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Anna > Hepatobiliary > Flashcards

Hepatobiliary Flashcards

1
Q

In dogs were does the common bile duct enter the duodenum?

A

Major duodenal papilla is a small raised mound on the mesenteric mucosa about 3-6 cm aboral to the pylorus.

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2
Q

In dogs, the common bile duct and the pancreatic duct are conjoined? T or F

A

False; In dogs, the common bile duct and the pancreatic duct are adjacent, not conjoined, to each other at the major duodenal papilla.

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3
Q

In dogs were does the accessory pancreatic duct enter the duodenum?

A

Minor duodenal papilla

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4
Q

The principal conduit for pancreatic secretions in the dog is either the major or the minor duodenal papilla?

A

Minor duodenal papilla

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5
Q

The major duodenal papilla is about 2 cm. orad, aboral, or in the same location as the minor duodenal papilla?

A

The major duodenal papilla is about 2 cm. orad to the minor duodenal papilla.

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6
Q

In cats, the common bile duct and the pancreatic duct enter the duodenum at which papilla?

A

Major duodenal papilla.

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7
Q

In cats, the common bile duct and the pancreatic duct are conjoined? T or F

A

True; in cats, the common bile duct and the pancreatic duct are conjoined before their entry into the duodenum at the major duodenal papilla.

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8
Q

What percentage of cats have an accessory pancreatic duct? a) 10%, b) 20%, c) 30%, d) 50%, e) > 80%

A

b) 20%; only about 20% cats have an accessory pancreatic duct exiting at a minor duodenal papilla.

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9
Q

Diseases affecting the major duodenal papilla in which species, dog or cat, has the greater potential to affect the entire exocrine pancreatic secretion?

A

Cat; Any surgery or diseases affecting the major duodenal papilla in the cat has the potential to affect the entire exocrine pancreatic secretion.

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10
Q

In the cat, what pancreatic disease has been reported as a complication of duodenal lesions involving the major duodenal papilla?

A

Pancreatic exocrine insufficiency

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11
Q

The greater percentage of the liver lies either to the LEFT or the RIGHT of the median plane in the dog?

A

RIGHT; right-to-left proportion of ~ 3:2 in dogs.

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12
Q

Name the four lobes and the four sublobes of the liver in dogs and cats?

A 
LOBES                 SUBLOBES/PROCESSES
LEFT lobe             LEFT lateral
                            LEFT medial
Quadrate lobe
RIGHT lobe           RIGHT medial lobe
                            RIGHT lateral lobe
Caudate lobe         Papillary Process
                            Caudate Process
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13
Q

Name the two parts of the caudate lobe of the liver in dogs and cats?

A

Papillary Process

Caudate Process

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14
Q

What two liver lobes comprise the fossa of the gall bladder?

A 
quadrate lobe (left half)
right medial hepatic lobe (right half)
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15
Q

What is the most caudal part of the liver?

A

Caudate process of the caudate lobe

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16
Q

What structures form the epiploic foramen?

A

Dorsal - vena cava
ventral - portal vein
lateral - caudate lobe

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17
Q

The hepatorenal ligament passed between which two structures?

A

caudate lobe to right kidney

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18
Q

The single left -sided triangular ligament attaches to which liver lobe?

A

The single left -sided triangular ligament attaches to the LEFT lobe of the liver

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19
Q

Describe the attachments of the RIGHT-sided triangular ligaments?

A

Both arise from the coronary ligament with the LARGER one going to the dorsal part of the RIGHT lateral lobe and the SMALLER one going to the RIGHT medial lobe.

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20
Q

Describe the PRINGLE MANEUVER.

A

Retract mesoduodenum to the LEFT.
Pass index finger cranially along ventral aspect of the vena cava.
Bring thumb together with index finger.
Compress the hepatic artery and portal vein.

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21
Q

What structures are occluded during the PRINGLE MANEUVER?

A

the hepatic artery and portal vein are occluded during the Pringle Maneuver.

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22
Q

How long can one perform the PRINGLE MANEUVER?

A

The PRINGLE MANEUVER can be done for about 20 minutes before hepatic necrosis results.

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23
Q

What structure provides blood supply to the liver?

A

Hepatic artery - 20 % of blood volume.

Portal Vein - 80% of blood volume.

24
Q

What percentage of oxygen supply to the liver is provided by the hepatic artery and Portal Vein, respectively?

A

Hepatic artery - 50 % of oxygen supply.

Portal Vein - 50 % of oxygen supply.

25
Q

What is the artery to the gall bladder? And what it the source of this vessel?

A

The CYSTIC ARTERY supplies the gall bladder; this vessel arises from a branch of the LEFT branch of the HEPATIC ARTERY

26
Q

What % of total body protein is made by liver?

A

20%

27
Q

What % of albumin is made by liver?

A

100%

28
Q

List several sources of hypoproteinemia

A

Severe hepatic failure
Protein loss through third spacing
Production of inflammatory acute phase proteins by the liver
Inappetence or anorexia

29
Q

Which coagulation factors are NOT synthesized in the liver?

A

1) Factor VIII

2) von Willebrands factor

30
Q

About 80% of bilirubin is produced as a breakdown product of what substance?

A

Hemoglobin, which occurs during natural or pathological erythrocyte destruction by the reticuloendothelial system.

