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13. Gastrointestinal > Anatomy 3. Liver, Biliary Tree, and Pancreas > Flashcards

Anatomy 3. Liver, Biliary Tree, and Pancreas Flashcards

1
Q

What is the largest organ in the body?

A

The liver.

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2
Q

How are nutrients absorbed from the digestive tract conveyed to the liver?

A

By the portal venous system.

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3
Q

Where does the liver lie?

A

Mainly in the right upper quadrant of the abdomen. It lies deep to ribs 7-11 on the right side and crosses the midline towards the left nipple.

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4
Q

Where does the liver move when standing?

A

Inferiorly due to gravity.

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5
Q

What is the curve of the diaphragmatic surface of the liver?

A

Convex.

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6
Q

What is the curve of the visceral surface of the liver?

A

Relatively flat or even concave.

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7
Q

How are the diaphragmatic and visceral surfaces of the liver separated?

A

By a sharp inferior border that follows the right costal margin inferior to the diaphragm.

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8
Q

What are the subphrenic recesses?

A

Superior extensions of the peritoneal cavity.

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9
Q

Where are the subphrenic recesses?

A

Between the diaphragm and the anterior and superior aspects of the diaphragmatic surface of the liver.

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10
Q

How are the subphrenic recesses separated into right and left?

A

By the falciform ligament.

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11
Q

Where does the falciform ligament extend from and to?

A

From the liver to the anterior abdominal wall.

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12
Q

What is the subhepatic space?

A

The portion of supracolic compartment of the peritoneal cavity immediately inferior to the liver.

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13
Q

What is contained within the falciform ligament?

A

The round ligament/ ligatmentum teres.

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14
Q

What is teh round ligament/ ligatmentum teres?

A

The embryonic remnant of the umbilical vein.

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15
Q

What covers the surface of the liver?

A

Visceral peritoneum.

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16
Q

What is the bare area of the liver?

A

Posterior diaphragmatic surface of the liver that has no visceral peritoneum lining it. It lies in direct contact with the diaphragm.

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17
Q

What travels through the deep groove in the bare area of the liver?

A

Inferior vena cava.

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18
Q

What marks out the bare area of the liver?

A

The reflection of the peritoneum from the diaphragm to the bare area as the anterior and posterior layers of the coronary ligament.

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19
Q

What do the anterior and posterior layers of the coronary ligament meet to form?

A

The triangular ligaments, on the left and right.

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20
Q

How does the right triangular ligament enclose the bare area?

A

It diverges left to enclose the triangular area.

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21
Q

Where is the left triangular ligament?

A

Near the apex of the wedge-shaped liver.

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22
Q

What is the visceral surface of the liver covered with?

A

Peritoneum.

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23
Q

Where on the liver, does peritoneum not cover the visceral surface?

A

At the fossa for the gallbladder and the porta hepatis.

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24
Q

What is the porta hepatis?

A

A transverse fissure where vessels that supply and drain the liver enter and leave it.

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25
Q

Which vessels enter and leave the porta hepatis?

A

The hepatic portal vein, hepatic artery, and lymphatics.

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26
Q

What causes the visceral surface of the liver to have fissures and impressions?

A

Contact with other organs.

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27
Q

What are the lobes of the liver?

A

Two anatomical lobes, two accessory lobes.

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28
Q

What divides the right and left anatomical lobes of the liver?

A

The falciform ligament.

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29
Q

What is the right anatomical lobe split into?

A

The quadrate and caudate lobes.

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30
Q

How is the right anatomical lobe split into the quadrate lobe and caudate lobe?

A

On the visceral surface, the right and left sagittal fissure splits it with the porta hepatis.

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31
Q

What is the position of the caudate lobe of the liver?

A

Posteriorly and superiorly.

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32
Q

What is the position of the quadrate lobe of the liver?

A

Anteriorly and inferiorly.

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33
Q

How long is the gallbladder?

A

7-10cm long.

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34
Q

Where does the gallbladder lie?

A

In the fossa for the gallbladder on the visceral surface of the liver.

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35
Q

Where is the gallbladder fossa on the liver?

A

At the junction of the right and left lobes of the liver.

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36
Q

Which anatomical lobe of the liver is bigger?

A

The right.

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37
Q

How much bile can the gallbladder hold?

A

Up to 50ml.

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38
Q

What does the peritoneum do on the gallbladder?

A

Completely surround its fundus and binds its body and neck to the liver.

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39
Q

How is the hepatic surface of the gallbladder attached to the liver?

A

By connective tissue of the fibrous capsule of the liver.

40
Q

What are the three parts of the gallbladder?

A

The fundus, body, and neck.

41
Q

What does the neck of the gallbladder join?

A

The cystic duct.

42
Q

What is the purpose of the biliary duct?

A

Convey bile from the liver to the duodenum.

43
Q

Where is bile produced by hepatocytes secreted into?

A

Canaliculi.

44
Q

Where do canaliculi drain bile into?

A

Into the small interlobular biliary ducts and then into the large collecting bile ducts which merge to form the right and left hepatic ducts.

45
Q

Where do the hepatic ducts unite?

A

Shortly after leaving the porta hepatis.

46
Q

What do the hepatic ducts unite to form?

A

The common hepatic duct.

47
Q

What forms the bile duct?

A

The common hepatic duct joined on the right side by the cystic duct.

48
Q

How does the bile duct convey bile to the duodenum?

A

Through the Ampulla of Vater.

49
Q

Which duct join the bile duct before the Ampulla of Vater?

A

The pancreatic duct.

50
Q

What are the symptoms of gallstones in the gall bladder?

A

Asymptomatic.

51
Q

What are the symptoms of gallstones in the cystic duct?

A

Actue cholecystitis.

