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Medicine year 1 semester 2 > Case 10- Anatomy > Flashcards

Case 10- Anatomy Flashcards

1
Q

The Liver

A

It is the largest internal organ and is an intraperitoneal structure. The Liver has a big role in metabolism, removing drugs, producing bile, recycling red blood cells and storing Glycogen.

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2
Q

Where is the liver located

A

It sits within the right upper quadrant (RUQ) of the abdomen. It is inferior to the diaphragm and is protected by the thoracic cage.

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3
Q

Lobes of the liver

A

Anteriorly you have the left and right lobe. Posteriorly you have the caudate lobe, which sits next to the inferior vena cava and the Quadrate lobe which sits next to the gall bladder.

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4
Q

Segments of the liver

A

You can divide the liver into 8 segments which are different functional units

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5
Q

The lesser omentum and the liver

A

The lesser omentum attaches the stomach to the liver, it attaches to the lesser curvature of the stomach. It is made of two ligaments, the hepato-gastric ligament and the hepato-duodenal ligament.

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6
Q

Hepato-duodenal ligament

A

Made of the lesser omentum. It connects the porto-hepatis of the liver and the first part of the duodenum. It is also attached to the gallbladder and the portal triad

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7
Q

What are the ligaments made from

A

Peritoneum, the visceral peritoneum comes of the liver to connect to somewhere else

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8
Q

Coronary ligament

A

Top of the liver, attached to the diaphragm. There is a posterior and anterior coronary ligament

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9
Q

Right and left triangular ligament

A

Comes of the coronary ligament

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10
Q

Falciform ligament

A

Double fold of the peritoneum in the centre of the liver. Attached to the anterior abdominal wall

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11
Q

Round ligament of the liver (ligamentum teres)

A

Comes off the free edge of the falciform ligament. Not a ligament of the peritoneum but an embryological remnant of the umbilical vein. Posteriorly it extends next to the quadrate lobe towards the portal vein.

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12
Q

Ligamentum venosum

A

Starts where the round ligament of the liver ends and extends superiorly. Not a ligament of the peritoneum but an embryological remnant of the ductus venosus, this allowed the blood supply from the placenta to bypass the liver. It will receive its blood supply later when the heart contracts.

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13
Q

The bare area of the liver

A

Has no peritoneum attached to it, it is a potential route for spread of infection. Part of the diaphragmatic surface

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14
Q

Posterior to the liver

A

IVC, gallbladder, stomach and pancreas

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15
Q

Porta hepatitis

A

Attaches to the hepato-duodenal ligament. It is a deep transverse fissure which separates the quadrate and caudate lobes. It is the entrance/exit for vessels in the liver. It contains the portal triad.

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16
Q

Where the gallbladder is located near the liver?

A

The gallbladder sits next to the quadrate lobe of the liver

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17
Q

Impressions of the liver

A

The posterior aspect of the liver has impressions where different organs indent on it. It has the renal and suprarenal impression (right kidney), gastric impression (stomach), oesophageal impression and colic impression (transverse colon).

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18
Q

Blood supply to the liver

A

The portal vein enters the liver and leaves as the hepatic vein which connects to the inferior vena cava. The hepatic artery provides the blood supply to the liver

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19
Q

Portal triad

A

Contains the portal vein, hepatic artery proper and the hepatic bile duct.

20
Q

Palpating the liver

A

The liver moves with the diaphragm during respiration. In inspiration you can palpate the liver

21
Q

Function of Portal venous system

A

How all nutrients (except for fat) are transported from the GI tract to the liver

22
Q

Hepatobiliary system

A

Anything involved with the transport and production of bile

23
Q

The biliary tree

A

Transports bile from the liver to the duodenum

24
Q

How bile drains through the liver

A

The Liver produces bile. The hepatocytes secrete bile into the bile canaliculi, the canaliculi drain into the small interlobular biliary ducts and then into the large collecting bile ducts of the intrahepatic portal triad which merge to form the hepatic duct.

