Class 4 Flashcards
How is the spleen peritonised and where is it located
Intraperitoneal
Left upper quadrant/Left Hypochondrium but it descnends on inspiration
The hilum of the spleen is up against the pancreas’ tail
Function of the spleen?
Stores RBCs
Phagocytosis
Red pulp filters RBCs + Recycles old ones
White pulp stores platelets and RBCs
What does the pancreas excrete?
Exocrine - Digestive pancreatic juice
Endocrine - Hormones (insulin/glucagon)
What are the parts of the pancreas?
Head - In C curve of duodenum
Neck
Body
Tail - Tickles Splenic hilum
How is the pancreas peritonised?
Retroperitoneal
What vein forms posterior to the neck of the pancreas?
Hepatic portal vein
From sup. mesenteric and splenic veins
Where does the pancreatic duct open?
Through the major duodenal papilla
What are the major ligaments of the liver?
Falciform - between two major lobes
Round - Remnant of foetal umbilical vein on bottom of falciform
Coronary Ligament - Along top of right lobe
Left Triangular Ligament - Sticking out top of left lobe
What is the bare area?
A section on the superior surface of the right lobe of the liver that lacks peritoneaum
What are the other lobes of the liver?
Caudate - Superior to porta hepatis and just medial to vena caval passage
Quadrate - Just medial to gall bladder
What structures pass into the porta hepatis and what fold of peritoneum wraps round them?
Portal Vein Hepatic Artery Hepatic Nerve plexus Common Hepatic Duct Lymph vessels
Lesser Omentum
What are the parts of the extrahepatic biliary apparatus?
- L & R hepatic ducts
- Common Hepatic Duct
- Gall Bladder
- Cystic Duct
- Common Bile Duct
Where is bile produced and stored?
Liver hepatocytes -> Bile Canaliculus -> Hepatic ducts -> Cystic Duct -> Gall bladder
What is the function of bile?
Emulsifies fat and fat soluble vitamins
Als eliminates toxins filtered from blood by hepatocytes
Parts of the pancreatic/biliary system?
Common bile duct joins with pancreatic duct to form hepatopancreatic ampulla (of vater).
There’s a bile duct sphincter and pancreatic duct sphincter prior to the ampulla.
Passes through sphincter of oddi and out major duodenal papilla into duodenum (2nd or 4 parts of duodenum)
(there’s also an accessory pancreatic duct that opens into duodenum slightly above the major duodenal papilla.)
What is the triangle of calot?
A triangle formed by the common hepatic duct, cystic duct and inferior surface of the liver.
It contains the cystic artery
What are the main histological features of the pancreas?
- Islets of langherans which are poorly stained endocrine areas
- Pure serous acini composed of large strongly stained cells
- Small lobules surrounded by connective tissue septa
How does the liver appear histologically?
Central vein with radiating sinusoids surrounded by hepatocytes forming a hexagonal lobule.
Portal triad visible at the corners of the hexagonal lobules
Describe the structure of the spleen?
Made up of:
Red pulp = RBCs & Splenic Sinusoids
White Pulp = WBCs, lymphatic nodues & Central arterioles
Its wrapped in a dense fibromuscular capsule of collagen and elastic fibres with scattered smooth muscle. It then branches into trabeculae that radiate inside the spleen.
What is the surface marking of the gall bladder?
The right 9th costal cartilage at the tip of the 9th rib
Whats the surface marking of the spleen?
The left 9-11th ribs
What abdominal plane crosses the pancreas and where?
The transpyloric plane goes through the neck of the pancreas (L1/L2)
What procedure would we use to look at the abdominal arteries?
Abdominal angiogram
How would we look at the ureter and what parts would we see?
An Intravenous Urogram (Also called a pylogram). Its a combination of X-ray & Special dye.
IT shows the major & minor calyces, pelvis of the ureter and the ureter itself.
Define calyces?
Cup shaped cavities collecting urine till it passes to the ureter
How would we differentiate jejunum from ileum on a barium swallow?
The jejunum is more to the left and feathery
The ileum is more to the right and smoother
Define paracolic gutter?
Space lateral to the asc./desc. colon. Fluid often collects here
How is the colon peritonised?
Transverse and sigmoid colon are intraperitoneal.
The caecum, asc, and desc are usually retroperitoneal
How does the splenic artery appear on a CT?
Spiralled due to its tortuous nature
Why might drawing up their hip indicate appendicitis?
The appendix often rests on the psoas major so they may draw thier hip up to minimise pain
