Hulka Anatomy Liver Pancreas Spleen Flashcards by Danielle Hayes

What are the functions of the liver?

Glycogen stores
Produces bile
Protein production 
Coagulation factors
Filter of enteric circulation

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What is the largest gland in the body and accounts for 2% of body weight?

liver

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What are the 2 surfaces of the liver?

diaphragmatic and visceral

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What surface of the liver is the superior, posterior and right lateral aspect that lays next to the diaphragm.

diaphragmatic

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What is considred the “bare area” of liver because it retroperitoneal. This area is in direct contact with diaphram and it has the IVC running through it?

posterior liver

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What is the inferior portion of the liver called?

the visceral surface

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What lies on the anterior surface of stomach, first and second portion of duodenum, gall bladder, lesser omentum, right colic flexure of colon (hepatic flexure)

inferior portion of liver

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THe H shaped fissure on the liver divides it into what? and what is the crossbar of the H?

4 lobes

porta hepatis

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What is this?
Fissure in the center of the inferior liver 
Contains 
Portal vein
Hepatic artery
Common bile duct
Lymphatics
Hepatic nerve plexus

porta hepatis

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What are the definitive lobes of the liver? What are they separated by? What does each lobe have?

the right and left
falciform ligament
arterial, venous and bilary system

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What does this describe:
Two smaller lobes within it
Quadrate lobe - lies between the gallbladder and the falciform ligament, inferior to porta
Caudate lobe - lies between the inferior vena cava and the ligamentum venosum, superior to the porta

right lobe of liver

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What lies between the gallbladder and the falciform ligament, inferior to porta

quadrate lobe

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What lies between the inferior vena cava and the ligamentum venosum, superior to the porta

caudate lobe

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What is this:
Develops from umbilicus and attached to anterior abdominal wall
Terminates in the bare area as the coronary ligament
Antepartum - contains the umbilical vein
Postpartum - umbilical vein becomes the ligamentum teres
Divides liver into left and right lobes

falciform ligament

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What comes off of the coronary ligament and keeps liver attached to diaphragm?

triangular ligament

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What is this:
Begins at the superior aspect of liver where the falciform ligament terminates
Surrounds the bare area of the liver
Left lateral aspect - left triangular ligament
Right lateral aspect - right triangular ligament

coronary ligament

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What is this:
Begins at the left triangular ligament and terminates in the lesser curvature of the stomach
This is a part of the lesser omentum
Contains the left and right gastric arteries and veins, gastric lymphatics

hepatogastric ligament

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What is this:
Begins along the caudate lobe and terminates along the C loop of the duodenum
This is a part of the lesser omentum
Contains the peripancreatic lymphatics

hepatoduodenal ligament

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What is this:
Includes the hepatogastric and hepatoduodenal ligaments
Portal triad runs along the free edge of the lesser omentum
Portal vein
Common bile duct
Proper hepatic artery

lesser omentum

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What three things are part of the portal triad?

portal vein
common bile duct
proper hepatic artery

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What is the double blood supply of the liver and what gives more?

hepatic artery (30%)
portal vein (70%)

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What is this?
Branch of celiac trunk
Passes to right of stomach and along first portion of duodenum
Gives off gastroduodenal and right gastroepiploic branches and becomes proper hepatic artery

common hepatic artery

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What is this?
This ascends along the free edge of the lesser omentum as part of the portal triad
Divides into right and left hepatic arteries

proper hepatic artery

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(blank) divides into right and left arteries. What are some variations of this artery?

proper hepatic
some L hepatics will come off L gastric
SomeR hepatics will come off SMA

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What is this: Formed by the confluence of the superior and inferior mesenteric veins and the splenic vein Runs posterior to bile duct and proper hepatic artery Divides into right and left portal veins

portal vein

What is this: Located at superior aspect of liver, below diaphragm Three of these - drain into inferior vena cava Right - drains right lobe Middle - drains caudate lobe Left - drains left lobe

Superior hepatic veins

What is this: Located at superior aspect of liver, below diaphragm Three superior hepatic veins - drain into inferior vena cava Right - drains right lobe Middle - drains caudate lobe Left - drains left lobe

Inferior hepatic veins

When replacing a liver what will the surgeon take so the multiple posterior branches are not sacrificed?

IVC

Superior and anterior portions of the liver drain to (blank) lymph nodes

parasternal

Inferior portions of the liver drain to (blank) lymph nodes in the porta hepatis and gastric lymph nodes in the lesser omentum.

hepatic

(blank) is made by the liver and drains through the bilary system

bile

Small (blank) bile ducts coalesce to form larger ducts

intralobular

What is this Drain bile from right and left lobes Form the common hepatic duct at the superior aspect of the porta hepatis

right and left hepatic ducts

What is this: After forming by the right and left hepatic ducts, travels approximately 3-5 cm where the cystic duct from the gallbladder drains into this

common hepatic duct

After the cystic duct, the common hepatic duct becomes the (blank)

common bile duct

What is this: Formed after the cystic duct joins the common hepatic duct Travels down the porta hepatis into the head of the pancreas Joins the pancreatic duct Drains into the second portion of the duodenum through the sphincter of Oddi

common bile duct

What is this: Gallstones form in the gallbladder Stones can exit the gallbladder through the cystic duct and block the common bile duct Known as “Choledocholithiasis” Symptoms include pain, jaundice, nausea, vomiting Evaluated by ERCP - endoscopic, retrograde cholangiopancreatogram

common bile duct stone

What is this: Pear shaped organ attached to the right lobe of the liver Stores bile and drains when stomach stimulates it to empty (CCK)

gallbladder

What is the wide end of gallbladder? What is the main portion of gallbladder? What is the narrow, tapered portion of gallbladder?

