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accessory organs of digestion Flashcards

1
Q

spleen

A

lymph organ, filters RBCs and platlets
LUQ
protected by lower 4 ribs, but very frequently ruptured
peritonealized

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2
Q

anatomical relationships of spleen

A

anterior- stomach
posterior- diaphragm
inferior- left colic flexure

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3
Q

external features of spleen

A

usually 12cm long, 7cm wide, weighs 7 ounces
hilum faces anteriomedially, receives blood vessels
borders:
superior and anterior notched and sharp
inferoposterior- smooth

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4
Q

ligaments associated w/spleen

A

gastrosplenic
splenorenal (spleen to posterior body wall)
rests inferiorly on phrenicocolic ligament

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5
Q

lymph of spleen

A

pancreaticosplenic nodes -> celiac nodes

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6
Q

pancreas exocrine function

A

secretion of pancreatic enzymes into duodenum for digestion

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7
Q

pancreas endocrine function

A

secretion of pancreatic hormones (insulin and glucagon) into bloodstream from islets of langerhans

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8
Q

pancreas

A

secondarily retroperitoneal

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9
Q

external features of pancreas

A 
head- lies w/in concavity of duodenum
ucinate process
neck- passes anterior to superior mesenteric vessels
body- continuous from neck to tail
tail- lies w/in splenorenal ligament
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10
Q

anatomical relationships head of pancreas

A

anterior- pyloric region of stomach, small intestines
posterior- LV1,2, IVC, renal vessels, bile duct
right and inferior- duodenum

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11
Q

anatomical relationships uncinate process of pancreas

A

anterior- superior mesenteric vessels

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12
Q

anatomical relationships neck of pancreas

A

anterior- transcerse mesocolon, small intestine

posterior- SMA, formation of hepatic portal v

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13
Q

anatomical relationships body of pancreas

A

anterior- stomach

posterior- aorta, left suprarenal gland, left kidney, renal vessels

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14
Q

anatomical relationships tail of pancreas

A

contacts hilum of spleen

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15
Q

main pancreatic duct

A

begins in tail, travels thru inferior portion of body and head
merges w/bile duct to form hepatopancreatic ampulla
empties into second portion of duodenum at major duodenal papilla
release controlled by sphincters (of pancreatic duct, of bile duct, and hepatopancreatic duct of oddi)

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16
Q

accessory pancreatic duct of santorini

A

travels through superior portion of head of panceas

empties into 2nd portion of duodenum at minor duodenal papilla

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17
Q

lymph of pancreas

A

II splenic a -> pancreaticospenic nodes -> celiac and superior mesenteric nodes

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18
Q

liver functions

A

metabolism of bile, lipids, carbs, proteins
produce urea
detox

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19
Q

surfaces of liver

A

diaphragmatic- (ant/sup) smooth and convex

visceral (post/inf) concave

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20
Q

porta hepatis

A

fissure on central portion of visceral surface
entrance of hepatic aa, portal v, hepatic bile ducts, lymphatics, nn
anterior to this is the quadrate lobe
posterior to this is the caudate lobe

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21
Q

sagittal fissues

A

on L and R of porta hepatis
R- contains gallbladder (ant) and IVC (post)
L- contains ligamentum teres hepatis (ant) ligamentum venosum (post)

22
Q

ligaments associated w/liver

A

falciform
coronary
lesser omentum

22
Q

ligaments associated w/liver

A

falciform
coronary
lesser omentum

23
Q

coronary ligaments

A

anterior and posterior layers not opposed medially, creating bare area of liver
laterally anterior and posterior layers fuse to form triangular ligaments

