Anatomy of Jaundice

Question 1

what is bilirubin

Answer 1

normal by-product of the breakdown of red blood cells

used to form bile

Question 2

where does breakdown of red blood cells occur

Answer 2

spleen

also occurs in the liver

Question 3

where is bile formed

Answer 3

liver (converts bilirubin to bile)

Question 4

what is the biliary tree

Answer 4

set of tubes transporting bile from liver to 2nd part of duodenum

Question 5

function of gallbladder

Answer 5

stores and concentrates bile

Question 6

function of bile

Answer 6

important for normal absorption of fats from small intestine

Question 7

what is jaundice

Answer 7

over production of bilirubin

Question 8

contents of portal triad

Answer 8

hepatic artery
hepatic portal vein
common bile duct

(blood supply to, and drainage to, the liver)

Question 9

what is the celiac trunk

Answer 9

first of the 3 midline branches of the abdominal aorta

retroperitoneal

Question 10

where does the celiac trunk arise

Answer 10

T12

Question 11

what does the celiac trunk supply

Answer 11

organs of foregut

Question 12

trifurcation of celiac trunk

Answer 12

splenic artery
hepatic artery
left gastric artery

Question 13

branches of trifurcations of celiac trunk

Answer 13

gastroduodenal

superior pancreatico-duodenal

Question 14

course of splenic artery

Answer 14

tortuous course;

superior border of pancreas

Question 15

describe the spleen and its location

Answer 15

intraperitoneal organ within left hypochondrium

Question 16

anatomical relations of the spleen

Answer 16

diaphragm posterior
stomach anterior
splenic flexure inferiorly
left kidney medially

Question 17

how is the spleen protected

Answer 17

by ribs 9-11

Question 18

arterial supply of the stomach

Answer 18

right and left gastric arteries

right and left gastro-ometal arteries

Question 19

course of right and left gastric arteries

Answer 19

run along the lesser curvature

anastomose together

Question 20

course of right and left gastro-ometal arteries

Answer 20

run along the greater curvature

anastomose together

Question 21

blood supply to the liver

Answer 21

hepatic artery - branches into right and left hepatic arteries
hepatic portal vein

Question 22

location of liver

Answer 22

mainly in upper right quadrant

Question 23

anatomical relations of liver

Answer 23

diaphragm superior, anterior and posterior
anterior aspect of stomach medial
gallbladder posterior and inferior
hepatic flexure inferior
right kidney, right adrenal, IVC and abdormnal aorta posterior

Question 24

how is liver protected

Answer 24

ribs 7-11

Question 25

anatomical segments of the liver

Answer 25

``` 4 in total; right lobe left lobe caudate lobe quadrate lobe ```

Question 26

functional segments of the liver

Answer 26

8 | I - VIII

Question 27

blood supply of functional segments of the liver

Answer 27

each functional segment has its own blood supply; hepatic artery hepatic portal vein venous drainage bile drainage

Question 28

venous drainage from the liver

Answer 28

via 3 main hepatic veins into the IVC

Question 29

describe the IVC and hepatic veins

Answer 29

lack valves

Question 30

hepatomegaly

Answer 30

a rise in central venous pressure is directly transmitted to the liver it enlarges as it engorges with blood

Question 31

areas of the peritoneal cavity related to the liver

Answer 31

``` hepatorenal recess (Morison's pouch) sub-phrenic recess ``` both within greater sac

Question 32

what is peritonitis

Answer 32

can result in a collection of pus in the recesses leading to an abscess formation

Question 33

describe the hepatorenal recess

Answer 33

one of the lowest parts of the peritoneal cavity when the patient is supine

Question 34

venous drainage of the liver - hepatic portal vein

Answer 34

drains blood from foregut, midgut and hindgut to the liver for first pass metabolism

Question 35

venous drainage of the liver - splenic vein

Answer 35

drains blood from foregut to hepatic portal vein

Question 36

venous drainage of the liver - inferior mesenteric vein

Answer 36

drains blood from hindgut to splenic vein

Question 37

venous drainage of the liver - superior mesenteric vein

Answer 37

drains the blood from the midgut to the hepatic portal vein

Question 38

venous drainage of the liver - inferior vena cava

Answer 38

retroperitoneal | drains the cleaned blood from the hepatic veins into the right atrium

Question 39

coronary ligament

Answer 39

attaches liver to diaphragm

Question 40

falciform ligament

Answer 40

attaches liver to anterior abdominal wall

Question 41

ligament teres/round ligament

Answer 41

remnant of the embryological umbilical vein

Question 42

location of gallbladder

Answer 42

lies on the posterior aspect of the liver | anterior to duodenum

Question 43

neck of gallbladder

Answer 43

neck narrows to become cystic duct | potential site for gallstone impaction

Question 44

function of cystic duct

Answer 44

bile flows in and out the gallbladder via the cystic duct

Question 45

blood supply of gallbladder

Answer 45

cystic artery - branch of right hepatic artery (75% of people)

Question 46

what type of organ is the gallbladder

Answer 46

foregut

Question 47

where does pain of the gallbladder present

Answer 47

epigastric region also the hypochondrium with or without pain referral to right shoulder - result of anterior diaphragmatic irritation

Question 48

where do visceral afferents of gallbladder enter spinal cord

Answer 48

T6-T9