Hepatobiliary System Flashcards

1
Q

Where is the liver suspended from?

A

IVC and diaphragm

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2
Q

bare area of liver

A

Adventitia.
Posterior, mostly R lobe.
Outlined by coronary ligament (reflected peritoneum).
NO PERITONEUM.

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3
Q

coronary ligament of liver

A

Serosa/viseral peritoneum.
Transitional from adventitia to mesothelium.
Surrounds bare area.
Reflected peritoneum.

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4
Q

mesentary

A

Double layer of peritoneum btwn body wall and organ.

Meso- prefix used.
Usually the posterior wall.

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5
Q

ligament

A

Double layer of peritoneum beetween organs or between an organ and the abdominal wall

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6
Q

omentum

A

Double layer of peritoneum between STOMACH and another organ

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7
Q

ventral mesentary

A

Liver develops within ventral mesentery.

Forms adult lesser omentum and falciform ligament

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8
Q

ligaments of lesser omentum

A

Hepatogastric ligament.

Hepatoduodenal ligament.

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9
Q

lesser sac

A

Opening: epiploic foramen (of Winslow).
Formed by lesser omentum.
Btwn stomach and liver.

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10
Q

portal triad

A

Portal vein.
Hepatic artery.
Common bile duct.

Within hepatoduodenal ligament.

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11
Q

hepatorenal recess

A

Potential site for collection of fluid.
Bounded by right kidney and liver.
Drains along right colic gutter into pelvis.

AKA Pouch of Morison

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12
Q

falciform ligament

A

From ventral mesentary.
Between ventral wall and the liver.
Lower free border = ligamentum teres

Separates R and L lobes of liver

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13
Q

ligamentum teres

A

Obliterated umbilical vein (carried blood from mother to fetus).
On lower free end of falciform ligament.

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14
Q

lobes of liver

A

Right.
Left.
Caudate.
Quadrate.

R and L separated ventrally by falciform ligament/ligamentum teres.
Posteriorly, L is separated from all others by umbilical fissure (ligamentum venosum, ligamentum teres hepatis)

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15
Q

umbilical fissure

A

Separates L lobe from Caudate, Quadrate lobes.

Consists of ligamentum venosum, ligamentum teres

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16
Q

blood supply to liver

A

75% venous flow via portal vein.

25% arterial flow via hepatic artery proper (divides into R/L hepatic aa) (from celiac trunk, common hepatic a)

17
Q

L hepatic artery supplies

A

Left lobe.
Quadrate lobe.
1/2 caudate lobe.

18
Q

R hepatic artery supplies

A

Right lobe.
1/2 Caudate lobe.
Gallbladder

19
Q

functional lobes of liver

A

Separated by hepatic arteries, portal veins, bile ducts, hepatic veins.

8 segments

20
Q

cause of hepatic cirrhosis

A

Alcohol abuse.
Hepatitis infection.
Autoimmune disease.
Industrial solvents.

21
Q

presentation of cirrhosis

A

Hobnail appearance.
Splenomegaly (bc portal hypertension.
Ascites.

22
Q

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

A

Ito/stellate cells.

23
Q

with portal hypertension (reduced portal blood flow), blood can be shunted _________

A
To systemic circulation, via:
Esophageal v.
Retroperitoneal v.
Rectal v.
Paraumbilical v.
24
Q

esophageal varices

A

enlarged veins in esophagus.
Due to portal hypertension, blood needs to be shunted here away from liver.
More flow than it can handle.
Rupture can be fatal.

25
intestinal varices
Enlarged retroperitoneal veins. Due to portal hypertension, blood needs to be shunted here away from liver. More flow than it can handle.
26
anorectal varices
Enlarged rectal veins. Due to portal hypertension, blood needs to be shunted here away from liver. More flow than it can handle.
27
caput medusa
Dilation of periumbilical veins. Due to portal hypertension, blood needs to be shunted here away from liver. Characteristic of cirrhotic liver.
28
porto-systemic shunt
Treatment for cirrhotic liver failure. Bypass function of the liver to get the blood back into systemic circulation without using anastomotic shunts that lead to varices.
29
bile duct system
Bile canaliculi --> terminal bile ductules --> hepatic ducts --> R/L hepatic duct --> common hepatic duct --> cystic duct
30
sympathetic input to hepatobiliary system
Greater splanchnic n, (T5-T9). Synapse on celiac ganglion. Periarterial plexus follows blood vessels to target.
31
parasympathetic input to hepatobiliary system
Vagus nerve (CN X). stimulate bile production, glycogen synthesis (BUT hormones control most functions)
32
what surrounds the bare area of the liver?
Coronary ligament. L triangular ligament. R triangular ligament.