23
coronary ligaments
anterior and posterior layers not opposed medially, creating bare area of liver laterally anterior and posterior layers fuse to form triangular ligaments
24
hepatoduodenal ligament
contains portal triad: - proper hepatic a (ant and left) - bile duct (ant and right) - heptatic portal v (post)
24
hepatoduodenal ligament
contains portal triad: - proper hepatic a (ant and left) - bile duct (ant and right) - heptatic portal v (post)
25
subphrenic recess
extensions of greater sac btwn ant surface of liver and diaphragm bounded deeply by ant layer of coronary lig seperated into Land R by falciform lig
25
subphrenic recess
extensions of greater sac btwn ant surface of liver and diaphragm bounded deeply by ant layer of coronary lig seperated into Land R by falciform lig
26
hepatorenal recess
extension of greater sac btwn visceral surface of liver and kidney bounded deeply by post layer of coronary lig deepest part of peritoneal cavity when patient supine
26
hepatorenal recess
extension of greater sac btwn visceral surface of liver and kidney bounded deeply b
27
subphrenic abcess
accumulation of purulent exudate in subphrenic recess (usually on R) often drain to hepatorenal recess, especially if patient supine drained w/incision just inferior to 12th rib
28
anatomical lobes of liver
right- separated form L by falciform left quadrate- subdivision of R, lies btwn anterior limbs of 'H' caudate- subdivision of R, lies bwn posterior limbs of "H" caudate process extends posterior to gall bladder
29
functional lobes of liver
each receives primary primary brr of hepatic a, portal v and drained via hepatic duct right left (includes quadrate) caudate further divided into 8 hepatic segeme tns
30
abbarrant R hepatic a
typically arises from SMA
31
biliary ducts
bile canaliculi -> interlobular biliary ducts -> L and R hepatic ducts -> common hepatic duct -> exit @ porta hepatis -> merges w/cystic duct = bile duct
32
bile duct
travels w/ free edge of hepatoduodenal ligament -> merges w/main pancreatic duct = hepatopancreatic ampulla -> 2nd portion of duodenum distally has sphincter (choledochal)
33
accessory hepatic duct
normal segemental hepatic duct that joins mail billiary sytem outside liver danger of being damages during hepatic surgeries
34
liver biopsy
thru 10TH ICS at MAL
35
abbarrant R hepatic a
typically arises from SMA
36
right hepatic a
91% anterior to portal v | 64% passes post to common hepatic duct
37
lymphatic drainage of liver
superficial plexus- deep to liver capsule, to hepatic nodes, some superior drainage to phrenic nodes deep plexus- parallel portal triad -> hepatic nodes-> celiac nodes, some deep follow IVC to post mediastinal nodes
38
elevation of central pressure
can be transmitted to liver causing it to engorge w/blood, painful, maybe cause of runner stitch
39
liver biopsy
thru 10TH ICS at MAL
40
gall bladder
maximum capacity 50ml lies w/in fossa of the gallbladder on the visceral surface of liver its fundus lies apporximately at the 9th costal cartilage at MCL peritonealized
41
external gallbladder
fundus- distal, expanded portion lying deep to anterior body wall body- main portion, contacting liver and 1st portion of dudenum neck- narrow s-shaped portion leading to cystic duct
42
cystic duct
attached to neck of gallbladder merges w/common hepatic duct to form bile duct mucosa of gallbladder neck forms spiral fold which maintains patency of proximal portion of cystic duct cytohepatic triange is formed by common hepatic duct, cystic duct, and visceral surface of liver
43
lymph of gallbladder
cystic -> hepatic nodes -> celiac nodes
45
cholecystectomy
surgical removal of gallbladder cystic a must be clamped and ligated cystohepatic triangle structures must be localized
46
variations of biliary ducts
low vs high union of cystic and common hepatic ducts | accessory hepatic ducts
47
cholelithiasis
gallstones more common in women 50% asymptomatic often cause obstruction at hepatopancreatic ampulla
49
pain from gallbladder
initially referred to epigastric region often shifts to the right T8,9 dermatomes due to inflammation of parietal peritoneum MCL 9TH ICS right can also refer to C3-5 due to sensory innervation of phrenic

GI (14 decks)

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