Anatomy Of Jaundice Pt2

Question 1

Other name for jaundice?

Answer 1

Icterus

Question 2

What is jaundice?

Answer 2

Yellowing of the sclera (white of eyes/skin)

Question 3

What is jaundice caused by?

Answer 3

Increase in blood levels of bilirubin

Question 4

What is the biliary tree?

Answer 4

Number of ducts which transport bile

Question 5

What unites to form the common hepatic duct?

Answer 5

Right & left hepatic ducts

Question 6

What unites to form the bile duct?

Answer 6

Common hepatic duct

Cystic duct

Question 7

How is the bile duct formed?

Answer 7

R & L hepatic duct form the common hepatic duct

Common hepatic duct and cystic duct form the bile duct (common)

Question 8

What does the bile duct drain into?

Answer 8

2nd part of duodenum along with main pancreatic duct

Question 9

Journey of bile duct?

Answer 9

• 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

Question 10

Another name for the ampulla of vater?

Answer 10

Hepatopancreatic ampulla

Question 11

What is an anatomical sphincter of bile duct?

Answer 11

Discrete areas where muscle completely surrounds lumen of tract

Question 12

Smooth muscle sphincters in bile duct?

Answer 12

Bile duct sphincter
Pancreatic duct sphincter
Sphincter of Oddi

Question 13

What does ERCP stand for?

Answer 13

Endoscopic Retrograde cholagio-pancreatography

Question 14

What is ERCP?

Answer 14

Investigation used to study biliary tree and pancreas and treat some pathologies associated with it.(bile duct stones)

Question 15

What happens in ERCP?

Answer 15

• 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

Question 16

Possible obstruction of Biliary tree?

Answer 16

Gall stones or carcinoma at head of pancreas

Question 17

What happens when there is an obstruction of the biliary tree?

Answer 17

Flow of bile can’t go down into duodenum as it should so it is pushed back to liver

=overspill into blood (including bilirubin)

Question 18

What is the pancreas?

Answer 18

Accessory digestive organ

Question 19

What does pancreas lie between?

Answer 19

Lies between duodenum on right
Spleen on the left
Posterior to stomach

Question 20

Where does pancreas lie?

Answer 20

Retroperitoneal

Lies transversely across posterior to abdomen

Question 21

What does pancreas consist of?

Answer 21

Head
Neck
Body
Tail

Question 22

What lies superoposteriorly to the pancreas?

Answer 22

Splenic vessels

Question 23

What lies anteriorly to pancreas?

Answer 23

Stomach

Question 24

Organs which lie posteriorly to pancreas?

Answer 24

Right kidney 
Adrenal gland 
IVC 
Bile duct 
Abdominal aorta 
Superior mesenteric vessels
Left kidney, adrenal gland

Question 25

Sympathetic nerves of the pancreas?

Answer 25

Abdominopelvic splanchnic nerves

Question 26

Parasympathetic nerves of the pancreas?

Answer 26

Vagus nerves

Question 27

What do nerves of the pancreas pass through?

Answer 27

Diaphragm then follow arteries from celiac and superior mesenteric plexus to reach pancreas

Question 28

What is secretion from pancreas mostly controlled by?

Answer 28

Hormones formed in duodenum and intestinal mucosa as response to acid contents from stomach

Question 29

What does the Gastroduodenal artery turn into?

Answer 29

Superior pancreaticoduodenal

Question 30

What does the superior mesenteric artery give way to?

Answer 30

Inferior pancreaticoduodenal

Question 31

Main reason for pancreatic pain?

Answer 31

Pancreatitis

Question 32

Cause of pancreatitis?

Answer 32

``` 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 ```

Question 33

What type of gut is pancreas?

Answer 33

Foregut, midgut

Question 34

Where can pancreatic pain present?

Answer 34

Epigastric and or umbilical region can also radiate to back

Question 35

How many parts of duodenum? Their names?

Answer 35

``` 4 parts Superior Descending Horizontal (Retroperitoneal) Ascending ```

Question 36

Where does the duodenum start?

Answer 36

Pyloric sphincter

Question 37

Sympathetic innervation promotes relaxation of smooth muscle. True or false?

Answer 37

False | Sympathetic innervation promotes contraction of smooth muscles

Question 38

How does pain from a duodenal ulcer present?

Answer 38

Epigastric pain

Question 39

Where does jejunum begin?

Answer 39

Duodenaljejunal flexure (L2 vertebrae left of midline)

Question 40

Where does the ileum end?

Answer 40

Ileocaecal junction

Question 41

How is jejunum and mucosa different?

Answer 41

Mucosa jejunum=highly folded | Mucosa of distal ileum are much smoother

Question 42

Blood supply to jejunum and ileum?

Answer 42

Arterial blood= superior mesenteric artery via jejunal and ileal arteries

Question 43

Venous drainage from jejunum and ileum?

Answer 43

Jejunal and ileal vein to superior mesenteric vein to HPV

Question 44

Jejunum has less vascularity than ileum. True or false?

Answer 44

False | Jejunum more vascular

Question 45

What is fat stored in?

Answer 45

Chylomicrons

Question 46

How absorption fats works?

Answer 46

Fat is the absorbed from interstitial cells into specialized lymphatic vessels of the SI called lacteals

Question 47

How do absorbed fats travel?

Answer 47

Via lymphatic system | Eventually drains into venous system at the left venous angle

Question 48

Main groups of lymph nodes draining abdominal organs?

Answer 48

``` Celiac (foregut) Superior mesenteric (midgut) Inferior mesenteric (hindgut) Lumbar (kidneys, posterior abdominal wall, pelvis and lower limbs) ```

Question 49

Where will lymph drain to?

Answer 49

``` Thoracic duct (3/4 body) Right lymphatic duct (1/4 body) ```

Question 50

What drains at left venous angle?

Answer 50

Thoracic duct

Question 51

What drains at right venous angle?

Answer 51

Right lymphatic duct