GI: Anatomy of liver, gall bladder and pancreas

Question 1

Describe the biliary tree

Answer 1

Begins with left and right hepatic ducts which drain bile from the liver
Then there is the common hepatic duct which joins to the cystic duct which is a continuation of the gallbladder
The common hepatic and cystic join to make the common bile duct
This joins with the pancreatic duct which empties into duodenum via major duodenal papilla

Question 2

Whats the blood supply to the pancreas?

Answer 2

The pancreatic branches of the splenic artery
The head is also supplied by the sup and inf pancreaticoduodenal arteries which are branches of the gastroduodenal and superior mesenteric arteries

Question 3

What is the blood supply to the spleen?

Answer 3

The splenic artery which arises from the coeliac trunk

Venous drainage is the splenic vein which combines with superior mesenteric vein to form the hepatic portal vein.

Question 4

What are the ligaments of the liver?

Answer 4

The falciform ligament: attaches anterior liver to anterior abdo wall . The free edge of this ligament contains the ligamentum teres which is a remnant of the umbilical vein. Attaches right and left lobes.
L and R coronary ligaments: attach superior liver to diaphragm
L and R triangular ligaments: attach superior liver to diaphragm

Question 5

What structure helps to suspend the liver in the abdominal cavity?

Answer 5

The liver is secured to the IVC

Question 6

What are the lobes of the liver?

Answer 6

Left, right
Caudate - superior
Quadrate - inferior

Question 7

What is the porta hepatis?

Answer 7

A deep fissure between the caudate and quadrate lobes of the liver which transmits all the vessels, nerves and ducts.

Question 8

What is the bare area of the liver?

Why is it important clinically?

Answer 8

A large triangular surface where there is no peritoneal covering - it is located between the two layers of the coronary ligament.
It is clinically important because it is a site where infection can spread from the abdominal to thoracic cavity.

Question 9

What structures pass through the porta hepatis?

Answer 9

hepatic portal vein 
hepatic artery proper 
Common hepatic duct 
Sympathetic Nerves 
Hepatic branch of the Vagus Nerve

Question 10

What are some serious duodenal ulcer complications?

Answer 10

If the duodenal wall is perforated this can result in peritonitis and erosion of the gastroduodenal artery

Question 11

What are some features that help distinguish the jejunum from the ileum?

Answer 11

The jejunum has thick intestinal wall and ileum has thin
The jejunum has longer vasa recta than ileum
The jejunum has less arterial loops than ileum
The jejunum is red and the ileum is pink

Question 12

What is the blood supply of the small intestine?

Answer 12

Duodenum:
Proximal to major duodenal papilla is the gastroduodenal artery
Distal to major duodenal papilla is the inferior pancreaticoduodenal artery

Jejunum and ileum: superior mesenteric artery

Question 13

What features would allow you to distinguish the large intestine from the small intestine?

Answer 13

The large intestine has omental appendices on its anterior surfaces - pouches of peritoneum filled with fat
The large intestine has 3 strips of muscle called the teniae coli which produce haustra
The large intestine has a much wider diameter

Question 14

What is the blood supply to the large intestine?

Answer 14

The asc colon recieves blood from 2 branches of the superior mesenteric artery
The transverse colon recieves blood from both superior and inferior mesenteric artery
The desc colon is supplied by a single branch of the inferior mesenteric artery