GI Anatomy - Jaundice Flashcards

1
Q

The liver, spell, gallbladder, pancreas and small intestine all produce?

A

Bilirubin and bile

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2
Q

What is bilirubin?

A

Normal by-product of the breakdown of red blood cells

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3
Q

What is jaundice (icterus)?

A

Yellowing of the sclera and skin caused by an increase in blood levels of bilirubin

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4
Q

Where does RBC breakdown mainly occur?

A

In the spleen

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5
Q

Bilirubin is used to form ___ in the liver

A

Bile

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6
Q

Bile is important for?

A

the normal absorption of fats from the SI

Contributes to pancreatic enzymes in digesting food in the SI

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7
Q

What is the function of the liver?

A

Glycogen storage
Bile secretion
Other metabolic functions

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8
Q

What is the surface anatomy of the liver?

A

Mainly located in the RUQ

Protected by ribs 7-11

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9
Q

What happens to the position of the liver during inspiration?

A

Lowers down

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10
Q

The liver is inferior to?

A

The right hemiödiaphragm

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11
Q

How is the gallbladder anatomically related to the liver?

A

It is posterior and inferior to the liver

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12
Q

The hepatic flexure is _____ to the liver

A

inferior

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13
Q

The right kidney, adrenal gland, IVC and abdominal aorta are _____ to the liver

A

posterior

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14
Q

The stomach is ______ at the ______ side of the liver

A

posterior

mid-left

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15
Q

What are the 4 anatomical lobes of the liver?

A

Right lobe
Left lobe
Caudate lobe (superior)
Quadrate lobe (inferior)

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16
Q

Which of the lung lobes contains a bare area?

A

Quadrate lobe

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17
Q

What is meant by a “bare area”?

A

Not touched by any peritoneum = pure liver parenchyma

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18
Q

What is the falciform ligament?

A

A remnant of ventral mesentary

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19
Q

What is the round ligament?

A

A remnant of the umbilical vein

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20
Q

The porta hepatis is closely associated with the gallbladder at _______ aspect

A

posterior

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21
Q

How many functional divisions of the liver are there?

A

8

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22
Q

Why can individual functional lobes be removed from the liver?

A

Because each lobe has a branch of the hepatic artery, hepatic portal vein and bile drainage (to bile duct) and venous drainage (to IVC)

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23
Q

The haptic veins directing deoxygenated blood from the liver come tiger as _ veins before entering the IVC

A

3

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24
Q

What does the portal triad contain?

