Anatomy Of Pancreas And Extrabilliary System Flashcards
Gall bladder Extends from—— free margin of the liver, which is notched by it, to——-
anterior
right extremity of the porta.
Gall bladder is anterior to
1-superior part of the duodenum,
2-hepatic flexure and
3-proximaltransverse colon
Gall bladder is —— organ
intraperitoneal (covered by peritoneum continued from the liver surface)
Galbladder firmly attached to visceral (inferior) surface of liver by ———— between right and
quadrate liver lobes in gallbladder fossa or bed
CT
Fossa for gallbladder is a ——————- placed on the undersurface of
———(segments —- and——], parallel with——-
Shallow, oblong fossa
right lobe (IV, V)
left sagittal fossa.
Gall bladder function ?
functionally connected through ?
Stores and concentrates bile
extrahepatic duct system.,
Gallbladder removal due to obstruction or chronic inflammation leads to
direct flow of bile from liver to gut, with few major consequences on digestion. Body
Mobile gallbladder -
vascular torsion
Rarely, the gallbladder is almost completely buried within the liver (intrahepatic
gallbladder or suspended from the liver by a peritoneal mesentery ),
or connected to the duodenum by an extension of the free edge of the lesser omentum
.
Gall bladder subdivided into 3 anatomical parts:
1-Fundus (bulbous fundus)
2-Body
3-Neck Infundibulum
The fundus projects to variable extent from ———onto ————- at the intersection of right 9th costal cartilage and lateral
margin of the rectus abdominis muscle (midclavicular line):
inferior border of liver
anterior abdominal wall
Fundus project from inferior border of liver onto anterior
abdominal wall at the intersection of
right 9th costal cartilage and lateral
margin of the rectus abdominis muscle (midclavicular line)
This is where
enlargement of the gallbladder is best sought on clinical examination.
intersection of right 9th costal cartilage and lateral
margin of the rectus abdominis muscle (midclavicular line)
Fundus is commonly lies adjacent to ?
transverse colon
Fundus my be
Elongated and highly mobile
Body of gallbladder lies in
gallbladder fossa
Body of gallbladder normally lies in contact with
visceral surface of the liver
Body: when this widening is clearly demarcated as a result of gallstone disease, it is
referred to as
Hartmann’s pouch’
Body:
Lies ant to
2nd part of duodenum and right end of transverse colon.
Neck Infundibulum:
S-shaped spiral mucosal folds (of Heister)
Neck Infundibulum:
lies at medial end, close to porta hepatis, and almost always has a short peritoneal attachment (mesentery) to liver, which usually contains cystic a
?
Neck Infundibulum:
Lies anterior to
2nd part of the duodenum
Bile produced by ?
Flows through ?
Hepatocytye
Bile canaliculi , bile ductules, bile duct
Bile canaliculi , bile ductules, bile duct These structures gradually merge, forming a
converging network that ultimately forms
The common hepatic duct
The common hepatic duct joins the cystic duct from the gallbladder and cont to the duodenum as
The common bile duct
Left hepatic duct is formed by the union of ————-,
most often behind or to the left of the umbilical portion of the left portal vein
segment II and III ducts,
Biliary drainage of segment IV is more variable but is usually by a single
duct into the
left hepatic duct.
Right hepatic duct is formed by the union of——— wich drains segment ———- and ——— which ddrains segments sectoral
ducts.
right anterior (medial) , V and VIII
posterior (lateral) VI and VII
Right posterior (lateral) sectoral duct usually curves around the—————- before fusing with its medial aspect
posterior aspect of right anterior (medial) duct
Hjortsjö’s crook
?
Bile ducts draining caudate lobe (segment —- ) usually join the ——————- near the hilar confluence.
Segment 1
origin of left hepatic
left ductal system.
duct or may drain into both hepatic ducts
Right hepatic duct and its branches are ——————— than the left ductal system
more often subject to variation
Luschka’s duct
A small bile duct from segment V of the liver may
traverse gallbladder fossa and join right hepatic
duct or its anterior sectoral branch or the common
hepatic duct.
Luschka’s duct
its importance lies
in the fact that it may be injured
during cholecystectomy, causing a postoperative bile leak.
An oblique groove on the inferior surface of the liver
posterior to gallbladder bed is present in 70–80% of
livers. • It is variably known as the
fissure of Gans, Rouviere’s
sulcus or the incisura hepatis dextra
It overlies the division of the right posterior (lateral)
portal pedicle, where it gives off the inferior segment
VI branch. • It has been increasingly recognized as a useful
anatomical landmark during hepatic resection and in
laparoscopic cholecystectomy
• (since cystic duct and artery lie anterosuperior to
the sulcus while CBD lies posteroinferior)
?
Sectoral ducts secrete bile via
Right and left hepatic ducts
Right and left hepatic ducts fuse into ————— in the ———
Common hepatic duct
Lateral part of the oorta hepatis
Neck of gallbladder funnels off into short
Cystic duct
Cystic duct combines with common helatic duct to form
Commin buke duct ( CBD )
Common bile duct united with pancreatic duct to form
Ampulla of vater
hepatopancreatic ampulla
Ampulla of vater
(hepatopancreatic ampulla) opens into
duodenum on the major duodenal
papilla.
The flow of bile and pancretic juice is controlled by
Sphincter of Oddi
Right and left hepatic ducts to emerge
from liver and unite near ———— to form the common
hepatic duct.
right end of
porta hepatis
Extrahepatic right + left duct
Right ; is short and nearly vertical
Left ; longer, more horizontal
Extrahepatic left duct lies along
Inf border of segment 4
Accessibility of extrahepatic segment of
left hepatic duct is exploited when
performing a
surgical biliary bypass in
patients with benign hilar bile duct
strictures.
