Anatomy Of Jaundice Pt2 Flashcards
Other name for jaundice?
Icterus
What is jaundice?
Yellowing of the sclera (white of eyes/skin)
What is jaundice caused by?
Increase in blood levels of bilirubin
What is the biliary tree?
Number of ducts which transport bile
What unites to form the common hepatic duct?
Right & left hepatic ducts
What unites to form the bile duct?
Common hepatic duct
Cystic duct
How is the bile duct formed?
R & L hepatic duct form the common hepatic duct
Common hepatic duct and cystic duct form the bile duct (common)
What does the bile duct drain into?
2nd part of duodenum along with main pancreatic duct
Journey of bile duct?
- Descends posteriorly to 1st (superior part of duodenum)
- Travels into groove on posterior aspect of pancreas
- Joins main pancreatic duct to form ampulla of vater
- Both then drain into 2nd part of duodenum through major duodenal papilla
Another name for the ampulla of vater?
Hepatopancreatic ampulla
What is an anatomical sphincter of bile duct?
Discrete areas where muscle completely surrounds lumen of tract
Smooth muscle sphincters in bile duct?
Bile duct sphincter
Pancreatic duct sphincter
Sphincter of Oddi
What does ERCP stand for?
Endoscopic Retrograde cholagio-pancreatography
What is ERCP?
Investigation used to study biliary tree and pancreas and treat some pathologies associated with it.(bile duct stones)
What happens in ERCP?
- Endoscope is inserted through the oral cavity, oesphagus, stomach and duodenum
- Cannula is then placed in the major duodenal papilla and radio-opaque dye is injected back into biliary tree, radiographic images are taken of dye filled tree
Possible obstruction of Biliary tree?
Gall stones or carcinoma at head of pancreas
What happens when there is an obstruction of the biliary tree?
Flow of bile can’t go down into duodenum as it should so it is pushed back to liver
=overspill into blood (including bilirubin)
What is the pancreas?
Accessory digestive organ
What does pancreas lie between?
Lies between duodenum on right
Spleen on the left
Posterior to stomach
Where does pancreas lie?
Retroperitoneal
Lies transversely across posterior to abdomen
What does pancreas consist of?
Head
Neck
Body
Tail
What lies superoposteriorly to the pancreas?
Splenic vessels
What lies anteriorly to pancreas?
Stomach
Organs which lie posteriorly to pancreas?
Right kidney Adrenal gland IVC Bile duct Abdominal aorta Superior mesenteric vessels Left kidney, adrenal gland
Sympathetic nerves of the pancreas?
Abdominopelvic splanchnic nerves
Parasympathetic nerves of the pancreas?
Vagus nerves
What do nerves of the pancreas pass through?
Diaphragm then follow arteries from celiac and superior mesenteric plexus to reach pancreas
What is secretion from pancreas mostly controlled by?
Hormones formed in duodenum and intestinal mucosa as response to acid contents from stomach
What does the Gastroduodenal artery turn into?
Superior pancreaticoduodenal
What does the superior mesenteric artery give way to?
Inferior pancreaticoduodenal
Main reason for pancreatic pain?
Pancreatitis
Cause of pancreatitis?
Blockage of ampulla by gall stone I GET SMASHED Idiopathic Gall stones Ethanol Trauma Steroids Mumps and other infectys Autoimmune Scorpion stings Hyperlipidaemia,hypothermia ERCP Drugs
What type of gut is pancreas?
Foregut, midgut
Where can pancreatic pain present?
Epigastric and or umbilical region can also radiate to back
How many parts of duodenum? Their names?
4 parts Superior Descending Horizontal (Retroperitoneal) Ascending
Where does the duodenum start?
Pyloric sphincter
Sympathetic innervation promotes relaxation of smooth muscle. True or false?
False
Sympathetic innervation promotes contraction of smooth muscles
How does pain from a duodenal ulcer present?
Epigastric pain
Where does jejunum begin?
Duodenaljejunal flexure (L2 vertebrae left of midline)
Where does the ileum end?
Ileocaecal junction
How is jejunum and mucosa different?
Mucosa jejunum=highly folded
Mucosa of distal ileum are much smoother
Blood supply to jejunum and ileum?
Arterial blood= superior mesenteric artery via jejunal and ileal arteries
Venous drainage from jejunum and ileum?
Jejunal and ileal vein to superior mesenteric vein to HPV
Jejunum has less vascularity than ileum. True or false?
False
Jejunum more vascular
What is fat stored in?
Chylomicrons
How absorption fats works?
Fat is the absorbed from interstitial cells into specialized lymphatic vessels of the SI called lacteals
How do absorbed fats travel?
Via lymphatic system
Eventually drains into venous system at the left venous angle
Main groups of lymph nodes draining abdominal organs?
Celiac (foregut) Superior mesenteric (midgut) Inferior mesenteric (hindgut) Lumbar (kidneys, posterior abdominal wall, pelvis and lower limbs)
Where will lymph drain to?
Thoracic duct (3/4 body) Right lymphatic duct (1/4 body)
What drains at left venous angle?
Thoracic duct
What drains at right venous angle?
Right lymphatic duct
