anatomy of the biliary tract and spleen

Question 1

what are the gut associated organs? 4

Answer 1

• liver
• gallbladder
• pancreas
• spleen

Question 2

describe bile production? 5

Answer 2

• Produced in hepatocytes
• Secreted into the canaliculi
• Canaliculi join to enter bile ductules and ducts in the portal triad
• Ductules= cuboidal epithelium
• Ducts=columnar epithelium

Question 3

describe the biliary tree? 3

Answer 3

• Smaller ducts continuously join together
• Liver, gallbladder and pancreas secretions enter the duodenum
• The large right lobe of the liver has sectors each comprising segments

Question 4

describe hepatic, cystic and bile ducts? 3

Answer 4

• Left and right hepatic ducts leave via porta hepatis
• Join to form the common hepatic duct
• Cystic ducts join to form the common bile duct

Question 5

describe the extra hepatic bile duct? 3

Answer 5

• Duct wall now contains fibrous connective tissue and smooth muscle
• Meets the pancreatic duct to form the (hepatopancreatic) ampulla of vater
• Finally, the sphincter of Oddi moderates emptying into the duodenum

Question 6

describe the bile duct and portal triad? 3

Answer 6

• Anatomical relations in this area are a crucial surgical consideration
• Bile duct is anterior to the portal vein
• Bile duct is to the right of the hepatic artery

Question 7

what are the functions of the gallbladder? 3

Answer 7

• Store and concentrate bile
• Selectively absorb bile salts
• Excrete cholesterol and mucous

Question 8

describe the anatomy of the gallbladder? 3

Answer 8

• Located on the inferior surface of the right lobe of the liver
• Characteristically conical/ pear-shaped
• Divided into the fundus, body and neck

Question 9

describe the pancreas? 3

Answer 9

• Located posterior to the stomach
• Exocrine function= secrete digestive enzymes into the duodenum
• Endocrine function= secretes hormones such as insulin

Question 10

describe the anatomy of the pancreas? 4

Answer 10

• Divided into the head, body and tail
• Supplied by:
  arteries= splenic, coeliac trunk, pancreaticoduodenal
• Veins= pancreatic (drain into the portal vein)
• Nerves= coeliac ganglia and vagus

Question 11

describe the pancreas exocrine pathway? 4

Answer 11

• Pancreatic secretions collect in small ducts
• These ducts join to form the wirsung
• The wirsung meets the common bile duct to form the hepatopancreatic ampulla/ ampulla of vater
• This then empties into the duodenum at the major duodenal papilla

Question 12

describe pancreatitis? 5

Answer 12

• inflammation of the pancreas
• Gallstones
• High alcohol intake
• Cystic fibrosis
• High levels of calcium or blood fats

Question 13

describe pancreatic cancer? 4

Answer 13

• Obstructive jaundice (gallstones)
• High alcohol intake
• Smoking
• Genetics

Question 14

what is the spleen? 3

Answer 14

• Lymphoid organ- associated with the lymphatic system, and has an immune role
• Blood gland removes old blood cells, stores platelets, produces blood cells during foetal life
• Delicate and friable (easily crumbled)

Question 15

what is the anatomy of the spleen? 4

Answer 15

• Surrounded by connective tissue (CT) capsule
• The inner portion is known as parenchyma this contains red and white pulp
• Red pulp= blood filled sinuses
• White pulp= lymphatic tissue (think white blood cells)

Question 16

describe visceral pain? 4

Answer 16

• Pain felt from the organs (viscera)
• Poorly localised in comparison to somatic pain due to innervation of structures (somatic vs autonomic innervation)
• Described as dull, aching, pressure
• Cause of referred pain (where pain is felt in a different location to where organ or structure injured)