Case 8: Liver and Biliary System

Question 1

How much blood does the liver receive per minute?

Answer 1

1.5L

Question 2

wHAT ARE THE 2 MAJOR SURFACES OF THE LIVER

Answer 2

Diaphragmatic and visceral surfaces

Question 3

What are the 4 surfaces of the diaphragmatic surface of he liver?

Answer 3

Anterior, posterior, left and right

Question 4

The inferior border of the liver is comprised `of the joining of which 2 surfaces?

Answer 4

Anterior and visceral surfaces

Question 5

what is the superior relation of the anterior surface of the liver?

Answer 5

Diaphragm

Question 6

What is able the superior surface of the liver?

Answer 6

Pleura, pericardium and lungs (plus diaphragm)

Question 7

What are the anatomical landmarks of the right surface of the liver?

Answer 7

Ribs 7-11

Question 8

What comprises each of the 3 compartments of the visceral surface of the liver?

Answer 8

Laterally = colic area and left lobe
Middle =  caudate and quadrate lobes

Question 9

What separates the caudate and quadrate lobes from the right lobe?

Answer 9

Gall bladder plus IVC

Question 10

What separates the caudate and quadrate lobes from the left lobe?

Answer 10

Ligamentum venosum and falciform ligament

Question 11

What separates the caudate and quadrate lobes?

Answer 11

Porta hepatis

Question 12

Where is the flalciform ligament of the liver located?

Answer 12

centre of the liver, left of the fungus of the gallbladder

Question 13

What is the left triangular ligament?

Answer 13

An extension of the falciform ligament as it continues to the left

Question 14

What is the upper border of the coronal ligament?

Answer 14

The extension of the falciform ligament as ti sweeps to the right

Question 15

The couinard segments are the ____ segments of the lie

Answer 15

Functional segments

Question 16

what determines each couinard segment?

Answer 16

The venous and biliary drainage

Question 17

Are the caudate and quadrate lobes part of the left or right lobe of the liver?

Answer 17

Left

Question 18

The quadrate lobe is locate between which 2 structures?

Answer 18

Falciform ligament and the gall bladder

Question 19

The caudate lobe is located between which 2 structures?

Answer 19

IVC and ligmaentum venosum

Question 20

What is the origin of the common hepatic artery?

Answer 20

Coeliac trunk

Question 21

What are the branches o fit ecommon hepatic artery?

Answer 21

Gastroduodenal, RIght hepatic, left heptic

Question 22

what are the bifurcation o the richt hepatic artery?

Answer 22

Anterior and posterior branches of the right hepatic artery

Question 23

Where does the right hepatic artery run?

Answer 23

Posterior t the hepatic bile duct

Question 24

What veins form the hepatic portal vein?

Answer 24

SMV ad Splenic veins

Question 25

What 3 structures form the portal canal?

Answer 25

Portal vein, hepatic artery and tributaries to he bible ducts

Question 26

Where does lymph from the liver drain?

Answer 26

To 3 or 4 nodes around the portal hepatis

Question 27

What are the contents of the portal hepatic?

Answer 27

Hepatic bile duct, Hepatic artery ad portal vein

Question 28

What is the arrangement of the hepatic lobule?

Answer 28

Central vein in the centre, with 6 portal triads at each point of a hexagon

Question 29

Where does bile originate and where does it run?

Answer 29

Synthesised by the hepatocytes, it runs away from the central vein and towards the portal triad

Question 30

Wha are the hepatic sinusoids

Answer 30

Grooves between the cords of hepatocytes, lined ty fenestrate endothelium

Question 31

What is special about hepatic endothelium?

Answer 31

Contains kupffer cells and fenestrations

Question 32

Outline the bile pathway through the liver

Answer 32

Made by hepatocytes }-> collected in the canaliculi }-> along the portal canals in the bile duct tributaries ]-> then to the right and left heatic ducts, emerging at porta hepatis }-> joining of right and left hepatic ducts form the common hepatic duct

Question 33

What is the function of the gallbladder?

Answer 33

Stores and concentrates the bile secreted by the liver

Question 34

What is the shape of the gallbladder?

Answer 34

globular and pear shaped with a fundus, body and neck

Question 35

The ___ artery, which originates from the ____ ____ artery, supplies the gallbladder

Answer 35

The cystic artery, which originates from the right hepatic artery, supplies the gallbladder

Question 36

The boundaries of Calot's triangle are as follows:

Answer 36

Visceral surface of the liver, common hepatic duct and cystic duct

Question 37

why is the cystic artery of clinical importance?

Answer 37

it must be ligated prior to cholecysctomy

Question 38

Name the 3 parts of the common bile duct and their relations

Answer 38

Supraduodenal: lies on the free edge of the lesser omentum Retroduodenal: posterior to the first part of the duodenum Pancreatic: feeds into the duodenum and is joined by the pancreatic duct

Question 39

What is the hepatopancreatic ampulla?

Answer 39

A swelling in the common bile duct just after it has joined the pancreatic duct

Question 40

what is the sphincter of Oddi?

Answer 40

A ring of smooth muscle on the common bile just proximal to the hepatopancreatic ampulla. It is therefore located just before the common bile duct and the pancreatic duct join

Question 41

What are the spiral valves of the cystic duct?

Answer 41

The muscular arrangement of the cystic duct to maintain patency and allow for bile motiliy

Question 42

where is the gall bladder located?

Answer 42

Gall bladder fossa

Question 43

What is thesurace anatomy of the gall bladder's funds?

Answer 43

MCL, 9th costal cartilage