Chapter 8 The Liver, Gall Bladder, and Gastrointestinal Tract Flashcards

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1
Q

Which fissure divides the liver anatomically?

A

Falciform ligament, ligamentum teres, ligamentum venosum

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2
Q

Which structures divide the liver functionally?

A

The line between fossa for gall bladder to the fossa with inferior vena cava behind it.

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3
Q

What remnant is the ligamentum venosum for?

A

Ductus venosus - which used to shunt oxygenated blood from umblical vein past liver and into inferior vena cava before birth.

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4
Q

What remnant is the ligamentum teres of?

A

left umbilical vein

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5
Q

Where does the lesser omentum merge with?

A

Visceral peritoneum of liver in floor of the fissure formed by the ligamentum venosum and ligamentum teres.

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6
Q

Which lobe is found between the fissure for the ligamentum venosum and the fossa for inferior vena cava?

A

Caudate lobe

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7
Q

Which lobe is located between fossa for gall bladder and anterior part of ligamentum teres fissure?

A

Quadrate lobe

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8
Q

Which ligaments enclose the bare area?

A

Anterior coronary ligament and posterior coronary ligament.

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9
Q

What are the triangular ligaments?

A

The right triangular ligament occurs when the anterior and posterior coronary ligament meet and run together in a straight line for a while. The left triangular ligament runs as double layer to the left of the falciform ligament.

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10
Q

Where does the right and left subphernic pockets lie between?

A

Between diaphragm and liver on either side of falciform ligament.

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11
Q

Where is the subhepatic pouch (hepatorenal space)?

A

Between inferior visceral surface of the liver and the right kidney.

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12
Q

Which structures is the liver in contact with?

A

Oesophegus, stomach, duodenum, right hepatic flexure of colon and right kidney, right suprarenal gland.

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13
Q

What fossa does the gall bladder lie on?

A

Cystic fossa

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14
Q

What are the parts of the gall bladder?

A

Fundus, Body, Neck, Cystic duct

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15
Q

Cystic duct joins the _?

A

Common hepatic duct

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16
Q

Left and right hepatic duct joins the _?

A

Common hepatic duct

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17
Q

Cystic duct and Common hepatic duct join to form the _?

A

Common bile duct

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18
Q

Common bile duct joins with pancreatic duct at the _?

A

Hepatopancreatic ampulla

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19
Q

Hepatopancreatic ampulla opens into the duodenum at the _?

A

Duodenal papilla in wall of second part of the duodenum

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20
Q

Which main artery supplies liver and gall bladder?

A

Coeliac trunk

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21
Q

Which branches do coeliac trunk sprout?

A

Left gastric artery, common hepatic artery, splenic artery

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22
Q

What does the common hepatic artery give off?

A

Right gastric artery
gastroduodenal artery
Then proceeds to give off the right and left hepatic arteries.

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23
Q

Which arteries pass close to porta hepatis?

A

Right and left hepatic arteries (right behind the common hepatic duct)

24
Q

How does the right hepatic artery branch off to supply the gall bladder?

A

It gives off a cystic artery to supply the gall bladder

25
Q

Which part of the stomach is seen to contain swallowed air on radiographs?

A

Fundus

26
Q

What is the incisura angularis?

A

Notch on the lesser curvature that marks the junction of the body with the antrum

27
Q

Difference between pyloric and cardiac sphincter?

A

Pyloric sphincter is thickened by circular smooth muscles.

28
Q

What is surface marking point of cardiac sphincter?

A

Just to the left of the 6th costal cartilage in the midline

29
Q

What is surface marking point of pyloric sphincter?

A

Just to the right of the midline in the transpyloric plane

30
Q

What does the stomach relate to anteriorly?

A

Liver, diaphragm and abdominal wall

31
Q

What does the stomach relate to posteriorly?

A

Suprarenal gland, left kidney, transverse colon, spleen, pancreas, left crus of the diaphragm

32
Q

What arterial blood supplies the stomach?

A

Coeliac trunk

33
Q

Where do the left and right gastric arteries branch off from?

A

Left gastric artery branches directly off the coeliac trunk hilst the right gastric artery is one of the branches of common hepatic artery.

34
Q

What level does the first part of the duodenum lie?

A

L1

35
Q

Where is the lesser omentum attached?

A

Upper surface of the first part of the duodenum

36
Q

Why is the duodenum after the first part immobile?

A

It becomes retroperitoneal

37
Q

Which part is the 2nd part of duodenum?

A

The part that descends and crosses over hilum of right kidney

38
Q

Which part of the duodenum is the duodenal papilla located?

A

2nd part

39
Q

Which part is the 3rd part of the duodenum? Which level is it at?

A

As it levels the horizontal part of the curve. It lies just above umbilicus at level L3.

40
Q

Which veins and arteries lie behind the 3rd part of the duodenum?

A

IVC, Aorta, Right and left gonadal vein and artery

41
Q

Which muscle does the right ureter lie on?

A

Right psoas muscle

42
Q

Which vessel passes anteriorly in front of the 3rd part of duodenum?

A

Superior mesenterric artery

43
Q

What two structures do the duodenojejunal junction link?

A

4th part of the duodenum and the jejunum

44
Q

What is the suspensory ligament of the duodenum (ligament of Treitz)?

A

This is a ligament that may have muscle fibres in it, and it joins the 4th part of the duodenum to the right crus.

45
Q

Where are the superior and inferior fossae?

A

The pouches that form as the 4th part of the duodenum enters the peritoneal cavity formed by the peritoneum.

46
Q

4 parts of the pancreas

A

Head, neck, body, tail (urinate process)

47
Q

Which parts of the pancreas is retriperitoneal?

A

All parts but the tail

48
Q

Which artery queezes out from behind the pancreas to run ontop of the front of the 3rd part of the duodenum?

A

Superior mesenteric artery

49
Q

Where is the urinate process in relation to the superior mesenteric artery?

A

It hooks behind the superior mesenteric artery as it is developed in the ventral mesentery.

50
Q

Which ligament does the tail of the pancreas run behind?

A

Lienorenal ligament

51
Q

Which rib does the spleen lie on?

A

10th rib

52
Q

When enlarged, which levels of ribs can the spleen be felt?

A

9th, 10th, 11th ribs on deep inspiration

53
Q

What are the 3 regions created by the Y shaped central region on the spleen?

A

Kidney lies against it posteriorly
Splenic fixure of colon lies anteriorly
Stomach lies above it

54
Q

Describe path of splenic artery

A

Direct branch of coeliac trunk that runs along upper border of pancreas an dthen within lineorenal ligament to the spleen.

55
Q

What is the ligament attaching the stomach and the spleen?

A

Gastrosplenic ligament

56
Q

What does the gastrosplenic ligament contain?

A

Short gastric arteries that run from splenic artery to fundus of the stomach.

57
Q

Which parts make up the small intestine

A

Jejunum and ilieum