Abdomen Week 2 (B) Flashcards
1
Q
What is the main function of the small intestines?
A
- Primary absorption site
2
Q
Small intestines
Origin:
A
Pylorus
3
Q
Small intestines
Termination:
A
ileocecal junction
4
Q
Small Intestine:
Admission into small intestine controlled by ______.
A
pylorus
5
Q
What are the 3 parts of the small intestine?
A
Duodenum
Jejunum
Ileum
6
Q
What is the duodenum?
A
7
Q
Where does the duodenum begin?
A
Begins at pylorus and terminates at duodenojejunal junction (level of L2)
8
Q
What are the 4 parts of the duodenum?
- Superior
- Descending
- Horizontal
- Ascending
A
9
Q
What is the superior part of the duodenum? (3)
A
10
Q
What is the descending part of the duodenum?
A
11
Q
What is the horizontal part of the duodenum?
A
12
Q
What is the ascending part of the duodenum?
A
13
Q
What is the arterial supply of the duodenum?
A
Following embryological origin of the gut
14
Q
Foregut: above major _____
Midgut: below foregut, until ____ ______
A
duodenal
hind guts
15
Q
Duodenum:
- Proximal to opening of bile duct (foregut):
A
16
Q
Duodenum:
- Distal to opening of bile duct (midgut):
A
17
Q
- Veins follow arterial supply but drain either directly or indirectly into _____ vein
A
portal
18
Q
Lymphatic drainage duodenum:
- Anterior lymphatic vessels:
- Posterior lymphatic vessels:
A
19
Q
Duodenum innervation:
- Vagus + greater & lesser abdominopelvic splanchnic nerves via: (3)
A
20
Q
What is the most common ulcer? (2)
A
- Gastric most common
- Duodenum second most common
21
Q
- Helicobacter ____ infection
- Chronic _____ predisposes
A
pylori
anxiety
22
Q
- Acid secretion —> weaken _____ —> H. pylori erodes into wall
- Eroding into arteries —> life threatening _____
A
mucosa
bleeds
23
Q
What does the vagus nerve control?
A
- Vagus nerves controls acid secretion
24
Q
Vagotomy =
A
old treatment of ulcers
25
Ulcer treatment:
- Prevention mostly today
26
What is the duodenum?
27
Duodenum
Extent:
28
Duodenum
Shape:
C-shaped with convexity to the right side and concavity enclosing the head of the pancreas.
29
Duodenum
Location:
epigastric and umbilical regions
30
Duodenum
* Parts: (4)
superior, descending, inferior and ascending
31
Duodenum
* Common bile duct and ______ ducts open into descending part
* Duodenojejunal flexure is widened by _______ muscle of the duodenum (ligament of Treitz)
pancreatic
suspensory
32
Duodenum
* Common bile duct and ______ ducts open into descending part
* Duodenojejunal flexure is widened by _______ muscle of the duodenum (ligament of Treitz)
pancreatic
suspensory
33
Superior (A&B)
* 5cm
* Lies at L1
Anterior:
Posterior:
Medial:
Superior:
Inferior:
34
Descending (C)
* 8.5cm
* Lies at L1-L3
Anterior:
Posterior:
Medial:
Superior:
Inferior:
35
Inferior (D)
* 7cm
* Lies at L3
Anterior:
Posterior:
Medial:
Superior:
Inferior:
36
Ascending (E)
5cm
Runs superomedially (left to right) from L3-L2
Anterior:
Posterior:
Medial:
Superior:
Inferior:
37
Neurovasculature and lymphatics:
Venous drainage:
38
Neurovasculature and lymphatics:
Lymphatic drainage:
39
Neurovasculature and lymphatics:
Innervation:
40
Arterial supply of the duodenum:
41
What is the liver? (2)
42
What does the liver occupy? (3)
43
Where are the functions of the liver? (3)
44
Liver surfaces:
▪ Convex diaphragmatic surface: (2)
▪Bare area
▪Subphrenic recesses
45
Liver surfaces:
▪ Flat to concave visceral surface: (2)
▪Hepatorenal recess ▪Subhepatic space
46
Inferior border:
47
What are the features of the diaphragmatic surface of the liver? (4)
48
What are the features of the visceral surface of the liver? (5)
49
What do the two saggital fissures & transverse ports hepatic form?
