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GI > accessory organs of digestion > Flashcards

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
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

24
Q

hepatoduodenal ligament

A

contains portal triad:

  • proper hepatic a (ant and left)
  • bile duct (ant and right)
  • heptatic portal v (post)
24
Q

hepatoduodenal ligament

A

contains portal triad:

  • proper hepatic a (ant and left)
  • bile duct (ant and right)
  • heptatic portal v (post)
25
Q

subphrenic recess

A

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
Q

subphrenic recess

A

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
Q

hepatorenal recess

A

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
Q

hepatorenal recess

A

extension of greater sac btwn visceral surface of liver and kidney
bounded deeply b

27
Q

subphrenic abcess

A

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
Q

anatomical lobes of liver

A

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
Q

functional lobes of liver

A

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
Q

abbarrant R hepatic a

A

typically arises from SMA

31
Q

biliary ducts

A

bile canaliculi -> interlobular biliary ducts -> L and R hepatic ducts -> common hepatic duct -> exit @ porta hepatis -> merges w/cystic duct = bile duct

32
Q

bile duct

A

travels w/ free edge of hepatoduodenal ligament -> merges w/main pancreatic duct = hepatopancreatic ampulla -> 2nd portion of duodenum
distally has sphincter (choledochal)

33
Q

accessory hepatic duct

A

normal segemental hepatic duct that joins mail billiary sytem outside liver
danger of being damages during hepatic surgeries

34
Q

liver biopsy

A

thru 10TH ICS at MAL

35
Q

abbarrant R hepatic a

A

typically arises from SMA

36
Q

right hepatic a

A

91% anterior to portal v

64% passes post to common hepatic duct

37
Q

lymphatic drainage of liver

A

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
Q

elevation of central pressure

A

can be transmitted to liver causing it to engorge w/blood, painful, maybe cause of runner stitch

39
Q

liver biopsy

A

thru 10TH ICS at MAL

40
Q

gall bladder

A

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
Q

external gallbladder

A

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
Q

cystic duct

A

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
Q

lymph of gallbladder

A

cystic -> hepatic nodes -> celiac nodes

45
Q

cholecystectomy

A

surgical removal of gallbladder
cystic a must be clamped and ligated
cystohepatic triangle structures must be localized

46
Q

variations of biliary ducts

A

low vs high union of cystic and common hepatic ducts

accessory hepatic ducts

47
Q

cholelithiasis

A

gallstones
more common in women
50% asymptomatic
often cause obstruction at hepatopancreatic ampulla

49
Q

pain from gallbladder

A

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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