Anatomy of jaundice Flashcards
Which ribs protect the spleen?
Ribs 9-11
What is the blood supply to the stomach?
The right and left gastric arteries running along the lesser curvature
The right and left gastro-omental arteries which run along the greater curvature
Where does the left gastro-omental artery arise from?
The splenic artery
Where does the right gastric artery arise from?
The hepatic artery
What connects the right and left gastro-omental arteries?
An anastamoses
What does the hepatic artery bifurcate into?
The right and left hepatic arteries
Why does a rise in central venous pressure cause hepatomegaly?
Because the IVC and the hepatic veins lack valves
What are the four lobes of the liver?
Right lobe
Left lobe
Caudate lobe
Quadrate lobe
What is the name of the space between the liver and the right kidney?
The hepatorenal recess
What is the name of the recess between the liver and the diaphragm
The subphrenic recess
What ligaments attach the liver to the diaphragm?
The coronary ligaments
What ligament attaches the liver to the abdominal wall?
The falciform ligament
What ligament is the remnant of the embryological umbilical vein?
The round ligament/ligamentum teres
What is the cystic artery a branch of in 75% of people?
The right hepatic artery
Where does the gallbladder lie in relation to the liver?
On the posterior aspect
Where do visceral afferents from the gallbladder enter the spinal cord?
Between T6 and T9
Where can early pain from the gallbladder present?
In the epigastric region
It can also present in the right hyperchondrial region with or without referral to the right shoulder as a result of anterior diagphragmatic irritation
What is the first branch to come off the hepatic artery? (inferiorly)
The gastroduodenal artery
Which branch of the gastro-duodenal artery descends over the anterior aspect of the head of the pancreas?
The superior pancreatico-duodenal
What forms the bile duct/common bile duct?
The union of the cystic duct with the common hepatic duct
What forms the common hepatic duct?
The union of the right and left hepatic ducts
What is ERCP?
endoscopic retrograde cholangiopancreatography
What is ERCP used for?
How does it work?
investigation used to study the biliary tree and pancreas (and treat certain pathologies associated)
• endoscope inserted through oral cavity, oesophagus, stomach and into duodenum
• cannula placed into major duodenal papilla and radio-opaque dye injected back into biliary tree
• radiographic images taken of the dye-filled biliary tree
How does the bile duct get to the duodenum?
The bile duct descends posterior to the 1st (superior) part of the duodenum and into a groove in the posterior aspect of the pancreas.
It then joins with the main pancreatic duct and both drain into the 2nd part of the duodenum through the major duodenal papilla
What is formed by the union of the bile duct and the main pancreatic duct?
The ampulla of vater/
the hepatopancreatic ampulla
Name 3 sphincters in the biliary tree
Sphincter of oddi
Bile duct sphincter
Pancreatic duct sphincter
What are the different parts of the pancreas?
The head with an uncinate process
The neck
The body
The tail
Which cavity is the pancreas found in?
The retroperitoneum
Is the pancreas a foregut, midgut or hindgut organ?
It is a foregut and a midgut organ
Where can pain from the pancreas present?
In the epigastric and/or the umbilical region
Which parts of the duodenum are foregut organs?
The first and second parts
How many parts does the duodenum have?
What are they?
It has four parts.
- Superior (part intraperitoneal)
- Descending (retroperitoneal)
- Horizontal (retroperitoneal)
- Ascending (retroperitoneal)
What is the inital section of the first part of the duodenum called?
The duodenal cap
It is intraperitoneal and relatively mobile
Which arteries supply the duodenum?
The gastro-duodenal artery
The superior mesenteric artery
What are the main groups of lymph node draining the abdominal organs?
Coeliac - draining the foregut organs
Superior mesenteric- draining the midgut organs
Inferior mesenteric- draining the hindgut organs
Lumbar- draining kidneys, posterior abdominal wall, pelvis and lower limbs
Where does the right lymphatic duct drain into?
The right venous angle:
The angle between the right subclavian and right internal jugular veins
Where does the thoracic duct drain into?
The left venous angle:
The angle between the left subclavian and left internal jugular veins
