GI - Why might my patient be jaundiced? Flashcards

1
Q

The Portal Triad consists of:

A

Hepatic Artery
Hepatic Portal Vein
Common bile duct

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2
Q

The portal triad is found in the..

A

…FREE EDGE of the LESSER OMENTUM.

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3
Q

Bilirubin is a product of the breakdown of..

A

… red blood cells.

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4
Q

The breakdown of red blood cells usually occurs in:

A

The spleen.

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5
Q

Bilirubin is used to form:

A

Bile.

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6
Q

The formation of bile, from bilirubin, occurs in the:

A

Liver.

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7
Q

Bile is stored and concentrated in the:

A

Gallbladder.

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8
Q

The pancreas excretes digestive enzymes into the:

A

2nd part of the duodenum.

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9
Q

What 3 branches trifurcate from the celiac trunk?

A

Splenic artery
Hepatic artery
Left gastric artery

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10
Q

The spleen is protected by which ribs?

A

Ribs 9-11

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11
Q

Where does the liver’s blood supply come from?

A

The hepatic artery
(Branches into right and left hepatic arteries)
Plus Hepatic Portal Vein!
(most of blood supplied by hepatic portal vein)

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12
Q

Which ribs protect the liver?

A

Ribs 7-11

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13
Q

What are the 4 anatomical segments of the liver?

A

Right lobe
Left lobe
Caudate lobe
Quadrate lobe

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14
Q

What supplies each functional segment (e.g. V) of the liver with blood?

A

Hepatic artery
Hepatic portal vein
Hepatic (bile) duct

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15
Q

Which of the following supplies the liver segments with blood?
Hepatic Vein
Hepatic Portal Vein

A

Hepatic Portal Vein

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16
Q

Which of the following drains blood from the liver segments?
Hepatic Vein
Hepatic Portal Vein

A

Hepatic Vein

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17
Q

Liver lobules contain:

A

A central vein in middle and an interlobular portal triad at each corner.

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18
Q

What does the “central vein” in a liver lobule do?

A

Collects “cleaned” blood and drains it into the hepatic veins.

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19
Q

What is a hepatocyte?

A

A liver cell.

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20
Q

Where does the bile that is formed in hepatocytes drain to (within the liver lobule)?

A

The bilary duct.

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21
Q

What 2 areas of the peritoneal cavity are clinically related to the liver?

A
Hepatorenal recess (Morison's pouch)
Sub-phrenic recess

(These are both within the greater sac)

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22
Q

How does peritonitis lead to an abscess formation?

A

Peritonitis can result in a collection of pus in the recesses (hepatorenal and sub-phrenic), leading to an abscess formation.

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23
Q

When may a hepatorenal recess abscess be likely to form.?

A

When the patient is bedridden.
When the patient is supine.
(Because the Hepatorenal recess is one of the lowest parts of the peritoneal cavity when the patient is supine).

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24
Q

Where does the hepatic portal vein drain blood from.

A

The foregut, midgut and hindgut. (To the liver, for cleaning)

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25
Q

The splenic vein drains blood from the _______ to the _______.

A

The splenic vein drains blood from the foregut to the hepatic portal vein.

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26
Q

The inferior mesenteric vein drains blood from the ______ to the _________.

A

The inferior mesenteric vein drains blood from the hindgut to the splenic vein.

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27
Q

The superior mesenteric vein drains blood from the ______ to the _________.

A

The superior mesenteric vein drains blood from the midgut to the hepatic portal vein.

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28
Q

The inferior vena cava drains _____ blood from the _________ into the _____________.

A

The inferior vena cava drains cleaned blood from the hepatic veins into the right atrium.

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29
Q

What ligaments attach the liver to the diaphragm?

A

Coronary ligaments.

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30
Q

What ligament attaches the liver to the anterior abdominal wall?

A

Falciform Ligament.

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31
Q

What is the roll of the gallbladder (in relation to bile)? And when does this occur?

A

The gallbladder stores and concentrates bile.

In between meals.

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32
Q

The neck of the gallbladder narrows and becomes the…

A

Cystic duct.

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33
Q

The blood supply to the gallbladder is via..

A

The Cystic Artery.

34
Q

Which one of the following is the gallbladder?
Foregut Organ
Midgut Organ
Hindgut Organ

A

The gallbladder is a foregut organ.

35
Q

Early gallbladder pain presents in what region?

A

The epigastric region.

36
Q

Why would gallbladder pain be referred to the right shoulder?

A

As a result of anterior diaphragmatic irritation.

37
Q

What is a cholecystectomy?

A

The surgical removal of the gallbladder.

38
Q

The right and left hepatic ducts unite to form:

A

Common hepatic duct.

