Hepato-biliary Anatomy and Hepatic Portal System Flashcards

1
Q

Describe surface anatomy of the Liver

A
  • Right hand side
  • upper border: 5th intercostal pace in midclavicular line
  • bottom border : 10th rib in midclavicular line
  • Left hand side
  • 5th intercostal space in midclavicular line
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2
Q

Where is the Subphrenic recess

A

between the Diaphragm and the Diaphragmatic surface of the liver

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3
Q

Where is the Hepatorenal recess

A

between the visceral surface of the liver and the right kidney

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4
Q

What are the two recesses surrounding the liver

A

1- Hepatorenal recess
2- Subphrenic recess

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5
Q

What two structures is the liver located between

A

Diaphragm and Right Kidney

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6
Q

What runs between the Right and Left lobe of the liver

A

Falciform Ligament

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7
Q

What runs within the falciform ligament

A

round ligament

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8
Q

What was the round ligament previously

A

round ligament is the obliterated remains of the umbilical vein which delivered oxygen rich blood from placenta to liver during foetal development

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9
Q

What structure does the coronary ligament attach to

A

Diaphraphm

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10
Q

Label

A
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11
Q

Label

A
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12
Q

Label

A
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13
Q

What lobe do we gain sight of with the Visceral surface view

A

Caudate lobe

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14
Q

Describe the bare area

A
  • part of liver that is not covered with visceral peritoneum
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15
Q

What is the doorway to the liver

A

porta hepatis that includes the hepatic portal vein , hepatic artery proper and bile duct

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16
Q

Label

A
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17
Q

Name the 4 liver lobes

A

1- righ lobe

2- left lobe

3- caudate lobe

4- quadrate lobe

18
Q

What does the hepatic artery proper split into

A

right and left hepatic arteries than subdivide into further branches

19
Q

Label

A

A: Fundus

B: Body

C: Neck

20
Q

How many hepatic veins drain into the IVC

A

3

21
Q

What are the two seperate systems meeting in the liver

A

portal system of the hepatic veins and the systemic system of the central vein

22
Q

What is the purpose of the gallbladder

A

to store bile produced in liver

23
Q

What is the cystic duct

A

duct responsible of draining the bile form galbladder to duodenum

24
Q

Surface of the gallbladder

A

inner tip of the 9th costal cartilage on the right hand sides

25
Q

Label

A
26
Q

What is the purpose of the hepatic ducts

A
  • drain bile from liver
  • join to form common hepatic duct
27
Q

Common hepatic duct + … duct = ….. duct

A

Common hepatic duct + cystic duct = bile duct

28
Q

What is anterior to the bile duct

A

pancreas

29
Q

What joins th ebile duct to enter the duodenum

A

the pancreatic duct

30
Q

What is the hepaatopancreatic ampulla / ampulla of vater

A

the bile and pancreatic duct join and open into ampulla in the second part of duodenum

31
Q

the terminal regions of the bile and pancreatic duct are surrounded by what

A

the sphincter of Oddi

32
Q

Label

A
33
Q

What does the ampulla of vater open into

A

the major duodenal papilla

34
Q

How is the hepatic vein formed

A
  • by the joinging of the superior mesenteric and splenic vein
35
Q

Where do the splenic and superior mesenteric vein unite

A

posterior to the neck of the pancreas

36
Q

What are porto=systemic anastomoses

A

connecting channels between the portal system and systemic venous system

37
Q

What happens with the porto-systemic anastamoses of individuals with portal hypertension

A
  • due to pressure in hepatic vein bein elevated
  • the portal venous blood will have to find an alternative route to the systemic circulation since the portal blood will not be recovered by the hepatic veins
  • collateral channels will have to open up
38
Q

What is the porto-systemic anastamoses in a healthy individual

A

all the portal venous blood ( drained form GI organs ) will be recevored by the hepatic veins

39
Q

What collateral channels are opened due to portal hypertension ( 3)

Identify which are part of the portal and systemic system

A

1- The gastro-oesophageal junction: the left gastric vein and tributaties (portal) will anastomose with the tributaries of the azygos system of veins (systemic)

2- the anterior abdominal wall at umbilicus: para-umbilical veins ( portal ) will anastamose with veins on the anterior abdominal wall ( systemic)

3- the ano-rectal junction : superior rectal vein (portal) will anastamose with inferior&middle rectal veins ( systemic )

40
Q

Where is the azygos vein located

A

posterior thoracic wall

41
Q

What can portal hypertension cause

A

varices : enlargement of veins , ex: oesophageal varices, ano-rectal

  • if ruptured there will be alot of blood in abdominal cavity
  • Caput medusae ( swollen veins) on anterior abdominal wall
42
Q

What is this condition

A

caput medusae on anterior abdominal wall due to varices from portal hypertension