GI - Why might my patient be jaundiced?

Question 1

The Portal Triad consists of:

Answer 1

Hepatic Artery
Hepatic Portal Vein
Common bile duct

Question 2

The portal triad is found in the..

Answer 2

…FREE EDGE of the LESSER OMENTUM.

Question 3

Bilirubin is a product of the breakdown of..

Answer 3

… red blood cells.

Question 4

The breakdown of red blood cells usually occurs in:

Answer 4

The spleen.

Question 5

Bilirubin is used to form:

Answer 5

Bile.

Question 6

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

Answer 6

Liver.

Question 7

Bile is stored and concentrated in the:

Answer 7

Gallbladder.

Question 8

The pancreas excretes digestive enzymes into the:

Answer 8

2nd part of the duodenum.

Question 9

What 3 branches trifurcate from the celiac trunk?

Answer 9

Splenic artery
Hepatic artery
Left gastric artery

Question 10

The spleen is protected by which ribs?

Answer 10

Ribs 9-11

Question 11

Where does the liver’s blood supply come from?

Answer 11

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

Question 12

Which ribs protect the liver?

Answer 12

Ribs 7-11

Question 13

What are the 4 anatomical segments of the liver?

Answer 13

Right lobe
Left lobe
Caudate lobe
Quadrate lobe

Question 14

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

Answer 14

Hepatic artery
Hepatic portal vein
Hepatic (bile) duct

Question 15

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

Answer 15

Hepatic Portal Vein

Question 16

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

Answer 16

Hepatic Vein

Question 17

Liver lobules contain:

Answer 17

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

Question 18

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

Answer 18

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

Question 19

What is a hepatocyte?

Answer 19

A liver cell.

Question 20

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

Answer 20

The bilary duct.

Question 21

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

Answer 21

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

(These are both within the greater sac)

Question 22

How does peritonitis lead to an abscess formation?

Answer 22

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

Question 23

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

Answer 23

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).

Question 24

Where does the hepatic portal vein drain blood from.

Answer 24

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

Question 25

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

Answer 25

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

Question 26

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

Answer 26

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

Question 27

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

Answer 27

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

Question 28

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

Answer 28

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

Question 29

What ligaments attach the liver to the diaphragm?

Answer 29

Coronary ligaments.

Question 30

What ligament attaches the liver to the anterior abdominal wall?

Answer 30

Falciform Ligament.

Question 31

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

Answer 31

The gallbladder stores and concentrates bile. | In between meals.

Question 32

The neck of the gallbladder narrows and becomes the...

Answer 32

Cystic duct.

Question 33

The blood supply to the gallbladder is via..

Answer 33

The Cystic Artery.

Question 34

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

Answer 34

The gallbladder is a foregut organ.

Question 35

Early gallbladder pain presents in what region?

Answer 35

The epigastric region.

Question 36

Why would gallbladder pain be referred to the right shoulder?

Answer 36

As a result of anterior diaphragmatic irritation.

Question 37

What is a cholecystectomy?

Answer 37

The surgical removal of the gallbladder.

Question 38

The right and left hepatic ducts unite to form:

Answer 38

Common hepatic duct.

Question 39

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

Answer 39

Bile Duct

Question 40

What two ducts unite to form the common bile duct?

Answer 40

Common hepatic duct and cystic duct.

Question 41

What two ducts unite to form the Common Hepatic Duct?

Answer 41

Right and left hepatic ducts.

Question 42

What ducts drains into the second part of the duodenum?

Answer 42

Bile duct | Main pancreatic duct

Question 43

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

Answer 43

The ampulla of Vater.

Question 44

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

Answer 44

Second part of the duodenum. | Through the major duodenal papilla.

Question 45

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

Answer 45

ERCP | Endoscopic Retrograde Cholangiopancreatography

Question 46

What causes jaundice?

Answer 46

An increase in the blood levels of bilirubin

Question 47

Name two obstructions of the biliary tree

Answer 47

Gallstones | Carcinoma at head of pancreas

Question 48

What pancreatic branch braches from the gastroduodenal artery?

Answer 48

Superior pancreaticoduodenal

Question 49

What pancreatic branch braches from the superior mesenteric artery?

Answer 49

Inferior pancreaticoduodenal

Question 50

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

Answer 50

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

Question 51

Where does pain from the pancreas present?

Answer 51

In the epigastric region and/or umbilical region.

Question 52

The small intestines consist of:

Answer 52

Duodenum Jejunum Ileum

Question 53

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

Answer 53

The 1st and 2nd parts.

Question 54

Name the four parts of the duodenum.

Answer 54

Superior Descending Horizontal Ascending

Question 55

Which part of the duodenum is partly intraperitoneal?

Answer 55

The Superior part

Question 56

What does the pyloric sphincter control the flow of?

Answer 56

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

Question 57

Pain from duodenal ulcer tends ti present in which region?

Answer 57

Te epigastric region.

Question 58

What flexure does the jejunum begin at?

Answer 58

THe duodenaljejunal felxure

Question 59

Which junction does the ileum end at?

Answer 59

Ileocaecal junction.

Question 60

What ends at the ileocaecal junction?

Answer 60

The ileum.

Question 61

What is the mucosa of the jejunum like?

Answer 61

Highly folded.

Question 62

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

Answer 62

Plicae circularis.

Question 63

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

Answer 63

Superior mesenteric artery via jejunal and ileal arteries.

Question 64

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

Answer 64

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

Question 65

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

Answer 65

The liver.

Question 66

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

Answer 66

Intestinal cells.

Question 67

What are lacteals?

Answer 67

Specialised lymphatic vessels of the small intestine. | Fat (with chilomicrons) is absorbed from intestinal cells into lacteals,

Question 68

The main groups of lymph nodes draining abdominal organs are:

Answer 68

Celiac Superior mesenteric Inferior mesenteric Lumbar

Question 69

Which abdominal organs drain to the celiac lymph nodes?

Answer 69

Foregut organs

Question 70

Which group of lymph nodes do foregut organs drain to?

Answer 70

Celiac.

Question 71

Which group of lymph nodes do midgut organs drain to?

Answer 71

Superior mesenteric

Question 72

Which group of lymph nodes do hindgut organs drain to?

Answer 72

Inferior mesenteric

Question 73

Which abdominal organs drain to the superior mesenteric lymph nodes?

Answer 73

Midgut organs.

Question 74

Which abdominal organs drain to the inferior mesenteric lymph nodes?

Answer 74

Hindgut organs.

Question 75

Which abdominal organs drain to the lumbar lymph nodes?

Answer 75

Kidneys Posterior abdominal wall Pelvis Lower limbs

Question 76

Which group of lymph nodes do the kidneys drain to?

Answer 76

Lumbar

Question 77

Which group of lymph nodes does the pelvis drain to?

Answer 77

Lumbar

Question 78

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

Answer 78

Lumbar

Question 79

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

Answer 79

Lumbar

Question 80

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

Answer 80

The thoracic duct.

Question 81

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

Answer 81

The right lymphatic duct.

Question 82

Where does the duodenal cap lie in the duodenum?

Answer 82

Superior part.