GI Tract Organs III

Question 1

The spleen performs what role in adults?

Answer 1

serve as a large lymph organ (WBC/antigen interactions) and remove RBCs

Question 2

What are the four surfaces of the spleen?

Answer 2

• diaphragmatic
• gastric
• colic
• renal

Question 3

Is the spleen intra or retroperitoneal?

Answer 3

intraperitoneal

Question 4

The splenic artery and vein run within what structure?

Answer 4

the splenorenal ligament

Question 5

The short gastric vessels run within what structure?

Answer 5

the gastrosplenic ligament

Question 6

What other abdominal organ lies near the splenic hilum?

Answer 6

the pancreatic tail

Question 7

The spleen is served by what artery?

Answer 7

the splenic artery

Question 8

The splenic artery originates from what greater vessel?

Answer 8

the celiac trunk

Question 9

How can you tell the splenic artery from the splenic vein?

Answer 9

the artery is more tortous and usually sits anterior to the vein

Question 10

The splenic artery supplies what organs?

Answer 10

the spleen, pancreas, and stomach

Question 11

The splenic vein empties into what structure?

Answer 11

the hepatic portal vein

Question 12

A slight rupture of the spleen will cause pain where?

Answer 12

in the epigastric region and in the left flank

Question 13

What is Kehr’s sign?

Answer 13

a sharp pain in the left shoulder due to splenic rupture and blood contacting the undersurface of the diaphragm

Question 14

Describe the pain associated with splenic rupture.

Answer 14

• possible Kehr’s sign if severe enough
• primarily epigastric and in the left flank
• worsens when patient lies down and legs are elevated

Question 15

Name a few causes of splenomegaly.

Answer 15

• portal hypertension
• leukemia/lymphoma
• mono

Question 16

How does the Kehr’s sign develop?

Answer 16

blood from splenic rupture releases WBCs which then release cytokines that irritate the diaphragm and generate referred pain in the upper left shoulder

Question 17

When doing a spleen needle biopsy, be careful not to pass the needle through what?

Answer 17

the costodiaphragmatic recess, which will likely cause a pneumothorax or pleuritis

Question 18

Is the pancreas intra or retroperitoneal?

Answer 18

retroperitoneal

Question 19

What are the divisions of the pancreas?

Answer 19

• head
• neck
• body
• tail

Question 20

The pancreas runs in line with what plane of the abdomen?

Answer 20

the transpyloric plane

Question 21

The transpyloric plane sits at what vertebral level?

Answer 21

L1

Question 22

What mesentery runs along the inferior edge of the pancreas?

Answer 22

the transverse mesocolon

Question 23

The head of the pancreas is defined by what structure?

Answer 23

it is everything to the right of the SMA and SMV

Question 24

The neck of the pancreas is defined by what structure?

Answer 24

it is everything that sits anterior to the SMA and SMV

Question 25

What is the uncinate process of the pancreas?

Answer 25

the portion of the head that sits immediately posterior to the SMA and SMV

Question 26

The pancreatic duct joins what other duct before entering the small intestine?

Answer 26

the common bile duct

Question 27

The common bile duct and pancreatic duct merge and form what structure?

Answer 27

the Ampulla of Vater (hepatopancreatic ampulla)

Question 28

What three sphincters control flow through the pancreatic and bile ducts?

Answer 28

- sphincter of the common bile duct - sphincter of the pancreatic duct - sphincter of Oddi/hepatopancreatic duct

Question 29

What enters the duodenum through the minor duodenal papilla?

Answer 29

an accessory pancreatic duct if present

Question 30

Is the major pancreatic duct cranial or cuadal to the minor pancreatic duct?

Answer 30

caudal

Question 31

The pancreas is served by what arteries?

Answer 31

- splenic - gastroduodenal - SMA

Question 32

The pancreas is served by what veins?

Answer 32

- splenic | - SMV

Question 33

The lymphatics that supply the pancreas drain to what lymph nodes?

Answer 33

celiac and superior mesenteric

Question 34

What sympathetic nerves innervate the pancreas?

Answer 34

the great thoracic spanchnic nerve (T5-T9)

Question 35

The liver runs between what ribs, anteriorly?

Answer 35

5th (right nipple) to costal margin

Question 36

The liver runs between what ribs, posteriorly?

Answer 36

9th to 12th

Question 37

The largest surface of the liver is the ____.

Answer 37

diaphragmatic surface

Question 38

Which surface of the liver isn't covered by peritoneum posteriorly?

Answer 38

the diaphragmatic surface

Question 39

The falciform ligament does what?

Answer 39

holds the liver to the anterior abdominal wall

Question 40

The coronary ligament does what?

Answer 40

suspends the liver from the diaphragm

Question 41

The coronary ligament is created by what?

Answer 41

a reflection of the parietal peritoneum

Question 42

Where are teh right and left triangular ligaments?

Answer 42

at the lateral ends of the coronary ligament

Question 43

Where is the subphrenic recess?

Answer 43

the recess between the anterior abdominal wall and anterior surface of the liver

Question 44

What is the portal hepatis?

Answer 44

a fissure in the inferior surface of the liver through which neurovascular structures enter the liver

Question 45

The portal hepatis is bordered on the left and right by what?

Answer 45

the right and left sagittal fissure

Question 46

Where is the right sagittal fissure?

Answer 46

from the fossa of the gallbladder to the groove of the IVC

Question 47

Where is the left sagittal fissure?

Answer 47

from the ligamentum teres to the ligamentum venosum

Question 48

What structures run through the hepatoduodenal ligament?

Answer 48

the renal artery and portal vein as well as the bile duct

Question 49

In which order and pattern do the portal triad structures run in the hepatoduodenal ligament?

Answer 49

- the bile duct anterior and lateral - the artery anterior and medial - the vein posteriorly

Question 50

What divides the right and left lobes of the liver?

Answer 50

the falciform ligament and left sagittal fissure

Question 51

The porta hepatis divides what liver lobes?

Answer 51

the quadrate and caudate

Question 52

What are the four non-functional liver lobes?

Answer 52

- right - left - quadrate - caudate

Question 53

The functional subdivisions of the liver are made based on what?

Answer 53

the divisions of the portal triad

Question 54

Functionally, the left and right lobes of the liver are divided by what?

Answer 54

the gallbladder bed and IVC

Question 55

The quadrate and caudate lobes of the liver functionally belong to which side?

Answer 55

the left

Question 56

How many hepatic veins leave the liver and drain into the IVC?

Answer 56

three

Question 57

Where should your needle enter for a liver biopsy?

Answer 57

below the 10th intercostal space and at the mid-axillary line

Question 58

Describe the order of vessels through while bile flows, beginning with bile canaliculi.

Answer 58

- bile canaliculi - intralobular ducts - periportal ducts - bile ducts - left/right hepatic duct - common hepatic duct - common bile duct

Question 59

What differentiates the common hepatic duct from the common bile duct?

Answer 59

the connection of the gall bladder

Question 60

What are the divisions of the gall bladder?

Answer 60

head, neck, and body

Question 61

The gall bladder is connected to the common bile duct by what?

Answer 61

the cystic duct

Question 62

Which population is most affected by gall stones?

Answer 62

older women

Question 63

What is a biliary colic gall stone?

Answer 63

one lodged in the cystic duct