Anatomy of the accessory organs

Question 1

Name the four lobes of the liver

Answer 1

Left lobe
Right lobe
Caudate lobe
Quadrate lobe

Question 2

Name the ligaments of the liver

Answer 2

Falciform ligament
Ligamentum teres (a.k.a round ligament)
Left and right triangular ligaments
Coronary ligament

Question 3

What embryological structure is the round ligament a remnant of?

Answer 3

The round ligament (ligamentum teres) is a remnant of the left umbilical vein

Question 4

The bare area of the liver is in direct contact with which structure?

Answer 4

The diaphragm

Question 5

Which ribs are the liver associated with?

Answer 5

7-11 on the right side

Question 6

Which three structures make up the portal triad?

Answer 6

Hepatic artery
Portal vein
Bile duct

Question 7

Describe the innervation of the liver parenchyma

Answer 7

Innervated by the hepatic plexus

• sympathetic fibres from the coelia plexus
• parasympathetic fibres from the vagus nerve

Question 8

What is Glisson’s capsule and what is it innervated by? Describe the clinical relevance of this innervation

Answer 8

A fibrous layer that covers the liver
Innervated by branches of the lower intercostal nerves
Damage to the Glisson’s capsule results in sharp, well-localised pain

Question 9

How much bile can be stored in the gallbladder?

Answer 9

50ml

Question 10

Which artery supplies the gallbladder?

Answer 10

Cystic artery (a branch of the right hepatic artery)

Question 11

What is the triangle of calot?

Answer 11

Triangle between the common hepatic duct, cystic duct an visceral surface of the liver

Question 12

Which plane passes through the neck of the pancreas? Which vertebral level does this correspond to?

Answer 12

The transpyloric plane

L1/L2

Question 13

What name is given to the part of the pancreas formed by the curvature of its head?

Answer 13

The uncinate process

Question 14

Where do the pancreatic duct and bile duct enter the duodenum?

Answer 14

The pancreatic and bile ducts fuse to form the hepatopancreatic ampulla of Vater
This enters the duodenum via the major duodenal papilla
This opening is controlled by the sphincter of Oddi

Question 15

Describe the histology of the duct system of the pancreas

Answer 15

Composed of acini cells which are connected by intercalated ducts.
Intercalated ducts drain into intralobular connecting ducts, which then drain into the main pancreatic duct

Question 16

Which ribs are the related to the spleen?

Answer 16

9-11 on the left side

Question 17

Which part of the spleen is not covered by peritoneum?

Answer 17

the hilum of the spleen

Question 18

Give two possible causes of splenomegaly

Answer 18

Anaemia

Typhoid fever

Question 19

Which structure connects the stomach to the spleen?

What other structures are the spleen attached to?

Answer 19

Gastro-splenic ligament - this is a continuation of the greater omentum
Left kidney by the lieno-renal ligament
Tail of the pancreas

Question 20

The pancreas is supplied by branches of which arterie?

Answer 20

Pancreatic branches of the splenic artery

Inferior pancreatic-duodenal artery