Form H
50
Visceral surface
- Right fissure:
51
Visceral surface
- Right fissure:
52
Visceral surface
- Left fissure:
53
What are the ligaments associated with the lesser omentum? (2)
54
What are the ligaments associated with the lesser omentum? (2)
55
Identify the border highlighted in green:
56
Identify the border highlighted in green:
57
What are the impressions of the liver?
58
Liver - Blood supply and drainage:
- Portal vein: (3)
59
Liver - Blood supply and drainage:
- Hepatic artery: (3)
60
Liver - Blood supply and drainage:
- Central veins:
61
What are the anatomical lobes of the liver? (4)
62
Liver
What do the tertiary divisions supply?
63
Liver
What do the secondary divisions supply?
64
Liver
Left lobe:
▪Left lobe – left anterior & posterior lateral segments
65
Liver
Right lobe:
▪Right lobe – left medial segment, right anterior & posterior medial segments and right anterior & posterior lateral segments
66
Liver
Caudate lobe:
Posterior segment
67
What is the lymphatic drainage of the liver?
68
Lymphatic drainage in liver
Superficial lymphatic:
▪Superficial lymphatics in subperitoneal fibrous capsule of the liver
69
Lymphatic drainage in liver
▪Deep lymphatics:
▪Deep lymphatics in connective tissue around vessels (portal triad & hepatic veins)
70
Lymphatic drainage in liver
▪Superficially anterior →
71
Lymphatic drainage in liver
▪ Superficially posterior of both _______ and visceral surfaces→ bare area of liver→______ lymph nodes→through diaphragm→ posterior _____ lymph nodes
diaphragmatic
phrenic
mediastinal
72
Lymphatic drainage in liver
▪ Posterior surface of left lobe→
left gastric lymph nodes
73
Lymphatic drainage in liver
▪ Anterior central diaphragmatic surface, along falciform ligament →
parasternal lymph nodes
74
Lymphatic drainage in liver
▪Round ligament of liver→
umbilicus →lymphatics of anterior abdominal wall
75
Liver - innervation:
▪ Sympathetic -
coeliac ganglion (greater splanchnic)
76
Liver - innervation:
▪ Parasympathetic –
anterior & posterior vagal trunks
77
Liver - innervation
Vasoconstriction function:
Limit amount of blood in and out of the liver
78
What are biliary ducts?
▪ Carry bile from liver to duodenum
79
Biliary ducts
- Hepatocytes:
▪ Hepatocytes → bile canaliculi → interlobular biliary ducts → collecting bile ducts→left & right hepatic ducts→ porta hepatis→ common hepatic duct →(joined by cystic duct) bile duct
80
Liver:
* Largest and heaviest gland
* Wedge-shaped or roughly _______ with dark reddish-brown colour
* Weight: __.__% of adult body weight
o Heavier in males
o Relatively larger in foetuses and _____-_____
triangular
2.5
new-borns
81
What are the functions of the liver? (5)
* Functions:
1. Secretes bile
2. Synthesises proteins
3. Metabolism of all nutrients except fat
4. Stores glycogen
5. Destruction of RBCs and toxins
82
Where is the liver located? (4)
83
What are the surfaces of the liver?
* Diaphragmatic and visceral surfaces separated by sharp inferior border
1. Convex diaphragmatic surface
2. Concave visceral surface
84
Surfaces of the liver:
1. Convex diaphragmatic surface
o Formed by anterior, superior and part of the posterior surfaces
o Subphrenic recesses: (3)
85
Surfaces of the liver:
1. Convex diaphragmatic surface
Anterior surface:
- Diaphragm separates it from 6-10 costal cartilages on the right and 7-8 costal cartilages on the left
86
Surfaces of the liver:
1. Convex diaphragmatic surface
Superior surface: (3)
87
Surfaces of the liver:
1. Convex diaphragmatic surface
Posterior surface:
- Against vertebral column
88
Surfaces of the liver:
2. Concave visceral surface
o Portahepatis:
- Transverse fissure for portal triad, hepatic nerve plexus and lymphatics
89
Surfaces of the liver:
2. Concave visceral surface
o H-shaped right and left sagittal fissures: (2)
90
Surfaces of the liver:
o Impressions and relations of the visceral surface: (6)
91
What are the peritoneal ligaments? (6)
92
What are the lobes of the liver?
