GI accessory organs

Question 1

largest gland in the body.

location-9

function-5 main ones

Answer 1

the liver

1. Right hypochondrium and epigastric regions and left hypochondrium
2. recieves all nutrientts absorbed by the alimentary tract except lipids

functions

1. production of bile, which emulsifies fat to facilitate digestion- main
2. storage of glycogen
3. detoxification
4. synthesis of albumen,
   
   1. which maintains plasma
5. synthesis of clotting factors

Question 2

list the two surfaces seperated by the sharp inferior borders

Answer 2

1. diaphragmatic surface
   
   1. facing the inferior surface of the diaphragm
2. visceral surface
   
   1. related to other abdominal organs
   2. protected

Question 3

list the recesses of the diaphragmatic surface, importantfeatures

Answer 3

1. subphrenic recess
   
   1. separates the diaphragmatic surface from the diaphragm
2. hepatorenal recess
   
   1. between the liver and right kidney and the right suprarenal gland

Question 4

visceral surface of the liver

Answer 4

1. covered by visceral peritoneum
   
   1. except
      
      1. in the fossa for gall bladder
      2. porta hepattis
2. structures associated
   
   1. esophagus
   2. R.anterior stomach
   3. superior portion of duodenum
   4. gall bladder
   5. right colic flexure
   6. transverse colon
   7. right kidney/adrenal gland

Question 5

list the ligaments of the liver

Answer 5

1. falciform ligament
2. hepatoduodenal ligament
3. hepatogastric ligament
4. r/l triangular ligaments
5. a/p coronary ligaments

Question 6

Describe the bare area of the liver

Answer 6

1. location
   
   1. diaphragmattic surface, no intervening peritoneum between the liver and diaphragm and the liver is in direct contact with the diaphragm
2. boundaries
   
   1. anterior boundry
      
      1. reflection of peritoneum-anterior coronary ligament
   2. posterior boundary
      
      1. reflection of peritoneum-posterior coronary ligament
   3. laterally
      
      1. where coronary ligaments come together to form R/L triragular ligaments

Question 7

describe the lobes of the liver

Answer 7

1. two functional lobes
   
   1. sagittal plane passing throug hteh gallbladder and inferior vena cava
   2. each lobe reveives its own branch of the
      
      1. hepatic artery
      2. portal vein
      3. and drained by its own hepatic duct
   3. when these structures meet they form the portal triad
2. two smaller lobes
   
   1. Quadrate lobe
      
      1. visible on anterior part of visceral surface
      2. bounded on left side by fissure for ligamentum teres and on the right by fossa for gall bladder
   2. cuadate
      
      1. visisble on the posterior aspect of the visceral surface of the liver
      2. bounded on the left side by fissure for the ligamentum venosum and on the right side by the groove for IVC

Question 8

describe the structure generated from the two lobes of the liver with the vessels, include the content.

Answer 8

portal triad

1. hepatic artery
   
   1. carries arterial blood to the liver
2. hepatic portal vein
   
   1. carries venous blood away from liver
   2. contains absorbed nutrients from the GI tract to the liver
3. hepatic bile duct

enters the visceral surface of the liver at the transverse fissure, the porta hepatis

Question 9

explain the process of cirrhosis of the liver

Answer 9

liver= primary detoxification site

1. toxins or viruses may cause damage
2. tissue death leads to replacement by fibrous connective tissue (fibrosis), inhibiting function of the liver
3. chronic alcoholism, hepatitis B and C

Question 10

list the super anatomy of the gallbladder

Answer 10

1. fundus
   
   1. blunt end that projects from the inferior border of the liver
   2. tip of right 9th costal cartilage
2. body
   
   1. main portion
3. neck
   
   1. narrow tapering that usually makes an S-shaped turning in to the cystic duct

Question 11

list three consequences of gall stones discussed in class

Answer 11

1. cholecystitis
   
   1. obstruct the bile passage->inflammation of the gallbladder
2. fistula
   
   1. opening may develop into the superior part of the duodenum
3. gallstone ileus
   
   1. obstruction at the ileocecal junction

Question 12

list the flow of bile from the liver

Answer 12

1. left and right hepatic ducts
2. common hepatic duct
   
   1. joined by the cycstic duct
3. hepatopancreatic ampulla
4. major duodenal papilla

Question 13

describe the sections of the pancreas

Answer 13

1. head
   
   1. c shaped concavity
2. uncinate process
   
   1. passes behind the superior mesenteric vessels
3. neck
   
   1. pancreas overlyins the superior mesenteric artery and vein
4. body
   
   1. longest part
5. tail
   
   1. portion closely related to the spleen

Question 14

describe the flow of content from the pancerease to the duodenum

Answer 14

1. pancreatic duct
   
   1. begins in the tail and runs through the body, neck and head
   2. splits, this goes down and joins the common bile duct at the hepatopancreatic ampulla
   3. drains into the major duodenal papilla
2. accessory pancreatic duct
   
   1. drains part of the head of the pacreas into the minor duodenal papilla

Question 15

what is the consequence of a gallstone becoming lodged in the major duodenal ampulla?

Answer 15

painless jaundice

must be differentiated from pancreatic cancer

Question 16

what is the location of the spleen?

what are the important attachments?

what is the peritoneum and where with repsect to the spleen?

Answer 16

• lies against the diaphragm
  
  • rib 9-10
  • left hypochondrium
  • left upper quadrant
• connected to
  
  • greater curvature of stomach by gastrosplenic ligament
  • left kidney by splenorenal ligament
• spleen is surrounded by visceral peritoneum except at the area of hilium on the medial surface of spleen