52
Q

What are the symptoms of gallstones in the common bile duct?

A

Biliary obstruction.

53
Q

What are the symptoms of gallstones in the terminal duct?

A

Pancreatitis.

54
Q

What is the arterial supply of the gallbladder and cystic duct?

A

The cystic artery.

55
Q

Where does the cystic artery commonly arise?

A

In the triangle between the common hepatic duct, cystic duct, and visceral surface of the liver - the cystohepatic triangle of Calot.

56
Q

What are the roots of the cystic artery?

A

Coeliac trunk -> common hepatic -> right hepatic -> cystic.

57
Q

What is the venous drainage from the neck of the gallbladder and the cystic duct?

A

The cystic veins.

58
Q

Where do the cystic veins drain?

A

Enter liver directly of drain through hepatic portal vein.

59
Q

Where does the venous drainage from the fundus and body of the gallbladder go?

A

Passes directly into the visceral surface of the liver and drain into the hepatic sinusoids.

60
Q

Where does the pancreas lie?

A

Retroperitoneally, overlying and transversely crossing the bodies of the L1 and L2 vertebrae on the posterior abdominal wall. It lies posterior to the stomach, between the duodenum on the right and the spleen on the left.

61
Q

Which plane level does the pancreas lie on?

A

The transpyloric plane.

62
Q

What attaches to the anterior margin of the pancreas?

A

Transverse mesocolon.

63
Q

What are the four parts of the pancreas?

A

Head, neck, body, and tail.

64
Q

What is the head of the pancreas?

A

The expanded part of the gland that fits the C-shaped curve of the duodenum.

65
Q

Where is the head of the pancreas?

A

To the right of the superior mesenteric vessels and just inferior to the transpyloric plane.

66
Q

What forms a groove in the posterior surface of the neck of the pancreas?

A

The superior mesenteric vessels that the pancreas overlies.

67
Q

What is the anterior surface of the neck of the pancreas covered by?

A

Peritoneum.

68
Q

Where is the neck of the pancreas?

A

Adjacent to the pylorus of the stomach.

69
Q

Where is the hepatic portal vein formed?

A

Posterior to the neck of the pancreas, where the superior mesenteric vein joins the splenic vein.

70
Q

Where is the body of the pancreas?

A

To the left of the superior mesenteric vessels, passing over the aorta and L2 vertebra, continuing just above the transpyloric plane, posterior to the omental bursa.

71
Q

How does the anterior surface of the body of the pancreas differ from the posterior surface?

A

The anterior surface is covered with peritoneum and forms part of the stomach bed, but the posterior surface has no peritoneal covering.

72
Q

What is the posterior surface of the body of the pancreas in contact with?

A

The aorta, superior mesenteric artery, left suprarenal glad, left kidney, and renal vessels.

73
Q

Where is the tail of the pancreas?

A

It lies anterior to the left kidney.

74
Q

Where does the main pancreatic duct begin?

A

At the tail of the pancreas and runs through the gland to the head.

75
Q

What forms the hepatopancreatic Ampulla of Vater?

A

The bile duct and the main panreatic duct joining.

76
Q

What is the main arterial supply of the pancreas derived from?

A

Branches of the splenic artery.

77
Q

What is the derivation of the pancreatic artery?

A

Coeliac trunk -> splenic artery -> pancreatic artery.

78
Q

What supplies the head of the pancreas?

A

The pancreaticoduodenal arteries.

79
Q

What are the derivations of the pancreaticoduodenal arteries?

A

Coeliac trunk -> common hepatic -> gastroduodenal -> anterior/ posterior superior pancreaticoduodenal.
Superior mesenteric artery -> inferior pancreaticogueodenal -> anterior/ posterior pancreaticoduodenal.

80
Q

What is the venous drainage of the pancreas?

A

The corresponding pancreatic veins. The head of the pancreas has corresponding superior and inferior pancreaticoduodenal veins.

81
Q

Where do the pancreaticoduodenal veins empty into?

A

Mostly the splenci vein, but some into the superior mesenteric vein.

82
Q

Where is the spleen located?

A

In the upper left quadrant/ hypochnodrium of the abdomen. It rests on the left colic flexure.

83
Q

What is the covering of the spleen?

A

Visceral peritoneum, completely covered except at the splenic hilum.

84
Q

What enters and leaves at the splenic hilum?

A

Splenic branches of the splenic artery and vein.

85
Q

What is the anterior relation of the spleen?

A

The stomach, attached by the gastrosplenic ligaments.

86
Q

What is the posterior relation of the spleen?

A

The left part of the diaphragm, separates it from the pleura, lung, and ribs 9-11.

87
Q

What is the inferior relation of the spleen?

A

The left colic flexure.

88
Q

What is the medial relation of the spleen?

A

The left kidney, attached by the splenorenal ligament.

89
Q

What does the gastrosplenic ligament attach?

A

The spleen to the stomach anteriorly.

90
Q

What does the splenorenal ligament attach?

A

The spleen to the left kidney medially.

91
Q

What is the arterial supply of the spleen?

A

The splenic artery.

92
Q

What is the course of the splenic artery to the spleen?

A

Tortuous course posterior to omental bursa, anterior to the left kidney and along the superior border of the pancreas.

93
Q

What is the root of the splenic artery?

A

The coeliac trunk, it is the largest branch from it.

94
Q

What is the venous drainage of the spleen?

A

The splenic vein.

95
Q

What does the splenic vein join for most of its course?

A

The inferior mesenteric vein, runs posterior to the body and tail of the pancreas.

96
Q

What does the splenic vein unite with to form the hepatic portal vein?

A

The superior mesenteric vein posterior to the neck of the pancreas.

13. Gastrointestinal (17 decks)

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