Hepatic Portal System

Question 1

Portal vein

Answer 1

2 inches long
valveless
formed by - splenic v, SMV, IMV

Question 2

Hepatic Portal System

Answer 2

forms posterior to the neck of the pancreas
ends as right and left branches in the liver
runs through the hepatoduodenal ligament to enter the liver at the aorta hepatis

Question 3

porta hepatis

Answer 3

deep fissure on the inferior surface of the liver through which all neurovascular structures (except hepatic) hepatic ducts enter and leave the liver

Question 4

SMV

Answer 4

drain the same parts of the small and large intestine supplied by branches of the SMA

Question 5

IMV

Answer 5

drain the the same parts of the large intestine that were supplied by branches of the inferior mesenteric a

Question 6

Veins of the Stomach and Esophagus

Answer 6

blood can drain superiorly into the azygous system
blood can drain inferiorly into the portal system
there is a submucous venous plexus in the esophagus

Question 7

IVC Location

Answer 7

common iliac veins joint to form IVC at L5
formation is posterior to and inferior to the aortic bifurcation
lies to the right and parallel to the aorta
lies to te right of the lumbar and thoracic vertebrae
passes through liver
pierces the central tendon of the diaphragm at T8
has connections with azygos system of veins

Question 8

IVC Drains

Answer 8

posterior body wall muscles, genitourinary system, lower limbs

Question 9

Esophageal Varicies

Answer 9

esophageal brances of left gastric vein connect with vens on lower thoracic esophagus
Portal drainage - L gastric v, Portal v
Caval drainage - Esophageal v, azygos v, SVC
clinical sign - esophageal varicies

Question 10

Caput Medusae

Answer 10

portal drainage - paraumbillical v (in falciform ligament)
caval drainage - superficial epigastric v
clinical sign - caput medusae

Question 11

Colic veins to retroperitoneal veins

Answer 11

portal drainage - vv draining the ascending colon (SMV) and descending colon (IMV)

Question 12

Rectal Varicies

Answer 12

portal drainage - superior rectal v
calval drainage - middle and inferior rectal veins
clinical sign - hemorhoids

Question 13

Pectinate line

Answer 13

upper 2/3 of anal canal is above pectinate line and gets visceral inn (not painful)
lower 1/3 of anal canal is below pectinate line and receives somatic inn (painful)

Question 14

Visceral pain

Answer 14

internal organ damaged
caused by activation of pain receptors in chest, abdomen, or pelvis
pain is vague and not well localized

Question 15

somatic pain

Answer 15

body surface or mm tissues

pain is dull or aching

Question 16

TIPS procedure

Answer 16

transjugular intrahepatic portosystemic shunting
procedure - jugular vein - SVC and IVC - Hepatic V tributary = liver paraenchyma - portal v
stent placement