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Question 1

Where does the liver lie?

Answer 1

Right upper quadrantLies deep to ribs 7-11 on RHS Across the midline towards the left nipple– Occupies most of right hypochondrium, upper epigastrium and into the left hypochondrium

Question 2

What is found on the naterior surface of the liver?

Answer 2

Falciform ligament

Question 3

What is the falciform ligament?

Answer 3

The embryonic remnant of the umbilical vein which helps to suspend the liver in the abdominal cavity

Question 4

What part of the liver lies in contact with the diaphragm? What is a particular characteristic about this area?

Answer 4

The bare area of the liver, found posteriorlyHas a groove in which the IVC runs

Question 5

What marks out the bare area of the liver?

Answer 5

The border of the coronary ligaments

Question 6

What is the porta hepatis?

Answer 6

Area where vessels that supply and drain the liver will enter and leave

Question 7

How many lobes is the liver made up of?

Answer 7

Four Right lobeLeft lobeCaudate lobeQuadrate lobe

Question 8

What divides the right and left lobes?

Answer 8

The falciform ligament

Question 9

Where are the different lobes found?

Answer 9

On the anterior surface, the falciform ligament separates the right and left lobe. On the visceral surface, the right lobe is split with the quadrate lobe found anteriorly and inferiorly and the caudate lobe is found posteriorly and superiorly.

Question 10

Where does the hepatic artery originate from?

Answer 10

The proper hepatic artery arises from the common hepatic artery which is a branch of the coeliac trunk.

Question 11

What is the portal triad made up of?

Answer 11

Proper hepatic arteryCommon bile duct Portal vein

Question 12

How does blood enter the liver?

Answer 12

Through the portal venous system from the duodenum

Question 13

Where is the gall bladder found?

Answer 13

In the fossa for the gall bladder on the viseceal surface of the liver

Question 14

How big is the gall bladder?What shape is it?

Answer 14

7-10 cm longPear shaped

Question 15

Describe four characteristics of the gall bladder

Answer 15

– Is made up of three parts – fundus, body and neck– The fundus is surrounded completely by peritoneum, binding is body and neck to the liver– It is attached to the liver via connective tissue of the fibrous capsule of the liver. – The neck of the gall bladder joins the cystic duct

Question 16

What is the biliary tree made up of?

Answer 16

Right and left hepatic ductsCommon hepatic ductCystic duct The common hepatic and the cystic duct join together to form the bile duct. The pancreatic duct joins onto the bile duct just before the ampulla of vater. This then secretes the bile into the duodenum via the ampulla of vater.

Question 17

Where are the four main places that you find gall stones?

Answer 17

In the gall bladderCystic ductCommon bile ductTerminal duct

Question 18

What can gall stones cause in each of the four places?

Answer 18

Gall Bladder - AsymptomatcCystic Duct – Acute CholecystitisCommon Bile Duct – Biliary ObstructionTerminal Duct – Pancreatitis

Question 19

What artery supplies the gall bladder?

Answer 19

Cystic artery

Question 20

Where does the cystic artery arise?

Answer 20

In the triangle between the common hepatic duct, the cystic duct and the visceral surface of the liver.– the cystohepatic triangle

Question 21

What arteries branch to give the cystic artery?

Answer 21

Coeliac trunkCommon hepaticRight hepaticCystic

Question 22

What are the difference in venous drainage in the differing parts of the gall bladder?

Answer 22

Head and fundus – drain into hepatic sinusoids. Neck – flows via the cystic veins either into the liver or though the hepatic portal vein.

Question 23

Where do you find the pancreas?

Answer 23

Lying retroperitoneally, overlying L1 and L2 on the posterior abdominal wall. Found posterior to the stomach and in between the duodenum on the right and the spleen on the left. The transverse colon is found attached to its anterior margin. – Is found in the curve of the duodenum.

Question 24

What are the parts that the pancreas is split up into?

Answer 24

HeadNeckBodyTail

Question 25

Describe the characteristics of the head of the pancreas

Answer 25

Lies in C-curved shape of duodenumSuperior mesenteric vessels are to the left Is just inferior to the transpyloric plane

Question 26

Describe the characteristics of the neck of the pancreas

Answer 26

Overlies superior mesenteric vessels (has a groove on its posterior surface for these)Anterior surface is adjacent to the pylorusThe hepatic portal vein is found posterior to the neck.

Question 27

Describe the characteristics of the body of the pancreas

Answer 27

Lies to left of superior mesenteric vessels, passing over the aorta and L2 vertebraAnt. surface is covered with peritoneum and is part of the stomach bud

Question 28

What is the posterior surface of the body of the pancreas in contact with?

Answer 28

AortaSMALeft suprarenal glandLeft kidney Renal vessels.

Question 29

Where does the tail of the pancreas lie?

Answer 29

Anterior to the left kidney

Question 30

Describe teh characteristics of the tail of the pancreas

Answer 30

Closely related to the splenic hilum and left colic fixtureTail passes between the layers of the splenorenal ligament with the splenic vessels

Question 31

Where is the main pancreatic duct formed?

Answer 31

Begins at the tail of the pancreas running through towards the head. It then turns inferiorly and runs alongside the bile duct until the form the hepatopancretic ampulla of vater

Question 32

What is the ampulla of vater?

Answer 32

Close relation of the main pancreatic duct and bile duct which secrete bile acids and digestive enzymes into the descending part of the duodenum.

Question 33

What is the arterial supply to the spleen?

Answer 33

Splenic artery (larges branch of coeliac trunk)– branches into five at the splenic hilum to supply the different areas of the spleen

Question 34

What is the course of the splenic artery?

Answer 34

Has a tortuous corse posterior to the omental bursa, anterior to the left kidney and along the superior border of the left pancreas.

Question 35

What is the venous drainage to the spleen?

Answer 35

Splenic vein, the inferior mesenteric vein and the superior mesenteric vein forming the hepatic portal vein posterior to the neck of the pancreas.

Question 36

What does the ligamentun teres represent?

Answer 36

The approximation between the right and left lobes of the liver

Question 37

At what level does the coeliac artery arise?

Answer 37

T12Found immediately after the descending thoracic aorta passes through the crura of the diaphragm and its name changes to the abdominal aorta.

Question 38

What are the branches of the coeliac trunk?

Answer 38

Left GastricSplenicCommon Hepatic

Question 39

Descreibe the branching from the Common Hepatic Artery

Answer 39

Branches into the Proper hepatic artery which supplies the liver and the gastroduodenal artery

Question 40

What is the uncinate process?

Answer 40

A projection from the inferior portion of the head of the pancreas.

Question 41

What is the main function of the spleen?

Answer 41

Detects, removes and destroys expended blood cells and broken down platelets. It also recycles globin and iron.

Question 42

What arteries supply the stomach?

Answer 42

Short gastric = fundusLeft gastric = lesser curvatureRight gastroepiploic = greater curvatureGastroduodenalLeft gastroepiploic = left side of greater curvature

Question 43

Which arteries anastamose around the stomach?

Answer 43

Right and left gastric arteriesRight and left epiploic arteries