fundus body neck

Continuous with neck of gallbladder, drains into common hepatic duct

cystic duct

What is this regarding? Position can vary considerable Relation to cystic artery, common bile duct and right hepatic artery can lead to injuries if care is not taken

cystic duct

What is this: Arises from right hepatic artery Multiple variations in position in relation to cystic duct

cystic artery

What is the venous drainage of the gallbladder?

drains into portal vein or liver directly

What is the lymphatic drainage of the gallbladder?

cystic lymph node (node of cliquot) which is found at confluence of cystic and common hepatic duct. Drains into hepatic and celiac lymph nodes

What is this: Gallstones form in the gallbladder Gallstone can lodge in the neck or cystic duct leading to colicky pain in the right upper quadrant Treatment is a cholecystectomy, usually laparoscopic

Biliary colic

What is this: Functions as both an exocrine and endocrine gland External excretion of enzymes into the duodenum through the (blank) duct Internal secretions of insulin and glucagon into blood directly

pancreas pancreatic

(blank) lies in the retroperitonum, behind the stomach in the lesser sac over the spine. The duodenum runs along the right portion and inferior portion of this. The tail of this ends in the hilum of the spleen in the left upper quadrant.

pancreas

This Lies inferior to the superior mesenteric vessels and rests against the aorta posteriorly and has the uncinate process.

head of pancreas

This is a continuation of the head of the pancreas and is app. where the superior mesenteric vessels cross the pancreas.

neck of pancreas

This is Continuous with the neck of pancreas Portion of pancreas to left of aorta and extends superiorly Has and anterior, posterior and inferior surface

body of pancreas

This is Continuous with the body of pancreas Crosses through the lienorenal ligament with the splenic vessels Terminates in the hilum of the spleen

tail of pancreas

THe pancreas develops as (blank)

2 separate buds

What are the two buds of the pancreas and what do they become?

Dorsal bud - becomes main gland Ventral bud - forms uncinate process The two buds fuse to form the normal pancreatic gland

Describe the formation of the pancreatic duct

main pancreatic duct begins in tail of pancreas via dorsal pancreatic bud, proximally the ventral bud (uncinate process) forms proximal pancreatic duct. The duct becomes Y shaped at ucinate process Proximal part of dorsal pancreatic bud duct is accessory pancreatic duct.

What is this: Joins with common bile duct to form the hepatopancreatic ampulla (Ampulla of Vater) Drains into the duodenum through the choledochal sphincter (Sphincter of Oddi)

main pancreatic duct

What is this: Usually is connected to the main pancreatic duct (90%) Can be a separate duct which drains into the duodenum through the minor duodenal papilla

accessory pancreatic duct

What is this: Usually develops in the head of the pancreas Presents with back pain, jaundice and weight loss Symptoms often occur with the blockage of the common bile duct where it traverses the pancreas

pancreatic cancer

What are the three sources of blood supply to the pancreas?

common hepatic artery->superior pancreaticduodenal arteries SMA-> pancreaticduodenal arteries Splenic-> dorsal pancreatic artery

Explain how the common hepatic artery can supply blood to the pancreas and what part of the pancreas does it supply?

common hepatic->gastroduodenal->superior pancreaticduodenal artery supplies head of pancreas and C loop of duodenum

HOw does the SMA supply the pancreas?

SMA-> inferior pancreaticduodenal artery | supplies head of pancreas

HOw does the splenic artery supply the pancreas?

splenic->dorsal pancreatic artery | supplies neck, body and tail of pancreas

HOw is the pancreas drained (venous drainage)?

into the splenic vein

what lymph nodes drain the pancreas and what parts?

Pancreaticosplenic - along superior aspect Pyloric - along head of pancreas Celiac - along draining veins

What is this: Largest lymph tissue in the body Functions to filter the blood of old red cells and clear antigens

spleen

Where is the spleen located?

left upper abdomen, against diaphragm, behind stomach

What ligaments attach the spleen to the stomach? | to the left kidney?

gastrolienal ligament | lienorenal ligament

HOw is the spleen divided and by what?

into 2 poles the superior and inferior | hilum (where BV enter and exit)

What is this: Branch of celiac trunk Runs along the superior aspect of the pancreas to enter the splenic hilum Divides into 3-5 branches in the hilum to supply the spleen All arteries are end arteries…no collateral circulation

splenic artery

What is this: Formed by smaller veins draining the splenic parenchyma Runs along the superior aspect of the pancreas Unites with the superior mesenteric vein to form the portal vein

splenic vein