25
Q

Function of the gallbladder

A

Stores, concentrates and ejects bile into the GI tract

26
Q

Structure of the gallbladder

A

Has a fundus, body and neck

27
Q

Where does the gallbladder sit

A

It sits in a fossa on the visceral surface of the liver

28
Q

Bile

A

Bile is made up of water, bile salts, bilirubin and biliverdin. It causes the green colour of the gallbladder. It is secreted into the duodenum where it emulsifies fats. Bilirubin and Biliverdin come from the breakdown of Heme in red blood cells.

29
Q

The cystic duct- structure

A

Contains spiral valves which control how much bile is secreted.

30
Q

Transport of bile from the liver to Gallbladder

A

Bile drains from the liver via the left and right hepatic ducts which join and form the common hepatic duct. Bile then drains into the cystic duct to enter the gallbladder.

31
Q

Secreting bile into the duodenum

A

From the gallbladder bile drains via the cystic duct into the common bile duct. The main pancreatic duct joins with the bile duct so both pancreatic juices and bile are secreted into the duodenum. The bile duct and pancreatic duct join at the Hepatopancreatic ampulla. The bile and pancreatic juices are then secreted via the major duodenal papilla.

32
Q

What forms the common bile duct

A

The common hepatic duct and the cystic duct

33
Q

The major duodenal papillar

A

Has a sphincter to control secretion. Where the bile and pancreatic juices enter the duodenum

34
Q

Positioning of the duodenum and pancreas

A

The duodenum is the first part of the small intestine, it is C-shaped. The pancreas sits within this C-shape

35
Q

Calot’s traingle

A

An anatomical space which contains the right hepatic artery, cystic artery, lymph node of Lund and lymphatics. The triangle is dissected out during laparoscopic cholecystectomy (removal of gall bladder) to ligate cystic vessels. It is bounded by the inferior part of the liver, the cystic duct and the hepatic duct.

36
Q

What artery does the cystic duct come of

A

In 75% of people the cystic duct comes of the right hepatic artery, In 25% of people it comes of the cystic artery

37
Q

Pancreas

A

It is an accessory organ of digestion and is retroperitoneal.

38
Q

Functions of the pancreas

A

It has an Exocrine function (pancreatic juice and enzymes) and an Endocrine function (regulates blood sugar by producing insulin).

39
Q

Structure of the Pancreas

A

Split into the head, neck, body and tail. The Uncinate process is a projection of the head

40
Q

Where the pancreas sits in the body

A

The head sits between the C-shape of the duodenum. The neck is superior to the vessels (portal vein, superior mesenteric artery). The tail sits in the hilum of the spleen. The splenic artery runs behind the body and tail. The body sits on the aorta.

41
Q

Location of the Pancreas

A

The pancreas lies transversely and anterior to the L1 and L2 vertebra at the level of the transpyloric plane. It is posterior to the stomach

42
Q

Endocrine function of the Pancreas

A

Produces hormones i.e. Insulin and Glucagon from the islets of Langerhans. There are no ducts and they are secreted directly into the blood or surrounding tissue

43
Q

Exocrine function of the Pancreas

A

Produce Pancreatic juice’s which are rich in digestive enzymes, it is Alkaline to neutralise gastric acid. It is secreted via ducts. You have external secretion i.e. into the duodenum via the pancreatic duct.

44
Q

What forms the exocrine pancreas

A

A compound acinar gland

45
Q

How pancreatic juice moves through the Pancreas

A

The Acinus produces pancreatic juice which then travels to the Intercalated ducts into the Interlobular ducts. It then drains into the main pancreatic duct

46
Q

Divisions of the Pancreas

A

The Pancreas is split into lobules which are made of Acini and intercalated ducts

47
Q

Cells within the Acinus

A
  • Pancreatic acinar cells: produce Zymogen granules (inactive enzyme precursors), contain Golgi and RER for protein production.
  • Centroacinar cells modify pancreatic juice. Smaller then pancreatic acinar cells
  • Duct epithelial cells: line the ducts. A continuation of the Centroacinar cells into the ducts

Medicine year 1 semester 2 (61 decks)

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