Chapter 8 The Liver, Gall Bladder, and Gastrointestinal Tract Flashcards
Which fissure divides the liver anatomically?
Falciform ligament, ligamentum teres, ligamentum venosum
Which structures divide the liver functionally?
The line between fossa for gall bladder to the fossa with inferior vena cava behind it.
What remnant is the ligamentum venosum for?
Ductus venosus - which used to shunt oxygenated blood from umblical vein past liver and into inferior vena cava before birth.
What remnant is the ligamentum teres of?
left umbilical vein
Where does the lesser omentum merge with?
Visceral peritoneum of liver in floor of the fissure formed by the ligamentum venosum and ligamentum teres.
Which lobe is found between the fissure for the ligamentum venosum and the fossa for inferior vena cava?
Caudate lobe
Which lobe is located between fossa for gall bladder and anterior part of ligamentum teres fissure?
Quadrate lobe
Which ligaments enclose the bare area?
Anterior coronary ligament and posterior coronary ligament.
What are the triangular ligaments?
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.
Where does the right and left subphernic pockets lie between?
Between diaphragm and liver on either side of falciform ligament.
Where is the subhepatic pouch (hepatorenal space)?
Between inferior visceral surface of the liver and the right kidney.
Which structures is the liver in contact with?
Oesophegus, stomach, duodenum, right hepatic flexure of colon and right kidney, right suprarenal gland.
What fossa does the gall bladder lie on?
Cystic fossa
What are the parts of the gall bladder?
Fundus, Body, Neck, Cystic duct
Cystic duct joins the _?
Common hepatic duct
Left and right hepatic duct joins the _?
Common hepatic duct
Cystic duct and Common hepatic duct join to form the _?
Common bile duct
Common bile duct joins with pancreatic duct at the _?
Hepatopancreatic ampulla
Hepatopancreatic ampulla opens into the duodenum at the _?
Duodenal papilla in wall of second part of the duodenum
Which main artery supplies liver and gall bladder?
Coeliac trunk
Which branches do coeliac trunk sprout?
Left gastric artery, common hepatic artery, splenic artery
What does the common hepatic artery give off?
Right gastric artery
gastroduodenal artery
Then proceeds to give off the right and left hepatic arteries.
Which arteries pass close to porta hepatis?
Right and left hepatic arteries (right behind the common hepatic duct)
How does the right hepatic artery branch off to supply the gall bladder?
It gives off a cystic artery to supply the gall bladder
Which part of the stomach is seen to contain swallowed air on radiographs?
Fundus
What is the incisura angularis?
Notch on the lesser curvature that marks the junction of the body with the antrum
Difference between pyloric and cardiac sphincter?
Pyloric sphincter is thickened by circular smooth muscles.
What is surface marking point of cardiac sphincter?
Just to the left of the 6th costal cartilage in the midline
What is surface marking point of pyloric sphincter?
Just to the right of the midline in the transpyloric plane
What does the stomach relate to anteriorly?
Liver, diaphragm and abdominal wall
What does the stomach relate to posteriorly?
Suprarenal gland, left kidney, transverse colon, spleen, pancreas, left crus of the diaphragm
What arterial blood supplies the stomach?
Coeliac trunk
Where do the left and right gastric arteries branch off from?
Left gastric artery branches directly off the coeliac trunk hilst the right gastric artery is one of the branches of common hepatic artery.
What level does the first part of the duodenum lie?
L1
Where is the lesser omentum attached?
Upper surface of the first part of the duodenum
Why is the duodenum after the first part immobile?
It becomes retroperitoneal
Which part is the 2nd part of duodenum?
The part that descends and crosses over hilum of right kidney
Which part of the duodenum is the duodenal papilla located?
2nd part
Which part is the 3rd part of the duodenum? Which level is it at?
As it levels the horizontal part of the curve. It lies just above umbilicus at level L3.
Which veins and arteries lie behind the 3rd part of the duodenum?
IVC, Aorta, Right and left gonadal vein and artery
Which muscle does the right ureter lie on?
Right psoas muscle
Which vessel passes anteriorly in front of the 3rd part of duodenum?
Superior mesenterric artery
What two structures do the duodenojejunal junction link?
4th part of the duodenum and the jejunum
What is the suspensory ligament of the duodenum (ligament of Treitz)?
This is a ligament that may have muscle fibres in it, and it joins the 4th part of the duodenum to the right crus.
Where are the superior and inferior fossae?
The pouches that form as the 4th part of the duodenum enters the peritoneal cavity formed by the peritoneum.
4 parts of the pancreas
Head, neck, body, tail (urinate process)
Which parts of the pancreas is retriperitoneal?
All parts but the tail
Which artery queezes out from behind the pancreas to run ontop of the front of the 3rd part of the duodenum?
Superior mesenteric artery
Where is the urinate process in relation to the superior mesenteric artery?
It hooks behind the superior mesenteric artery as it is developed in the ventral mesentery.
Which ligament does the tail of the pancreas run behind?
Lienorenal ligament
Which rib does the spleen lie on?
10th rib
When enlarged, which levels of ribs can the spleen be felt?
9th, 10th, 11th ribs on deep inspiration
What are the 3 regions created by the Y shaped central region on the spleen?
Kidney lies against it posteriorly
Splenic fixure of colon lies anteriorly
Stomach lies above it
Describe path of splenic artery
Direct branch of coeliac trunk that runs along upper border of pancreas an dthen within lineorenal ligament to the spleen.
What is the ligament attaching the stomach and the spleen?
Gastrosplenic ligament
What does the gastrosplenic ligament contain?
Short gastric arteries that run from splenic artery to fundus of the stomach.
Which parts make up the small intestine
Jejunum and ilieum
