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Emma IV > Hepatobiliary System > Flashcards

Hepatobiliary System Flashcards

1
Q

liver

A 
lgst gland (2.5% body weight)
processes all digested materials, venous blood from spleen and pancreas

exocrine gland –> secretes bile
endocrine gland –> serum albumin, lipoproteins, thyroid hormone (active form) etc.

occupies most fo RUQ (R hypochondrium) and into epigastrium

displaced several inches w/ excursions of diaphragm during respiration (6-12cm in midclavicular line)

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2
Q

liver is suspended from the

A

IVC and diaphragm

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3
Q

liver and gallbladder are part of the

A

foregut

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4
Q

major duodenal papilla

A

opening for bile duct and main pancreatic duct into duodenum

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5
Q

liver, gall bladder, pancreas develop from outgrowth from ____________________

A

2nd pt of duodenum (explaining common duct system opening)

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6
Q

T/F, neuromuscular structures are found in peritoneal cavity

A

F. Instead must pass to organs encased between two peritoneal layers

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7
Q

Mesentery

A

double layer of peritoneum between body wall (usu posterior) and organ (“meso” prefix used)

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8
Q

Ligament

A

double layer of peritoneum between stomach and another organ

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9
Q

Omentum

A

double layer of peritoneum between stomach and another organ

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10
Q

Developing liver forms w/i a _____ mesentery

A

ventral mesentery…this forms the adult lesser omentum and falciform ligament

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11
Q

2 ligaments of lesser omentum

A

hepatogastric ligament (between liver and stomach)

hepatoduodenal ligament (linear to 1st pt of duodenum)

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12
Q

epiploic foramen of Winslow

A

opening into lesser sac

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13
Q

omental bursa

A

lesser sac

has only one opening (epiploic foramen of Winslow)

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14
Q

portal hepatis

A

doorway to the liver

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15
Q

portal triad

A

w/i hepatoduodenal ligament

portal vein
hepatic a.
common bile duct

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16
Q

pouch of morison

A

hepatorenal recess

space between liver an R kidney

blood pools here during abd bleed (lowest pt of abd in person laying down)

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17
Q

umbilical vein travels through _____ mesentery to get to heart

A

ventral mesentery

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18
Q

falciform ligament

A

derived from ventral mesentery between ventral wall and the liver

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19
Q

What structure is on lower free border of falciform ligament?

A

Ligamentum teres (aka round ligament of the liver)

obliterated umbilical vein

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20
Q

The fetal ___________ allowed maternal blood to bypass the fetal liver

A

ductus venosus

21
Q

Obliterated ductus venosus

A

ligamentum venosum

22
Q

caudate lobe

A

portion on the posterior surface between the IVC and the ligamentum venosum

lies anterior to the IVC

has a papillary process

23
Q

umbilical fissure

A

ligamentum venosum

ligamentum teres hepatis (round ligament)

24
Q

quadrate lobe

A

posterior surface of liver, between fossa for gall bladder and the ligamentum teres

25
Q

hepatic portal vein carries blood that is

A

nutrient rich

oxygen poor

26
Q

main arterial blood supply to liver is from…

A

R and L hepatic a. (arise from the hepatic a. proper which is ascending in the hepatoduodenal ligament

27
Q

venous supply to liver

A

75% of inflow via hepatic portal vein

28
Q

arterial supply to liver lipids as

A

lipoproteins (indirectly from GI via lymphatics)

29
Q

L hepatic a. supplies

A

left lobe
quadrate
1/2 caudate

30
Q

R hepatic a. supplies

A

right lobe
1/2 caudate
gall bladder

31
Q

hepatic segments

A

(8)

hepatic v. run thru R/mid/L fissures and join IVC

portal v/ and hepatic a. run horizontally –> transverse fissure (separates upper and lower segments)

32
Q

causes of cirrhosis

A

alcohol abuse
hepatitis infection
AI disease
industrial solvents

33
Q

cirrhosis presents as

A

hobnail appearance (nodules due to contraction of scar tissue and hepatic cellular regeneration)

splenomegaly (due to portal HTN)

ascites

34
Q

which hepatic cells play critical role in generating cirrhotic scar tissue?

A

Ito/stellate cells

35
Q

Reduced portal blood flow (portal HTN) can cause blood to be shunted to the systemic circulation via

A

esophageal v.
retroperitoneal v.
rectal v.
paraumbilical v.

(Portocaval (portosystemic) anastamoses)

36
Q

esophageal varices

A

portal HTN –> chronic shunting through L. esophageal v. (anastomoses w/ azygos v.) –> twisted, dilated v. in esophagus

37
Q

intestinal varices

A

portal HTN –> chronic shunting through retroperitoneal v. –> colonic varices (less common than esophageal)

38
Q

caput medusa

A

paraumbilical veins located in the falciform ligament near the ligamentum teres (round ligament) communicate with the systemic para-umbilical veins on the superficial abdominal wall (thoraco-epicastric v. and lateral thoracic v.)

engorgement of these v. –> “Caput Medusa“

39
Q

transjugular intrahepatic portosystemic shunt (TIPS)

A

to treat cirrhotic liver

internal jugular v. –> SVC –> RV –> IVC –> central tendon of diaphragm –> turn anteriorly to enter hepatic v.

gets blood from portal system back into systemic

40
Q

common bile duct formed by union of ______ and ______, and is joined by ______ just as it enters the duodenum.

A

common bile duct formed by union of cystic duct and hepatic duct, and is joined by pancreatic duct just as it enters the duodenum.

41
Q

hepatopancreatic ampulla

A

receives fluid from liver and pancreas

42
Q

common bile duct and main pancreatic duct enter duodenum together and form

A

major duodenal papilla (Vater) w/ sphincter of Oddi (closes ampulla when bile is not to be released into the duodenum)

43
Q

spiral valve function w/i galbladder

A

keeps cystic duct open (constitutively making bile)

44
Q

complications of gallstones

A

cholecystitis
jaundice
pancreatitis

45
Q

autonomic (sympathetic) input to hepatobiliary system

A

preganglionic fibers: greater splanchnic n. (T5-T9)
^ synapse in celiac ganglia

postganglionic fibers: accompany blood vessels

46
Q

autonomic (parasympathetic) n. to hepatobiliary system

A

vagus n. has br. that extend to liver and gallbladder

  • stimulate bile prod
  • stimulate glycogen synthesis
47
Q

What controls most function of the hepatobiliary system

A

HORMONES

  • cholecystokinin (gallbladder contraction)
  • secretin (inc bile flow)
48
Q

First 2 big branches off abd aorta

A

coeliac trunk
superior mesenteric a.

technically first 2 branches (smaller) are R/L inferior phrenic a.

49
Q

Usually portal vein is joined by

A

superior mesenteric v.

splenic v. (joined by inferior mesenteric v.)

Emma IV (22 decks)

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