Hepatic, Biliary and Pancreatic Anatomy

Question 1

Peds patient who needs a liver transplant: which adult liver segments do you donate?

Answer 1

You give segments 2 and 3 (fed by left hepatic vein).

-they are smaller than segments 5,6,7,8 (right hepatic vein), which is given to adult pts

Question 2

Adult patient who needs a liver transplant: which adult liver segments do you donate?

Answer 2

You donate segments 5,6,7,8 (fed by right hepatic vein)

(you give segments 2,3 to peds pt)

Question 3

How long does it take for adult liver to regenerate after donating part of it to another pt?

Answer 3

6 weeks

Question 4

What blood vessels supply the liver, and what are their % of blood flow?

Answer 4

1. Portal vein - 70%
2. Hepatic a - 30%

Question 5

Kupffer cells

• what are they/functions?
• where are they located

Answer 5

• Macrophages that line the sinusoids
• host defense from materials coming from portal circulation
• breakdown of RBCs (production of bilirubin)

Question 6

What is in the portal triad?

Answer 6

4 things:

1. hepatic artery
2. hepatic vein
3. bile duct (drain bile canuliculi)
4. lymphatic duct

Question 7

Stellate cell

• where located
• function

Answer 7

• located in the Space of Disse (between sinusoids and hepatocytes)
• Responsible for scar tissue formation (fibrosis) that leads to cirrhosis.

Question 8

Hepatic acinus

Answer 8

Region connected by 2 central veins and 2 portal triads. 3 zones of blood supply inside.

Question 9

Portal lobule

Answer 9

Triangle Region connected by 3 central veins and their portal triad in the center.

Question 10

Bile concentration mechanism:

-what is absorbed?

Answer 10

• water
• Na
• Cl

Question 11

What stimulates gallbladder to contract?

-how long does it take for complete gallbladder emptying?

Answer 11

1. CCK–empties GB in <1 hr. Fatty foods in duodenum stim CCK release
2. Ach from vagal n

Question 12

What acts on biliary epithelium to produce secretion of NaHCO3?

Answer 12

Secretin

Question 13

What do they secrete:

1. pancreatic acini
2. pancreatic ducts

Answer 13

1. enzymes
2. HCO3

Question 14

3 main Proteases secreted by pancreas:

what activates trypsinogen to trypsin?

Answer 14

1. trypsin
2. chymotrypsin
3. carboxypolypeptidase
   - enterokinase (in duodenum)

Question 15

Where is HCO3 in duodenum secreted from? (2)

-what enzyme in those cells allows this to occur

Answer 15

• Pancreatic duct
• Biliary duct
• Carbonic anhydrase

Question 16

How do these act on the pancreas?

• CCK
• Secretin

Answer 16

1. secrete enzymes from acini
2. secrete HCO3 from ducts (epithelium)