Anatomy Topic 4 Case 3 Flashcards
Outline the position of the pancreas
- Posterior to stomach
- Across posterior abdomdinal wall
- From duodenum on right to spleen on left
Is the pancreas retroperitoneal or intraperitoneal?
- Retroperitoneal
- Except for a small part of tail
Where is the head of the pancreas located?
- Against the C-shaped concavity of the duodenum
Where is the uncinate process of the pancreas located?
- Projects from lower part of head
- Passes posterior to superior mesenteric vessels
Where is the neck of the pancreas located?
- Anterior to superior mesenteric vessels
Where is the body of the pancreas located?
- From neck to tail of pancreas
Where is tail of pancreas located?
- Between the layers of the splenorenal ligament
Outline the course of the pancreatic duct
- Begins in tail of pancreas
- Passes right through body of pancreas
- Joined by bile duct to form hepatopancreatic ampulla
- Which enters the duodenum at the major duodenal papilla
What is the sphincter of Oddi?
- A collection of smooth muscle
- That surrounds the ampulla
- Controlling when bile and pancreatic juice are released into duodenum
Where does the accessory pancreatic duct open begin and enter the duodenum?
- One branch from uncinate process and another from head
- Enters duodenum through minor duodenal papilla
- Which is superior to the major duodenal papilla
What are the embryological origins of the main and accessory pancreatic ducts?
- Dorsal and ventral buds from the foregut
Outline the arterial supply of the pancreas
- Gastroduodenal artery which gives off anterior and posterior superior pancreaticoduodenal arteries
- Splenic artery which gives off dorsal and great pancreatic arteries
- Superior mesenteric artery which gives off anterior and posterior inferior pancreaticoduodenal arteries
Outline the venous drainage of the pancreas
- Pancreatic veins into splenic vein
Outline the lymphatic drainage of the pancreas
- Lymph nodes situated on the arteries supplying the pancreas
- Drain into coeliac and superior mesenteric lymph nodes
Outline the histological structures of the exocrine pancreas
- Pyramidal shaped secretory cells surrounding a central lumen
- Which secrete into intercalated ducts
- Which transport secretions into intralobular ducts
- Which transport secretions into interlobular ducts
- Which transport secretions into main pancreatic duct
In which regions of the abdomen is the liver located?
- Right hypochondrium
- Epigastric region
- Left hypochondrium
In which directions is the diaphragmatic surface of the liver located?
- Anterior
- Superior
- Posterior
Identify the two recesses on the diaphragmatic surface of the liver
- Subphrenic recess: separates the liver from the diaphragm
- Hepatorenal recess: part of the peritoneum on the right side between the liver, right kidney and suprarenal gland
What is the role of the falciform ligament of the liver?
- Attaches the liver to the anterior abdominal wall
- Separates the subphrenic recess into right and left areas
Which regions of the gallbladder are not covered by visceral peritoneum?
- Fossa of the gallbladder
- Porta hepatis
Aside from the falciform ligament, identify six other ligaments of the liver
- Hepatogastric ligament
- Hepatoduodenal ligament
- Right and left triangular ligaments
- Anterior and posterior coronary ligaments
Identify the four lobes of the liver
- Right lobe
- Left lobe
- Caudate lobe
- Quadrate lobe
What is the caudate lobe bounded by on its left and right side?
- Left: fissure for ligamentum venosum
- Right: portal vein
What is the quadrate lobe bounded by on its left and right side?
