GI anatomy

Question 1

name the 4 liver lobules

Answer 1

left, right, caudate, quadrate

Question 2

how many functional segments of the liver are there?

Answer 2

8

I, II, III, IVa, IVb, V, VI ,VII, VIII

Question 3

venous drainage of the liver?

Answer 3

left middle and right hepatic veins all drain into the IVC

Question 4

arterial blood supply to the liver

Answer 4

DUAL supply
portal vein (80%) and hepatic artery (20%)

Question 5

where does the proper hepatic artery come from?

Answer 5

coeliac trunk -> common hepatic (gives off gastroduodenal artery) to become proper hepatic artery

Question 6

purpose of the falciform ligament?

Answer 6

connect the anterior surface of the liver to the abdominal wall. It is not an embryological remnant

Question 7

what is the ligamentum teres hepatis (round ligament) and where is it located?

Answer 7

round ligament is a remnant of the ductus venosis and is located on the free edge of the falciform ligament

Question 8

left triangular ligament?

Answer 8

on the posterior surface of the liver, a mix of lesser omentum and falciform ligament

Question 9

coronary ligament?

Answer 9

attaches the liver to the diaphragm

Question 10

name the main 4 ligaments of the liver?

Answer 10

coronary, falciform, ligamentum teres (round ligament), left triangular ligament

Question 11

contents of the portal triad?

Answer 11

portal vein (branch), hepatic artery (branch) and bile duct

all enter the liver via porta hepatis

Question 12

bile is made in the ___ and stored in the ___?

Answer 12

bile is made in the liver and stored in the gall bladder

Question 13

why does liver pain present as shoulder tip pain?

Answer 13

referred pain! liver inflammation can irritate the overlaying diaphragm (C3,4,5) and present as right shoulder tip pain (supraclavicular nerve C3, 4)

Question 14

where in the abdomen in the liver located?

Answer 14

RUQ

Question 15

where does the coeliac trunk branch from the aorta and what are its three branches?

Answer 15

T12

left gastric, splenic and common hepatic arteries

Question 16

which vessel supplies most of the arterial blood to the liver?

Answer 16

hepatic portal vein (80%) from gastruduodenal ligament in the lesser omentum.

Question 17

which arteries anastamose on the greater curvature of the stomach to form the gastro-omental artery?

Answer 17

left gastric and gastroduodenal

Question 18

at which vertebral level does the coeliac trunk branch off the descending aorta?

Answer 18

T12

Question 19

the coeliac artery supplies the ___gut organs. name these?

Answer 19

oesophagus, stomach to the first half of the duodenum, half of the pancreas, the gall bladder and liver.

visceral afferents enter at T6-T8

Question 20

the SMA supplies organs of the ___gut. name these?

where does SMA branch off the abdominal aorta?

Answer 20

branches off aorta at: L1-L2

1/2 of duodenum, 1/2, of pancreas, small intestine to the proximal 2/3rds of the transverse colon

visceral afferents enter at T9-12

Question 21

the IMA supplies organs of the ___gut. name these organs?

where does it branch off aorta?

Answer 21

branches off aorta at: L3

distal 1/3rd of transverse colon to the anal canal

visceral afferents enter at T12-L2

Question 22

draw the hepatic triangle of calot

Answer 22

inferior border of liver
cystic duct
common hepatic duct

cystic artery in the middle

Question 23

name the blood supply to the gall bladder?

Answer 23

cystic artery - a branch from the right hepatic artery

Question 24

bile is released into the duodenum via the ____?

Answer 24

spinchter of oddi relaxes and allowed digestive juices to flow to the duodenum via the ampulla of vatar

Question 25

what are the two potential spaces in the greater sac of the peritoneal cavity?

Answer 25

• hepatorenal recess (morrisons pouch): lowest part of the peritoneal cavity when patient in supine
• subphrenic recess: between diaphragm and superior border of the liver

Question 26

what vertebral level does the thoracic aorta become the abdominal aorta?

Answer 26

diaphragmatic level

T12-L4

Question 27

what vertebral level does the the abdominal aorta bifurcate into the common iliacs?

Answer 27

L4