.27). It functions as a lymphoid gland and as a filter for old or abnormal red blood cells.

Question 37

Answer 37

Question 38

Answer 38

Question 39

The spleen is connected to adjacent organs by peritoneal ligaments.

The _____ ligament, which contains the branches of the splenic vessels and the tail of the pancreas, connects the spleen to the kidney.

The ______ ligament, which contains the short gastric and left gastro-omental vessels, connects the spleen to the stomach.

The _____ ligament connects the spleen to the left colic flexure.

The _____ ligament connects the spleen to the diaphragm.

Answer 39

The spleen is connected to adjacent organs by peritoneal ligaments.

The splenorenal ligament, which contains the branches of the splenic vessels and the tail of the pancreas, connects the spleen to the kidney.

The gastrosplenic ligament, which contains the short gastric and left gastro-omental vessels, connects the spleen to the stomach.

The splenocolic ligament connects the spleen to the left colic flexure.

The phrenicosplenic ligament connects the spleen to the diaphragm.

Question 40

The ____ artery, a large tortuous branch of the celiac trunk, divides within the ____ ligament at the splenic ____

Answer 40

The splenic artery, a large tortuous branch of the celiac trunk, divides within the splenorenal ligament at the splenic hilum

Question 41

The splenic vein courses behind the pancreas, where it joins with the superior ____ vein to form the ____ vein

Answer 41

The splenic vein courses behind the pancreas, where it joins with the superior mesenteric vein to form the portal vein

Question 43

what plexus innervates the spleen

Answer 43

the splenic plexus, a derivative of the celiac plexus.