- Left: Fissure for ligamentum teres
- Right: Fossa for the gallbladder
Describe the structure of the biliary tree
- Liver secretes bile into right and left hepatic ducts
- Which join to form common hepatic duct
- Which empties into bile duct
- Which unites with the pancreatic duct to form the hepatopancreatic ampulla
- Which opens into major duodenal papilla
- Excess bile backs up bile duct and cystic duct into gallbladder
Identify three functions of the liver
- Metabolises fat, carbohydrate and protein
- Storage of glycogen, vitamins and iron
- Detoxifies drugs and toxins
Outline the arterial supply of the liver
- Coeliac trunk gives off common hepatic artery
- Which gives off hepatic artery proper which ascends towards liver in free edge of lesser omentum along with bile duct and portal vein
- It gives off right and left hepatic arteries
Outline the lymphatic drainage of the liver
- Several lymph nodes near porta hepatis
- Efferent vessels pass to coeliac nodes
Outline the innervation of the liver
- Sympathetic and parasympathetic nerves from coeliac plexus
- Anterior vagus nerve give rise to large hepatic branch
Identify the different parts of the gallbladder
- Fundus which may project against inferior border of liver
- Body which may be against transverse colon
- Neck
Identify the arterial supply to the gallballder
- Cystic artery
- From right hepatic artery
What is the function of the gallbladder?
- Receives, concentrates and stores bile from the liver
What does the superior mesenteric vein drain?
- Small intestine
- Cecum
- Ascending colon
- Transverse colon
Outline the course of the superior mesenteric vein
- Begins in right iliac fossa as veins draining terminal ileum, cecum and appendix join
- Ascends in mesentery to the right of the superior mesenteric artery
- Joins the splenic vein to form the portal vein posterior to the neck of the pancreas
Identify tributaries to the superior mesenteric vein
- Right gastro-omental vein
- Anterior and posterior inferior pancreaticoduodenal veins which empty into right-gastro-omental vein
- Posterior superior pancreaticoduodenal vein which drains directly into portal vein
What are salivary glands?
- Glands that open or secrete into oral cavity
- Which are located in the submucosa or mucosa of the oral epithelium
Identify the boundaries of the parotid gland
- Sternocleidomastoid behind
- Ramus of mandible in front
- External acoustic meatus and zygomatic arch above
Which muscles does the parotid gland extend over?
- Anteriorly over masseter
- Inferiorly over digastric muscle
Identify the course of the parotid duct
- Passes anteriorly across external surface of masseter muscle
- Turns medially to penetrate buccinator muscle of cheek
- Opens into oral cavity adjacent to the crown of the second upper molar tooth
Identify the neurovascular contents of the parotid gland
- External carotid artery
- Retromandibular vein
- Facial nerve
Describe the shape and location of the submandibular glands
- Hook shaped
- Larger arm directed forward below the mylohyoid muscle in the submandibular fossa
- Smaller arm loops around the posterior margin of the mylohyoid muscle floor of oral cavity where it is lateral to the
(root of the tongue on the lateral surface of the hyoglossus muscle)
Where does the submandibular duct emerge?
- Emerges from medial side of deep part of gland
- Opens onto sublingual papillae beside the frenulum of tongue
Which nerve loops under the submandibular duct
- Lingual nerve
Identify the shape and location of the sublingual gland
- Small almond shaped located lateral to submandibular duct
- Lies against medial surface of mandible where it forms sublingual fossa
How does the sublingual gland drain into the oral cavity
- Via numerous small ducts (minor sublingual ducts)
- Which open onto crest of sublingual fold
Outline the arterial supply of the submandibular and sublingual gland
- Facial and lingual arteries
Outline the lymphatic drainage of the parotid gland
- Superficial and deep cervical nodes
Outline the lymphatic drainage of the submandibular and sublingual nodes
- Deep cervical nodes mainly jugulo-omohyoid node
What nerve supplies parasympathetics to the salivary glands
- Facial nerve
- Which joins branches of maxillary and mandibular nerves to reach target destinations
Identify the excretory ducts and epithelium that lines them
- Intercalated lined by low cuboidal epithelia
- Striated (formed by merging intercalated ducts) formed by simple columnar epithelia
- Intralobular ducts (formed by merging striated ducts)
- Interlobular epithelium lined by pseudostratified epithelia
- Interlobular ducts lined by pseudostratified epithelia
Identify the three surfaces of hepatocytes
- Sinusoidal between cells and blood sinuses (70%)
- Canalicular between cell and bile canaliculi (15%)
- Intracellular (between adjacent cells (15%)
