accessory GI organs W9

Question 1

how is the liver divided externally?

Answer 1

right lobe
left lobe
caudate lobe (between L & R, anterior & superior)
quadrate lobe (inferior surface of right lobe)

Question 2

where is the bare area of the liver?

Answer 2

area of liver with no peritoneal covering (lies next to diaphragm)
posterior superior surface of the right lobe (between two layers of the coronary ligament (aka right triangular ligament))

Question 3

impressions on the inferior surface of the liver?

Answer 3

colic impression (right anterior)
right renal impression (right middle)
right adrenal gland impression (medial to right renal impression)
duodenal impression (central, near gallbladder)
gastric impression (left, large)

Question 4

what structures would an endoscope need to pass through to get from the stomach to the gallbladder?

Answer 4

stomach
duodenum
duodenal papilla (hepatopancreatic sphincter)
hepatopancreatic ampulla
common bile duct
cystic duct
gallbladder

Question 5

why might a tumour occurring in the head of the pancreas cause painless jaundice? what would cause painful jaundice?

Answer 5

distal obstruction of the bile duct
painless as opposed to the painful presentation of gallstones

Question 6

what structures have an anatomical relationship with the spleen

Answer 6

superior - diaphragm
anterior - stomach
posterior - left kidney, ribs XI & X
inferior - left colic flexure
medial - pancreas
lateral - ribs XI & X, abdominal muscles

Question 7

which anatomical relationship with the spleen makes it susceptible to traumatic injury?

Answer 7

maybe ribs? idk its not in the worksheet

Question 8

blood supply to the liver/pancreas/gallbladder/spleen

Answer 8

celiac trunk
>common hepatic artery
>gastroduodenal artery
>superior pancreaticoduodenal
arteries (ant and post)
>right gastric artery
>hepatic artery proper
>cystic artery
>splenic artery
>left gastric artery

superior mesenteric artery
>inferior pancreaticoduodenal arteries (ant and post)

Question 9

hepatic portal system veins?

Answer 9

short gastric and left gastro-omental veins drain into splenic vein.
inferior mesenteric vein drains into the splenic vein.
splenic vein and superior mesenteric join to form the portal vein.
left gastric vein drains into portal vein.

Question 10

which veins drain blood from the accessory GI organs?

Answer 10

liver - IVC
spleen - splenic vein
gallbladder - cystic vein (tributary of portal vein)
pancreas - tributaries of splenic vein

Question 11

spaces around the liver?

Answer 11

right subphrenic space
left subphrenic space
hepatorenal space

Question 12

what is the name of the reflexion of peritoneum running between the diaphragm and the liver, which limits the right subphrenic space?

Answer 12

anterior/superior coronary ligament

Question 13

what is the name of the reflexion of peritoneum running between the diaphragm and the liver, which limits the hepatorenal space?

Answer 13

posterior/inferior coronary ligament

Question 14

what forms the hepatic portal triad?

Answer 14

hepatic artery proper
hepatic portal vein
common bile duct

Question 15

features of the hepatoduodenal ligament?

Answer 15

part of the lesser omentum
contains the portal triad
forms roof of epiploic/omental foramen

Question 16

function of the hepatic artery proper?

Answer 16

carries oxygen-rich blood to the liver

Question 17

function of the hepatic portal vein

Answer 17

carries oxygen-poor, nutrient-rich blood to the liver

Question 18

function of the common bile duct?

Answer 18

carries bile from liver and gallbladder to duodenum

Question 19

9 connective abdominal tissue that keeps the organs of the abdomen in place?

Answer 19

falciform ligament
hepatogastric ligament
splenorenal ligament
lesser omentum
ligamentum teres (round lig of liver)
dorsal mesentery
gastrophrenic ligament
gastrosplenic ligament
phrenicocolic ligament

Question 20

what are the structural units of the liver

Answer 20

hepatic lobules

Question 21

histological appearance of the Islets of Langerhans?

Answer 21

lightly stained, consist of smaller cells

Question 22

what cells are Islets of Langerhans made up of and what is their function

Answer 22

endocrine cells:
alpha cells - glucagon
beta cells - insulin
delta cells - somatostatin/gastrin

Question 23

what is the bulk of the pancreas made up of? what is their function?

Answer 23

acinar cells lining blind-ending ducts
produce enzymes (protease, lipase, amylase)
enzymes drain via small ducts into larger ducts which ultimately drain into the gut tube at the 2nd part of the duodenum

Question 24

spleen histology?

Answer 24

fibrocollagenous outer capsule surrounding core of densely stained clusters of larger cells.
these surround arterial branches and are described as white pulp (made up of aggregates of lymphoid cells - T & B lymphocytes)
less densely stained cells make up red pulp (endothelial-lined sinusoids are common here)

Question 25

gallbladder histology?

Answer 25

luminal wall is irregular and thrown up in many folds
epithelium is single layer columnar
tiny folds (rugae/microvilli) line surface of epithelium
these flatten as the gallbladder fills (increase surface area)