39
Q

The Common Hepatic Duct and the Cystic duct unite to form the:

A

Bile Duct

40
Q

What two ducts unite to form the common bile duct?

A

Common hepatic duct and cystic duct.

41
Q

What two ducts unite to form the Common Hepatic Duct?

A

Right and left hepatic ducts.

42
Q

What ducts drains into the second part of the duodenum?

A

Bile duct

Main pancreatic duct

43
Q

The bile duct joins with the main pancreatic duct to form..

A

The ampulla of Vater.

44
Q

Bile duct and main pancreatic duct both drain into the ____ through the ________.

A

Second part of the duodenum.

Through the major duodenal papilla.

45
Q

What is the name of the investigation used to study the bilary tree and pancreas?

A

ERCP

Endoscopic Retrograde Cholangiopancreatography

46
Q

What causes jaundice?

A

An increase in the blood levels of bilirubin

47
Q

Name two obstructions of the biliary tree

A

Gallstones

Carcinoma at head of pancreas

48
Q

What pancreatic branch braches from the gastroduodenal artery?

A

Superior pancreaticoduodenal

49
Q

What pancreatic branch braches from the superior mesenteric artery?

A

Inferior pancreaticoduodenal

50
Q

How can blockage of the ampulla by a gallstone cause pancreatitis?

A

The ampulla is blocked by a gallstone.
Bile is then diverted into the pancreas.
This leads to irritation and inflammation of the pancreas.

51
Q

Where does pain from the pancreas present?

A

In the epigastric region and/or umbilical region.

52
Q

The small intestines consist of:

A

Duodenum
Jejunum
Ileum

53
Q

What part(s) of the duodenum are foregut organs?

A

The 1st and 2nd parts.

54
Q

Name the four parts of the duodenum.

A

Superior
Descending
Horizontal
Ascending

55
Q

Which part of the duodenum is partly intraperitoneal?

A

The Superior part

56
Q

What does the pyloric sphincter control the flow of?

A

The pyloric sphincter controlls the flow of chyme from stomach to duodenum.

57
Q

Pain from duodenal ulcer tends ti present in which region?

A

Te epigastric region.

58
Q

What flexure does the jejunum begin at?

A

THe duodenaljejunal felxure

59
Q

Which junction does the ileum end at?

A

Ileocaecal junction.

60
Q

What ends at the ileocaecal junction?

A

The ileum.

61
Q

What is the mucosa of the jejunum like?

A

Highly folded.

62
Q

The folds in the mucosa of the jejunum are called..

A

Plicae circularis.

63
Q

The jejunum and ileum are supplied with arterial blood from the…

A

Superior mesenteric artery via jejunal and ileal arteries.

64
Q

The jejunum and ileum are drained from the _____ and _______ veins, to the _____ vein and the _______ vein.

A

The jejunum and ileum are drained from the jejunal and ileal veins, to the superior mesenteric vein and the hepatic portal vein.

65
Q

Where are proteins that are absorbed from the small intestines into the portal venous system taken to?

A

The liver.

66
Q

Bile helps the absorption of fats from the GI tract lumen into what cells?

A

Intestinal cells.

67
Q

What are lacteals?

A

Specialised lymphatic vessels of the small intestine.

Fat (with chilomicrons) is absorbed from intestinal cells into lacteals,

68
Q

The main groups of lymph nodes draining abdominal organs are:

A

Celiac
Superior mesenteric
Inferior mesenteric
Lumbar

69
Q

Which abdominal organs drain to the celiac lymph nodes?

A

Foregut organs

70
Q

Which group of lymph nodes do foregut organs drain to?

A

Celiac.

71
Q

Which group of lymph nodes do midgut organs drain to?

A

Superior mesenteric

72
Q

Which group of lymph nodes do hindgut organs drain to?

A

Inferior mesenteric

73
Q

Which abdominal organs drain to the superior mesenteric lymph nodes?

A

Midgut organs.

74
Q

Which abdominal organs drain to the inferior mesenteric lymph nodes?

A

Hindgut organs.

75
Q

Which abdominal organs drain to the lumbar lymph nodes?

A

Kidneys
Posterior abdominal wall
Pelvis
Lower limbs

76
Q

Which group of lymph nodes do the kidneys drain to?

A

Lumbar

77
Q

Which group of lymph nodes does the pelvis drain to?

A

Lumbar

78
Q

Which group of lymph nodes does the posterior abdominal wall drain to?

A

Lumbar

79
Q

Which group of lymph nodes do the lower limbs drain to?

A

Lumbar

80
Q

Which duct will the lymph from 3/4 of the body drain to?

A

The thoracic duct.

81
Q

Which duct will the lymph from 1/4 of the body drain to?

A

The right lymphatic duct.

82
Q

Where does the duodenal cap lie in the duodenum?

A

Superior part.