GA - Mihaila - Liver & Biliary System - 2/16 Flashcards

1
Q

Describe the peritoneal structures related with the liver

A
  • falciform lig.
  • Ligamentum teres
  • Ligamentum venosum
  • Coronary ligaments
  • Triangular ligaments
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2
Q

The portion of the liver that contacts the undersurface of the diaphragm and that has no peritoneum, is called __

A

bare area

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3
Q

The visceral peritoneum of the liver is connected to the stomach by the __1__ formed by the __2__ and the __3__ ligaments. The visceral peritoneum of the liver is attached to the anterior body wall by the __4__ ligament

A
  1. lesser omentum
  2. hepatogastric
  3. hepatoduodenal
  4. falciform
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4
Q

Vestiges of the embryonic circulatory system that are found in the adult liver include __1__ and __2__

A
  1. ligamentum venosum

2. ligamentum terres

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5
Q

What is an anatomic liver lobe? And a functional liver lobe? How many of each do most of us have?

A

We have 4 anatomic lobes, regions of the liver delineated by specific anatomical landmarks (falciform ligament demarcates right and left anatomical lobe, on diaphragmatic surface; gallbladder fossa, fossa for IVC, ligamentum venosum and ligamentum terres separate caudate and quadrate lobes from right and left lobes, on visceral surface). We have 2 functional lobes, determined by the branching of the hepatic portal triad.

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6
Q

How does the location of a normal infant’s liver differ from a normal adult’s liver? What is the significance of an adult liver that extends below the rib cage more than 4cm?

A

A normal infant liver DOES extend below the margin of the rib-cage. Normal livers in adults DO NOT extend below the costal margin. A liver that can be palpated 4cm below this costal margin is abnormally enlarged, and indicative of liver pathology.

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7
Q

What is the porta hepatis? What are the components of the liver triad? What does each of these components carry?

A

Porta hepatis = door to the liver, located on the visceral surface. Its components include the hepatic portal vein (carries nutrient-rich and toxin- rich blood TO the liver), proper hepatic artery (carries well-oxygenated arterial blood TO the liver) and common hepatic duct (carries bile AWAY from the liver).

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8
Q

What is a portal system? If venous blood flow through the liver is impeded, portal vein pressure increases and blood may be rerouted to the heart via porto-caval anastomosis. Name 3 such connections. What symptoms would indicate that these channels are being used?

A

A portal system is a blood vessel system in which a vessel carries blood between TWO CAPILLARY BEDS before routing that blood to the heart.

a. Azygos v. (caval) - lower esophageal & short gastric veins (portal) = esophageal varices & ascites
b. Sup.hemorrhoidal veins (portal) -middle and/or inferior rectal veins (caval) = hemorrhoids & ascites
c. Paraumbilical veins (portal) – superficial, superior and inferior epigastric veins (caval) = caput medusa & ascites
d. Right and left colic veins (portal)–retroperitoneal parietal veins (caval) = retroperitoneal hemorrhages & ascites

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9
Q

Both biliary and pancreatic secretions empty into the __1__, via the __2__

A
  1. 2nd part of the duodenum

2. ampulla of Vater

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10
Q

Describe the origin and course of the common bile duct and the major pancreatic duct.

A

Common Bile Duct: right and left hepatic ducts – common hepatic duct; common hepatic duct + cystic duct (from gallbladder) = common bile duct; CBD empties into ampulla of Vater, and (via sphincter of Oddi) into 2nd part of duodenum.
Major Pancreatic Duct: empties into ampulla of Vater, together with common bile duct; ultimately drains into 2nd part od duodenum, just like CBD.

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