Anatomy of the Biliary Tract, Pancreas and Spleen Flashcards
Gallbladder location:
- fossa of gallbladder (visceral surface of the liver)
- 9th costal cartilage MCL or transpyloric MCL
Common bile duct location
Within free edge of lesser omentum
Relations of the common bile duct(2):
- posterior to 1st part of duodenum
- medial to 2nd part of duodenum
Gallbladder and common bile duct
Features of the gallbladder and common bile duct
- fund us
- body
- infundibulum
- neck (continuous with cystic duct) contains a spiral valve
Gallbladder and common bile duct
Gallbladder and common bile duct function
- storage of bile
- convey bile
Páncreas location:
- lies retroperitoneal except tail
- neck lies in the transpyloric plane
Pancreas relations:
- anterior
- posterior
- medial
- lateral
- anterior: stomach, SMA(uncinate process), SMV (uncinate process)
- posterior: L1-3, abdominal aorta, superior mesenteric artery (neck), IVC, superior mesenteric vein (neck)
- Medial: duodenum (head and uncinate process)
- Lateral: spleen (tail)
Pancreas
Pancreas features:
- head
- uncinate process (projection from head)
- neck
- body
- tail
Pancreas function:
- endocrine: glucagon, insulin secretion
- exocrine: pancreatic digestive enzymes: main pancreatic duct, accessory pancreatic duct more so than the minor duodenal papilla
Spleen location:
- superolateral UCQ
- left hypochondriac
- ribs 9-11
Spleen Relations:
- anterior
- posterior
- inferior
- medial
- anterior: stomach (gastrosplenic ligament)
- posterior: left hemidiaphram
- inferior: splenic flex her
- medial: left kidney (so Lenore all ligament)
Spleen location
Spleen Features:
- diaphragmatic surface
- hilum
- superoanterior notched border
- inferoposterior smooth border
Spleen function:
- haemopoietic (red pulp= sinusoids) for storage of RBC and platelets, phagocytosis of defective RBC
- lymphoid (white pulp) for storage of T and B lymphocytes and macrophages
Spleen features
Biliary Tree
Biliary Tree: Hepatic Part: Ducts:
- right and left hepatic ducts join to form the
- common hepatic duct, the cystic duct joins to form
- the common bile duct
Biliary Tree: Hepatopancreatic part: Structures:
- main pancreatic duct + common bile duct join to form
- the hepatopancreatic ampulla (of Vater)
- which has the hepatopancreatic sphincter of Oddi
- after which lies the major duodenal papilla (2nd part
of duodenum)
Biliary Tree
Lesser Omentum arises from
development and rotation of foregut
Lesser omentum is:
- a single fold of peritoneum
- a double fold of peritoneum
- a triple fold of peritoneum
a double fold of peritoneum
Lesser Omentum: Ligaments:
- hepatoduodenal ligament
- hepatogastric ligament
Lesser omentum and ligaments: Label lesser omentum and boundaries and ligaments:
Omental foramen (epiploic foramen, foramen of Winslow) is
a communication between the greater and lesser sacs
Omental foramen: boundaries:
- anterior
- posterior
- superior
- inferior
- anterior: hepatoduodenal ligament and portal triad
- posterior: IVC, right crus diaphragm
- superior: caudate lobe
- inferior: 1st part of duodenum
Omental foramen
Sphincter of Oddi controls
the amount of bile secreted into the duodenum
Which artery supplies the gallbladder and where does it arise from?
- cystic artery
- coeliac trunk gives off common hepatic artery, which
turns into hepatic artery proper, which splits into the
right and left hepatic artery; the right hepatic artery
gives off the cystic artery
The common bile duct is supplied with blood from which arteries?
- the right hepatic artery
- posterior superior and inferior pancreaticduodenal
arteries
The right hepatic artery supplies the common bile duct. Where does the right hepatic artery arise from?
the coeliac trunk gives off the common hepatic artery, which becomes the hepatic artery proper, which splits into the right and left hepatic artery
Venous drainage of the gallbladder and common bile duct:
- cystic veins
- which drain into the portal vein
Lymphatics of the gallbladder and common bile duct:
- cystic lymph nodes
- which drain into coeliac lymph nodes
Innervation of the gallbladder and common bile duct:
- Coeliac plexus:
- Parasympathetic: Vagus (CNX)
- Sympathetic: Greater and Lesser splanchnic (T5-
9,10/11)
- Somatosensory: phrenic nerves
Referred pain from the gallbladder and common bile duct
C3-5
sometimes neck and shoulders
because phrenic nerve
Gallbladder and common bile duct
gallbladder and common bile duct
Where are cystic lymph nodes and coeliac lymph nodes?
Pancreas blood supply
coeliac trunk gives off common hepatic artery which gives off gastroduodenal artery before becoming the hepatic artery proper. Gastroduodenal artery givess of pancreaticduodenal artery anterior and posterior superior arteries
Inferiorly, coming off the superior mesenteric artery is the pancreaticduodenal artery inferiorly anterior and posterior
Venous drainage of the pancreas:
- pancreatic veins drain into the splenic vein
- pancreatic veins can also drain into the superior
mesenteric vein - splenic and superior mesenteric vein join to form the
portal vein
Lymphatics of pancreas:
pancreaticosplenic lymph nodes drain into coeliac lymph nodes
Innervation of the Prancreas:
- Coeliac plexus:
- Parasympathetic: Vagus (CNX)
- Sympathetic: Greater and lesser splanchnic (T5-
9,T10/11)
Pancreas neurovasculature:
Pancreas neuorvasculature
Blood supply to the spleen:
- splenic artery
- arises from the coeliac trunk
Venous drainage of the spleen:
- splenic vein joins with superior mesenteric vein to
form the portal vein
Lymphatics of the spleen:
pancreaticosplenic lymph nodes which drain into coeliac nodes
Innervation of the spleen:
- Coeliac Plexus:
- Parasympathetic: Vagus (CNX)
- Sympathetic: Greater and Lesser splanchnic (T5-
9/T10/11)
Spleen neurovasculature
