Chapter 51: Liver- Anatomy Flashcards

1
Q

Identify the branches of the celiac trunk

A
  1. Celiac trunk
  2. Splenic artery
  3. Left gastric artery
  4. Common hepatic artery
  5. Gastroduodenal artery
  6. Proper hepatic artery
  7. Left hepatic artery
  8. Right hepatic artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the venous supply?

A

Portal vein (formed from the splenic vein and the superior mesenteric vein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the hepatic venous drainage?

A

Via the hepatic veins, which drain into the IVC (three veins: left, middle, andright)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What sources provide oxygen to the liver?

A

Portal vein blood—50%

Hepatic artery blood—50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

From what sources does the liver receive blood?

A

Portal system—75%

Hepatic artery system—25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Identify the segments of the liver (French system)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the overall arrangement of the segments in the liver?

A

Clockwise, starting at segment 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the maximum amount of liver that can be resected while retaining adequate liver function?

A

>80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Child’s class? (Child–Turcotte–Pugh)

A

Classification system that estimates hepatic reserve in patients with hepatic failure and mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can the criteria comprising the modified Child’s classification be remembered?

A

Use the acronym: “A BEAP”:

Ascites

Bilirubin

Encephalopathy

Albumin

PT (prothrombin time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the operative mortality for a portacaval shunt versus overal lintraabdominal operations with cirrhosis in the following Child’s classes:

A

A

<5% versus overall = 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the operative mortality for a portacaval shunt versus overal lintraabdominal operations with cirrhosis in the following Child’s classes:

B

A

<15% versus overall = 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the operative mortality for a portacaval shunt versus overal lintraabdominal operations with cirrhosis in the following Child’s classes:

C

A

≈33% versus overall = 75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the MELD score stand for?

A

Model for End-stage Liver Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is measured in the MELD score?

A
  1. INR
  2. total bilirubin
  3. serum creatinine (SCR)

find good MELD calculators online

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the mortality in cirrhotic patients for nonemergent nontransplant surgery?

A

Increase in mortality by 1% per 1 point in the MELD score until 20, then 2% foreach MELD point

17
Q

What is the mortality in cirrhotic patients for emergent nontransplant surgery?

A

14% increase in mortality per 1 point of the MELD score