Anatomy of Jaundice Pt 1

Question 1

How is bilirubin made?

Answer 1

By-product of RBC break down

This usually occurs in the spleen

Question 2

What does bilirubin do??

Answer 2

Used to form bile in liver which travels through biliary tree

Question 3

What is the biliary tree?

Answer 3

Set of tubes connecting liver to 2nd part of duodenum

Question 4

Why is bile important?

Answer 4

Important for normal absorption of fats from small intestine

Question 5

What does a pancreas do that is necessary for digestion?

Answer 5

Excrete digestive enzymes into 2nd part of duodenum

Question 6

What is portal triad and where is it?

Answer 6

• Consists of 3 tubes- hepatic artery, hepatic portal vein and common bile duct
• Part of the biliary tree linking liver to duodenum
• Free edge of lesser omentum

Question 7

What does portal triad do?

Answer 7

Blood supply and drainage TO the liver

Question 8

3 tubes in portal triad?

Answer 8

Hepatic Artery
Hepatic Portal Vein
Common Bile duct

Question 9

What is the celiac trunk?

Answer 9

1st of 3 midline branches of abdominal aorta

Question 10

Where does celiac trunk arise from?

Answer 10

Retroperitoneal and arises from around T12 vertebral level

Question 11

What does the celiac trunk supply?

Answer 11

Organs of the foregut

Question 12

What happens to celiac trunk?

Answer 12

Trifurcates into 3 branches
1) Splenic artery
2) Hepatic artery
3)Left gastric artery
Each of these give rise to further branches such as
Gastroduodenal and superior pancreatico-duodenal

Question 13

Where is the splenic artery route?

Answer 13

Above pancreas

Question 14

Where is the spleen?

Answer 14

Intraperitoneal

Within left hypochondrium

Question 15

What is the spleen anatomically related to?

Answer 15

Posterior to dipahragm
Anterior to stomach
Inferior to splenic flexure
Medial to Left Kidney

Question 16

What does spleen do?

Answer 16

Breaks down RBCs to produce bilirubin

Question 17

What protects the spleen?

Answer 17

Ribs 9-11

Question 18

When the spleen is palpable it is..

Answer 18

3 times the size it’s meant to be

Question 19

Why does spleen move in respiration?

Answer 19

It and the liver are anatomically related to spleen

Question 20

2 main supplies of blood to the stomach?

Answer 20

R/L gastric arteries

R/L gastro-omental arteries

Question 21

Where do gastric arteries run?

Answer 21

Along lesser curvature

Anastamose together

Question 22

Where do R/L gastro-omental arteries run?

Answer 22

Along greater curvature

Anastamose together

Question 23

Blood supply to liver?

Answer 23

Heaptic artery (20-25%) (poor nutrient, well oxygenated)
Rest comes from HPV (75%)= rich nutrients/poor O2

Question 24

Where does liver lie?

Answer 24

Mainly upper right quadrant `

Question 25

What is the liver anatomically related to?

Answer 25

- Superior, anterior and posterior to diaphragm - Anterior aspect of stomach medially - Posterior & Inferior to Gall bladder - Inferior to hepatic fixture

Question 26

What does the liver do?

Answer 26

Converts bilirubin to bile

Question 27

What is the liver protected by?

Answer 27

Rib 7-11

Question 28

4 anatomical segments of liver?

Answer 28

``` Right lobe (seen anteriorly) Left lobe Caudate lobe Quadrate lobe (all 4 seen posteriorly, caudate lobe above quadrate) ```

Question 29

IVC and hepatic veins have valves. True or false?

Answer 29

False

Question 30

Venous drainage from liver?

Answer 30

Via 3 main hepatic veins into IVC

Question 31

What is special about caudate venous drains?

Answer 31

Has own hepatic veins which drains straight to IVC

Question 32

How many functional segments in liver?

Answer 32

8 functional segments

Question 33

Functional segment of liver blood supply?

Answer 33

HA and HPV | Each have their own venous drainage and bile drainage

Question 34

What lies in centre of lobule?

Answer 34

Central vein

Question 35

2 clinically important areas of the peritoneal cavity related to liver?

Answer 35

``` Hepatorenal recess (Morrison's pouch) Sub-phrenic recess ```

Question 36

What is peritonitis?

Answer 36

Collection of pus in recesses leading to abscess formation

Question 37

What does the HPV drain?

Answer 37

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

Question 38

Where does the splenic vein drain to?

Answer 38

Drains blood from foregut to HPV

Question 39

Where does inferior mesenteric vein drain to?

Answer 39

Drains blood from hindgut to splenic vein

Question 40

Where does superior mesenteric vein drain to?

Answer 40

Drains blood from midgut to HPV

Question 41

What veins are in the portal venous system?

Answer 41

HPV Splenic vein IMV SMV

Question 42

Where does the IVC drain to?

Answer 42

Drains cleaned blood from hepatic veins into the RA

Question 43

What is in the systemic venous system?

Answer 43

IVC

Question 44

Where does GB lie?

Answer 44

Posterior aspect of liver, anterior to duodenum

Question 45

What is role of Gall Bladder?

Answer 45

Stores and concentrates bile in between meals

Question 46

Structure of GB?

Answer 46

Head body and neck which narrows to become cystic duct

Question 47

What does the cystic duct potentially house?

Answer 47

Potential site of Gall stone

Question 48

Where will early pain present if GB is involved?

Answer 48

Epigastric region or in hypochondrium Sometimes with pain in right shoulder Because visceral afferents enter spinal cord between T6-T9

Question 49

What is a cholecystectomy?

Answer 49

Removal of GB, cystic duct and artery