31
Q

Bilirubin is transported to the liver bound or unbound?

A

Bound; bilirubin is bound to albumin and is transported to the liver.

32
Q

In the hepatocyte, bilirubin becomes conjugated to what before being excreted into the bile canaliculi?

A

Glucuronic acid; In the hepatocyte, bilirubin becomes conjugated to glucuronic acid before being excreted into the bile canaliculi.

33
Q

Bile acids are synthesized in the liver exclusively from what?

A

Cholesterol; Bile acids are synthesized in the liver exclusively from cholesterol.

34
Q

Bile acids are conjugated with what in dogs?

A

Taurine or Glycine; Bile acids are conjugated with taurine or glycine in dogs.

35
Q

Bile acids are conjugated with what in cats?

A

Taurine; Bile acids are conjugated with taurine in cats.

36
Q

What substance is released from small intestine mucosal cells in response to food entering the duodenum?

A

Cholecystokinin; CCK is released from small intestine mucosal cells in response to food entering the duodenum?

37
Q

What effect does cholecystokinin (CCK) have on gall bladder function?

A

Cholecystokinin causes gall bladder contraction and relaxation of the sphincter of Oddi, facilitating passage of bile into the duodenum.

38
Q

Describe two (2) functions of bile in the intestines.

A

1) Bile salts emulsify fats, aiding in their absorption and digestion.
2) Bile salts bind endotoxins and prevent their absorption into the portal circulation.

39
Q

Bacteria degrades bilirubin into what in the intestine?

A

Urobilinogen; Bacteria degrades bilirubin into urobilinogen in the intestine.

40
Q

Urobilinogen is converted into what in the intestine?

A

Urobilin or Stercobilin; Urobilinogen is converted into either urobilin or stercobilin in the intestine.

41
Q

What percentage of urobilinogen is excreted in the feces?

A

90%; About 90% of urobilinogen is excreted in the feces.

42
Q

What percentage of urobilinogen is reabsorbed into the portal circulation?

A

10%; 10 percent of urobilinogen is reabsorbed into the portal circulation, transported to the liver, and re-excreted into the bile.

43
Q

A small percentage of reabsorbed urobilinogen is excreted into the urine, TRUE or FALSE?

A

TRUE, A small percentage of reabsorbed urobilinogen is excreted into the urine.

44
Q

What substance gives feces its characteristic brown color?

A

Stercobilin; Stercobilin gives feces its characteristic brown color.

45
Q

In experimental studies, normal dogs tolerate acute removal of what percentage of total liver volume?

A

65-70%; In experimental studies, normal dogs tolerate acute removal of 65-70% of total liver volume.

46
Q

In experimental studies, normal dogs DID NOT tolerate acute removal of what percentage of total liver volume?

A

84%; In experimental studies, normal dogs DID NOT tolerate acute removal of 84% of total liver volume?

47
Q

In experimental studies, what percentage of normal dogs survived for at least 7 days after 80% hepatectomy?

A

28%; In experimental studies, 28% of normal dogs survived for at least 7 days after 80% hepatectomy?

48
Q

Mortality associated with excessive hepatectomy was associated with hepatic failure, excessive portal hypertension, both, or neither?

A

Excessive portal hypertension

49
Q

Posthepatectomy portal pressure of what resulted in significantly lower survival and liver regeneration rates?

A

> 16 mm Hg; Posthepatectomy portal pressure of > 16 mm Hg resulted in significantly lower survival and liver regeneration rates.

50
Q

Following 70% hepatectomy near complete hypertrophy and hyperplasia is reached by how long?

A

6 days; Following 70% hepatectomy near complete hypertrophy and hyperplasia is reached by 6 days but may take up to 6 to 10 weeks.

51
Q

The most frequent cause of extrahepatic biliary tract injury is what?

A

Blunt abdominal trauma after a motor vehicle accident. The most frequent cause of extrahepatic biliary tract injury is blunt abdominal trauma after a motor vehicle accident.

52
Q

The most frequent location of extrahepatic biliary tract leakage after blunt abdominal trauma is where?

A

Common bile ducts or hepatic ducts; The most frequent location of extrahepatic biliary tract leakage after blunt abdominal trauma is almost always the common bile ducts or hepatic ducts.

53
Q

Avulsion injuries of the common bile duct typically occur at what location?

A

Duodenum; Avulsion injuries of the common bile duct typically occur from the duodenum.

54
Q

Avulsion injuries of the hepatic ducts typically occur at what location?

A

Common bile duct; Avulsion injuries of the common bile duct typically occur at the common bile duct.

55
Q

The most common causes of extrahepatic biliary tract obstruction in the dog are what?

A

Pancreatitis, neoplasia, gallbladder mucocele, cholangitis, and cholelithiasis; The most common causes of extrahepatic biliary tract obstruction in the dog are pancreatitis, neoplasia, gallbladder mucocele, cholangitis, and cholelithiasis.

56
Q

The most common causes of extrahepatic biliary tract obstruction in the cat are what?

A

The most common causes of extrahepatic biliary tract obstruction in the cat are a complex of inflammatory diseases including pancreatitis, cholangiohepatitis, cholecystitis (+/- cholelithiasis), and neoplasia.

Anna (9 decks)

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