A

Hepatic portal vein
Hepatic artery proper
Bile duct

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25
The portal triad runs within which ligament?
The hepato-duodenal ligament
26
The coequal trunk is the ___ midline branch of the aorta
first
27
Is the coeliac trunk intra or retroperitoneal?
Retroperitoneal
28
Where does the coeliac trunk leave the abdominal aorta?
T12
29
The coeliac trunk trifurcates into?
splenic artery Left gastric artery Common hepatic artery
30
The common hepatic artery branches into? then becomes?
Gastroduodenal artery | Hepatic artery proper
31
The splenic artery has a _______ course along the _____ border of the pancreas
torturous | superior
32
Is the spleen intra- or retroperitoneal?
Intraperitoneal
33
Where is the spleen?
Left hypochondrium
34
What are the anatomical relations of the spleen?
Diaphragm posteriorly Stomach anteriorly Splenic flexure inferably Left kidney medially
35
Major blood supply to the stomach comes from?
the right and left gastric arteries and right and left gastro-mental arteries
36
Where do the right and left gastric arteries anastomose?
Along the junction of the lesser curvature and lesser momentum of the stomach
37
Where do the right and left gastro-mental arteries anastomose?
Along the junction of the greater omentum and greater curvature of the stomach
38
Blood supply to the liver comes from?
Right and left hepatic arteries
39
The right and left hepatic arteries are branches of?
the hepatic artery proper
40
Histologically, the liver consists of?
Hexagonal iver lobules with a central vein at the centre and an interlobular portal triad at each corner
41
What does the interlobular portal triad consist of?
Branch of the HPV, branch of HA and biliary duct
42
Both the hepatoreanl recess (Morrison's pouch) and the sub-phrenic recess are located within the?
Peritoneal cavity
43
The hepatorenal recess is one of the lowest parts of the peritoneal cavity when the patient is?
Supine
44
Pus in the sub-phrenic recess can drain into the _____ when the patient is bedridden
subphrenic
45
The HPV drain blood from where into the liver for 1st pass metabolism
Fore, mid and hangout
46
The HPV is formed by?
the splenic and superior mesenteric vein
47
THE IVC is retroperitoneal and drained cleaned blood from the ________ into the right atrium
Hepatic veins
48
Anatomically how are the portal triad structures arranged anterior to posterior?
Bile duct HAP HPV
49
What is the function of the gallbladder?
Store and concentrate bile between meals
50
The gallbladder lies on the ______ aspect of the liver (often firmly attached) and ____ to the duodenum
posterior | anterior
51
Bile flows in and out of the gall bladder via?
The cystic duct
52
Blood supply to the gall bladder comes from the?
Cystic artery
53
In 75% of people the cystic artery is a branch of the?
right hepatic artery
54
The right cystic artery is located in the?
Cystohepatic triangle (of Calot)
55
What makes up the triangle of Calot (aka cystohepatic triangle)
Liver boarder Common hepatic duct Cystic duct
56
Inflammation of the gallbladder/cystic duct can follow irritation from or impaction of a?
gallstone
57
The gall bladder is part of the ____-gut?
foregut
58
Visceral afferents from the gall bladder enter the spinal cord at?
T6-T9
59
Early pain from cholyangitis will develop in the ______
epigastrium
60
Where can pain from cholyangitis arise besides the epigastrium?
Hypochondrium +/- pain referral to the right shoulder as a result of anterior diaphragmatic irritation
61
What is a cholecystectomy?
Surgical removal of the gallbladder
62
What are the parts of the pancreas?
Head Neck Body Tail
63
The head of the pancreas is surrounded by?
C-shaped curve of the duodenum
64
What are the 4 parts of the duodenum? For each of these parts state whether they are intra- or retroperitoneal.
Superior (intra) with duodenal cap Descending (retro) Horizontal (retro) Ascending (retro)
65
What is the end of the duodenum?
Duodenojejunal flexure
66
The duodenum secretes _____ and ______ into the blood
gastrin | CCK
67
Pain from duodenal ulcers to to present in which region?
Epigastric
68
What is found posterior to the pancreas?
``` Right kidney and adrenal gland IVC Bilde duct Abdominal aorta Superior mesenteric vessels (start at head of pancreas) Left kidney and adrenal gland Part of portal venous system ```
69
What is found anterior to the pancreas?
Stomach
70
What is found superoposteriorly to the pancreas?
Splenic vessels
71
What are the exocrine functions of the pancreas?
Acinar cells release digestive enzymes into the pancreatic duct
72
What are the endocrine functions of the pancreas?
Islets of Langerhans secrete insulin and glucagon into the blood stream
73
The bile duct travels _____ to the superior part of the duodenum to a grove in the posterior aspect of the ____ where it joins with pancreatic duct to form the?
posterior pancreas Ampulla of Vader/Hepatopancreatic ampulla
74
The ampulla of Vater/hepatopancreatic ampulla drains into the duodenum via?
the major duodenal papila
75
It is possible to have accessory pathways of the pancreatic duct into the duodenum via?
Minor duodenal papillae
76
Where are the 3 points of flow control of bile?
Bile duct sphincter Pancreatic duct sphincter Sphincter of Oddi
77
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography
78
What is ERC used for?
To study the pancreas and biliary tree
79
Jaundice is caused by?
Increased levels of bilirubin in the blood
80
What are extra-hepatic causes of jaundice?
Obstruction of the biliary tree (gallstones/carcinoma) leading to back-up of bile to the liver and overspill in theblood
81
Blockage of the ampulla can causes bile to be diverted into the pancreas leading to?
Pancreatitis
82
Where is pancreatitis pain felt?
Epigastric and umbilical region | + Patietn's back
83
Acute pancreatitis can be caused by?
Gall stone obstruction leading to reflux of bile and pancreatic juice into the main pancreatic duct
84
What is Grey-Turner's and Cullen's sign of acute pancreatitis? What is the cause?
Vascular haemorrhage can cause blood accumulation in the retroperitoneal space Grey-Turner's sign = right +/- left flank Cullen's sign = around umbilicaus via falciform ligament
85
Where does the jejunum begin?
At the duodenaljejunal flexure
86
Where does the ileum end?
At the ileocaecal junction
87
Which, of the jejunum and ileum, is thicker and heavier?
Jejunum
88
Which, of the jejunum and ileum, has more fat?
Ileum
89
Which, of the jejunum and ileum, is more vascular?
Jejunum
90
Which, of the jejunum and ileum, has sparse folds?
Ileum
91
Which, of the jejunum and ileum, contains Peyer's Patches?
Ileum
92
What is the arterial supply to the jejunum/ileum?
SMA via ileal and jejunal arteries
93
Where does the SMA leave the aorta?
L1
94
What drains the jejunum/ileum?
Jejunal/ileal veins
95
The jejunum/ileal veins drain into the?
SMV
96
The SMV drains into the?
HPV
97
The vascular supply to the jejunum and ileum travels within the?
mesentery
98
The SMA and SMV are located ____ to the neck of the pancreas
posterior
99
The SMA and SMV travel ________ to the uncinate process to enter the mesentery proper
anteroinferior
100
Fat digestion is aided by _______. With chylomicrons they are absorbed into specialised lymphatic vessels in the SI called?
bile | lacteals
101
Lacteals travel through lymphatics and enter the venous system at?
Left venous angle
102
Lymph vessels tend to travel alongside?
Arteries