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M2 GI/Nutrition > Hepatic, Biliary, & Pancreatic Anatomy - Franco > Flashcards

Hepatic, Biliary, & Pancreatic Anatomy - Franco Flashcards

1
Q

The superior edge of the liver corresponds to approximately what intercostal level?

A

5th

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2
Q

Describe the two major blood supplies to the liver and the approximate perentage each contributes to the net perfusion of the liver.

Name the blood vessel that drains the liver. Into what major vessel does it flow?

A

Portal vein: 70%

Proper hepatic artery: 30%

The hepatic vein (or veins - left, right, and middle) drains the whole liver into the IVC

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3
Q

Which hepatic segments for the right lobe of the liver?

Which hepatic segments form the left lobe of the liver?

A

5, 6, 7, 8

2, 3, 4

(segment 1 is kind of an oddball)

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4
Q

Donor livers given to adults are sourced from which segments of the liver?

Donor livers given to children are sourced from which segments of the liver?

A

Adult: 5, 6, 7, 8

Peds: 2, 3

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5
Q

Which part(s) of the pancreas are retroperitoneal?

Pain originating in the pancrease primarily radiates to which part of the body?

A

Everything, except the tail (the tail is intraperitoneal)

Pain radiates to the back, especially to the mid-pack on the left side (according to Netters and Google)

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6
Q

What is the precursor cell for Kupffer cells?

Where are stellate cells found?

A

Monocyte

Space of Disse

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7
Q

Identify (1-10)

A
  1. Left gastric v.
  2. Esophageal and R. gastric vv.
  3. Pancreatic vv.
  4. Left gastro-omental v.
  5. Right Gastro-omental v.
  6. SMV
  7. Inferior pancreaticoduodenal v.
  8. Superior pancreaticoduodenal v.
  9. Portal v.
  10. Cystic v.
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8
Q

Identify (1-14)

A
  1. Proper hepatic a.
  2. Gastroduodenal a
  3. Right gastric a.
  4. Superior pancreaticoduodenal a.
  5. Duodenal branches
  6. SMA
  7. Inferior pancreaticoduodenal a.
  8. Right gastro-omental a.
  9. Pancreatic branches
  10. Left gastro-omental a.
  11. Left gastric a.
  12. Splenic a.
  13. Common hepatic a.
  14. Abdominal aorta
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9
Q

Gaze upon this drawing of the structural organization of the liver. Once you have recovered from its overwhelming virtuosity, identify the type of lobule outlined in purple.

A

portal lobule

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10
Q

See this somewhat less impressive drawing of the structural organization of the liver. Identify the type of lobule outline in purple.

A

acinus

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11
Q

Identify (1-7)

A
  1. Portal triad (tetrad if you inlcude lymphatics)
  2. hepatocytes
  3. sinusoid fenestrations
  4. sinusoid
  5. central vein
  6. classic hepatic lobule
  7. Space of Disse
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12
Q

Describe the main mechanism(s) of bile salt concentration in the gallbladder. By what factor does this change the volume of the bile?

Cholesterol and lecithin are solubilized by what?

A

Water, sodium, and chloride are absorbed in the gallbladder (this concentrates the bile) -> reduces volume by approximately 10X

Bile salts

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13
Q

Describe the effect(s) of the following on the gallbladder and biliary tree:

  1. Cholecystokinin (CCK)
  2. Secretin
A
  1. CCK: gallbladder contraction and emptying, relaxation of the Sphincter of Oddi
  2. Secretin: acts on biliary epithelium to produce a solution rich in sodium bicarbonate
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14
Q

Name the chief product released by the following:

  1. Pancreatic acini
  2. Pancreatic ducts
A
  1. digestive enzymes (trypsin, chymotrypsin, carboxypeptidase
  2. bicarbonate
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15
Q

What activates trypsinogen to trypsin?

What feature of the pancreas is relevant to the timely functioning of trypsin? What happens if this fails?

A

Trypsinogen is activated by trypsin enterokinase (found in the small intestine), or by other trypsin

The pancreas contains trypsin inhibitor to prevent activation of trypsin in the pancreas and subsequent digestion of pancreatic tissue. Failure of this enzyme leads to pancreatitis.

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16
Q

Describe the process of breaking down dietary starches into glucose

What about lactose?

What about sucrose?

A
  1. Starches are broken down into maltose and 3-9 glucose polymers by (1) Ptyalin (salivary amylase in the mouth) and (2) pancreatic amylase (secreted by the pancreas)
  2. Maltose and glucose polymers are further broken down into glucose by maltase and alpha-dextrinase (located in the intestine)

Lactose is broken down into galactose and glucose by intestinal lactase

Sucrose is broken down into fructose and glucose by intestinal sucrase

17
Q

What enzyme, secreted by the pancreas, is primarily responsible for digestion of dietary triglycerides?

What are the products of this breakdown?

A

pancreatic lipase

emulsified fat (triglycerides) –> fatty acids and 2-monoglycerides

18
Q

Describe the effect(s) of the following on the pancreas:

  1. Cholecystokinin (CCK)
  2. Secretin
A
  1. CCK acts on the pancreatic acini to produce digestive enzymes
  2. Secretin acts on the pancreatic duct epithelium to produce a bicarbonate-rich solution

M2 GI/Nutrition (43 decks)

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