Gross Anat. of the Paraalimentary Tract

Question 0

Which pancreatic bud migrates more extensively?

Answer 0

Ventral pancreatic bud.

Question 1

What are the 3 salivary “glands”? Which are serous? Which are mixed serous/mucinous? Innervation?

Answer 1

Parotid - serous only - CN IX
Submandibular - serous and mucinous - CN VII
Sublingual - serous and mucinous - CN VII
(Sublingual is actually a lot of tiny glands)

Question 2

Which bud forms the head of the pancreas?

Answer 2

The ventral pancreatic bud.

Question 3

Which bud forms the neck, body, and tail of the pancreas?

Answer 3

The dorsal pancreatic bud.

Question 4

What divides the liver into left and right anatomic lobes?

Answer 4

The falciform ligament.

Question 5

What’s actually in the left functional lobe?

Answer 5

The left anatomical lobe, the quadrate lobe, and most of the caudate lobe.
The border is the IVC / gall bladder fossa.

Question 6

What defines the 8 resectable areas of the liver?

Answer 6

Different blood supplies.

I - IV are in the left functional lobe…

Question 7

What’s the break down of oxygen supply to the liver?

Answer 7

25% from proper hepatic artery.

75% from the hepatic portal vein.

Question 9

When there’s an accessory pancreatic duct, where did it come from?

Answer 9

The dorsal pancreatic duct.

Question 10

Where is the spiral valve?

Answer 10

Coming out of the gall bladder.

Question 11

Wheres the blood supply to the gall bladder usually come from?

Answer 11

It comes from the cystic a., which 75.5% of time comes off the right hepatic artery.

Question 12

4 parts of the gallbladder?

Answer 12

Fundus, body, infundibulum, and neck.

Question 13

What’s the significance of the infundibulum of the gallbladder?

Answer 13

This is a very common place for gall stones to form… which can then compress the cystic duct.

Question 14

What’s the blood supply of the head of the pancreas?

Answer 14

Pancreaticoduodenal a. - its blood supply is shared with the duodenum.

Question 15

What’s the blood supply of the body and tail of the pancreas?

Answer 15

Branches of the splenic a.

Question 16

What blood vessels run between the head/neck of pancreas and the duodenum?

Answer 16

SMA and SMV.

Question 17

What happens when the SMV and splenic vein join?

Answer 17

They form the hepatic portal vein.

Question 18

What mainly drains the hindgut?

Answer 18

The IMV

Question 19

What drains directly into the hepatic portal vein (not the SMV or splenic vein)?

Answer 19

The left gastric vein.

Question 20

What happens when the hepatic portal drainage gets blocked?

Answer 20

Portal hypertension -> dilation of portal caval anastomoses.

Question 21

3 (or 4) sites of portal-caval anastomoses? Clinical sign of each?

Answer 21

Esophageal - esophageal varices
Paraumbilical - caput medusae
Rectal veins - internal hemorrhoids
Retro-peritoneal - “not clinically relevant”

Question 22

What’s the blood supply to the appendix?

Answer 22

A branch of the ileocolic a.

Question 23

Where is the appendix, 2/3 of the time?

Answer 23

“Retrocecal” - hanging out behind the cecum. Important for surgery…