GI Tract Organs III Flashcards
The spleen performs what role in adults?
serve as a large lymph organ (WBC/antigen interactions) and remove RBCs
What are the four surfaces of the spleen?
- diaphragmatic
- gastric
- colic
- renal
Is the spleen intra or retroperitoneal?
intraperitoneal
The splenic artery and vein run within what structure?
the splenorenal ligament
The short gastric vessels run within what structure?
the gastrosplenic ligament
What other abdominal organ lies near the splenic hilum?
the pancreatic tail
The spleen is served by what artery?
the splenic artery
The splenic artery originates from what greater vessel?
the celiac trunk
How can you tell the splenic artery from the splenic vein?
the artery is more tortous and usually sits anterior to the vein
The splenic artery supplies what organs?
the spleen, pancreas, and stomach
The splenic vein empties into what structure?
the hepatic portal vein
A slight rupture of the spleen will cause pain where?
in the epigastric region and in the left flank
What is Kehr’s sign?
a sharp pain in the left shoulder due to splenic rupture and blood contacting the undersurface of the diaphragm
Describe the pain associated with splenic rupture.
- possible Kehr’s sign if severe enough
- primarily epigastric and in the left flank
- worsens when patient lies down and legs are elevated
Name a few causes of splenomegaly.
- portal hypertension
- leukemia/lymphoma
- mono
How does the Kehr’s sign develop?
blood from splenic rupture releases WBCs which then release cytokines that irritate the diaphragm and generate referred pain in the upper left shoulder
When doing a spleen needle biopsy, be careful not to pass the needle through what?
the costodiaphragmatic recess, which will likely cause a pneumothorax or pleuritis
Is the pancreas intra or retroperitoneal?
retroperitoneal
What are the divisions of the pancreas?
- head
- neck
- body
- tail
The pancreas runs in line with what plane of the abdomen?
the transpyloric plane
The transpyloric plane sits at what vertebral level?
L1
What mesentery runs along the inferior edge of the pancreas?
the transverse mesocolon
The head of the pancreas is defined by what structure?
it is everything to the right of the SMA and SMV
The neck of the pancreas is defined by what structure?
it is everything that sits anterior to the SMA and SMV
What is the uncinate process of the pancreas?
the portion of the head that sits immediately posterior to the SMA and SMV
The pancreatic duct joins what other duct before entering the small intestine?
the common bile duct
The common bile duct and pancreatic duct merge and form what structure?
the Ampulla of Vater (hepatopancreatic ampulla)
What three sphincters control flow through the pancreatic and bile ducts?
- sphincter of the common bile duct
- sphincter of the pancreatic duct
- sphincter of Oddi/hepatopancreatic duct
What enters the duodenum through the minor duodenal papilla?
an accessory pancreatic duct if present
Is the major pancreatic duct cranial or cuadal to the minor pancreatic duct?
caudal
The pancreas is served by what arteries?
- splenic
- gastroduodenal
- SMA
The pancreas is served by what veins?
- splenic
- SMV
The lymphatics that supply the pancreas drain to what lymph nodes?
celiac and superior mesenteric
What sympathetic nerves innervate the pancreas?
the great thoracic spanchnic nerve (T5-T9)
The liver runs between what ribs, anteriorly?
5th (right nipple) to costal margin
The liver runs between what ribs, posteriorly?
9th to 12th
The largest surface of the liver is the ____.
diaphragmatic surface
Which surface of the liver isn’t covered by peritoneum posteriorly?
the diaphragmatic surface
The falciform ligament does what?
holds the liver to the anterior abdominal wall
The coronary ligament does what?
suspends the liver from the diaphragm
The coronary ligament is created by what?
a reflection of the parietal peritoneum
Where are teh right and left triangular ligaments?
at the lateral ends of the coronary ligament
Where is the subphrenic recess?
the recess between the anterior abdominal wall and anterior surface of the liver
What is the portal hepatis?
a fissure in the inferior surface of the liver through which neurovascular structures enter the liver
The portal hepatis is bordered on the left and right by what?
the right and left sagittal fissure
Where is the right sagittal fissure?
from the fossa of the gallbladder to the groove of the IVC
Where is the left sagittal fissure?
from the ligamentum teres to the ligamentum venosum
What structures run through the hepatoduodenal ligament?
the renal artery and portal vein as well as the bile duct
In which order and pattern do the portal triad structures run in the hepatoduodenal ligament?
- the bile duct anterior and lateral
- the artery anterior and medial
- the vein posteriorly
What divides the right and left lobes of the liver?
the falciform ligament and left sagittal fissure
The porta hepatis divides what liver lobes?
the quadrate and caudate
What are the four non-functional liver lobes?
- right
- left
- quadrate
- caudate
The functional subdivisions of the liver are made based on what?
the divisions of the portal triad
Functionally, the left and right lobes of the liver are divided by what?
the gallbladder bed and IVC
The quadrate and caudate lobes of the liver functionally belong to which side?
the left
How many hepatic veins leave the liver and drain into the IVC?
three
Where should your needle enter for a liver biopsy?
below the 10th intercostal space and at the mid-axillary line
Describe the order of vessels through while bile flows, beginning with bile canaliculi.
- bile canaliculi
- intralobular ducts
- periportal ducts
- bile ducts
- left/right hepatic duct
- common hepatic duct
- common bile duct
What differentiates the common hepatic duct from the common bile duct?
the connection of the gall bladder
What are the divisions of the gall bladder?
head, neck, and body
The gall bladder is connected to the common bile duct by what?
the cystic duct
Which population is most affected by gall stones?
older women
What is a biliary colic gall stone?
one lodged in the cystic duct