* Larger left lobe and smaller right lobe separated by falciform ligament and left sagittal fissure
93
Lobes of the liver:
* Transverse porta hepatis separates right lobe between right and left sagittal fissures into: (2)
o Quadrate-anterior and inferior
o Caudate-posterior and superior
94
Lobes of the liver:
* Transverse porta hepatis separates right lobe between right and left sagittal fissures into: (2)
o Quadrate-anterior and inferior
o Caudate-posterior and superior
95
What are the functional segments of the liver?
* 8 segments each having its own branch of the hepatic artery, portal vein and bile duct
96
Left segment
Division:
Segment:
Lobe:
97
Right segment
Division:
Segment:
Lobe:
98
STUDY:
99
Blood supply, Venous drainage, Lymph drainage and innervation of liver: (4)
100
What is the bile duct? (4)
101
Bile duct:
▪ Main pancreatic and bile ducts unite in wall of
duodenum, form _________ ampulla in open into duodenum as major duodenal _____.
hepatopancreatic
papilla
102
What is the sphincter of the bile duct?
103
What I the gallbladder?
▪ 7-10 cm long pear-shaped organ
104
Where does the gallbladder lie?
▪ Lies in fossa for gallbladder (visceral surface of liver) attached by connective tissue of fibrous capsule of liver
105
What are the 3 parts of the gallbladder?
106
What is the blood supply of the gallbladder?
107
What is the venous drainage of the gallbladder?
▪Neck and cystic duct→
▪Fundus & body→
108
What is the venous drainage of the gallbladder?
▪Neck and cystic duct→
▪Fundus & body→
108
What is the cystic duct of the gallbladder?
109
What is the lymphatic drainage of the gallbladder?
▪ Cystic lymph nodes (near neck) →
110
Gallbladder innervation:
- Coeliac ganglia:
▪ Coeliac ganglia (greater splanchnic) – sympathetic & visceral afferent fibres (pain)
111
Gallbladder innervation:
- Coeliac ganglia:
▪ Coeliac ganglia (greater splanchnic) – sympathetic & visceral afferent fibres (pain)
112
Gallbladder innervation:
▪ Vagus nerve –
113
Gallbladder innervation
▪Right phrenic nerve –
114
What is liver cirrhosis?
115
What is liver cirrhosis?
116
What is cholelithiasis?
117
What is the gallbladder?
* Piriform-shaped sac lying in its fossa on the visceral surface of the liver
* Length: 7-10cm
* Breadth: 3cm at widest
* Capacity: 30-50ml
* Function: storage, concentration and release of bile
118
Parts of the gallbladder:
Fundus =
119
Parts of the gallbladder:
Body =
120
Parts of the gallbladder:
Neck =
121
What is the cystic duct? (2)
Cystic duct:
* 3-4cm long
* Connects the neck of the gallbladder to the common hepatic duct
122
Cystic duct:
* Mucosa of the neck spirals into the spiral fold...(3)
123
Cystic duct:
* Mucosa of the neck spirals into the spiral fold...(3)
124
Blood supply, venous drainage, lymph drainage, innervation:of the gallbladder:
125
What is the path to the common bile duct?
126
How does the bile duct form?
* Forms in the free edge of the lesser omentum by union of common hepatic and cystic ducts
127
How does the bile duct form?
* Forms in the free edge of the lesser omentum by union of common hepatic and cystic ducts
128
Bile duct:
* Course: (4)
129
What is the blood supply of the bile duct? (3)
130
What is the venous drainage of the bile duct? (2)
131
What is the applied anatomy of the bile duct? (4)
