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Block 3 Week 1 > Hulka Anatomy Liver Pancreas Spleen > Flashcards

Hulka Anatomy Liver Pancreas Spleen Flashcards

1
Q

What are the functions of the liver?

A 
Glycogen stores
Produces bile
Protein production 
Coagulation factors
Filter of enteric circulation
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2
Q

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

A

liver

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3
Q

What are the 2 surfaces of the liver?

A

diaphragmatic and visceral

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4
Q

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

A

diaphragmatic

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5
Q

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?

A

posterior liver

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6
Q

What is the inferior portion of the liver called?

A

the visceral surface

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7
Q

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)

A

inferior portion of liver

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8
Q

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

A

4 lobes

porta hepatis

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9
Q 
What is this?
Fissure in the center of the inferior liver 
Contains 
Portal vein
Hepatic artery
Common bile duct
Lymphatics
Hepatic nerve plexus
A

porta hepatis

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10
Q

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

A

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

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11
Q

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

A

right lobe of liver

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12
Q

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

A

quadrate lobe

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13
Q

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

A

caudate lobe

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14
Q

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

A

falciform ligament

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15
Q

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

A

triangular ligament

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16
Q

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

A

coronary ligament

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17
Q

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

A

hepatogastric ligament

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18
Q

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

A

hepatoduodenal ligament

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19
Q

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

A

lesser omentum

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20
Q

What three things are part of the portal triad?

A

portal vein
common bile duct
proper hepatic artery

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21
Q

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

A 
hepatic artery (30%)
portal vein (70%)
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22
Q

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

A

common hepatic artery

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23
Q

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

A

proper hepatic artery

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24
Q

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

A

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

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25
Q

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

A

portal vein

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26
Q

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

A

Superior hepatic veins

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27
Q

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

A

Inferior hepatic veins

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28
Q

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

A

IVC

29
Q

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

A

parasternal

30
Q

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

A

hepatic

31
Q

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

A

bile

32
Q

Small (blank) bile ducts coalesce to form larger ducts

A

intralobular

33
Q

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

A

right and left hepatic ducts

34
Q

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

A

common hepatic duct

35
Q

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

A

common bile duct

36
Q

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

A

common bile duct

37
Q

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

A

common bile duct stone

38
Q

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)

A

gallbladder

39
Q

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

A

fundus
body
neck

40
Q

Continuous with neck of gallbladder, drains into common hepatic duct

A

cystic duct

41
Q

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

A

cystic duct

42
Q

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

A

cystic artery

43
Q

What is the venous drainage of the gallbladder?

A

drains into portal vein or liver directly

44
Q

What is the lymphatic drainage of the gallbladder?

A

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

45
Q

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

A

Biliary colic

46
Q

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

A

pancreas

pancreatic

47
Q

(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.

A

pancreas

48
Q

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

A

head of pancreas

49
Q

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

A

neck of pancreas

50
Q

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

A

body of pancreas

51
Q

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

A

tail of pancreas

52
Q

THe pancreas develops as (blank)

A

2 separate buds

53
Q

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

A

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

54
Q

Describe the formation of the pancreatic duct

A

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.

55
Q

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)

A

main pancreatic duct

56
Q

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

A

accessory pancreatic duct

57
Q

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

A

pancreatic cancer

58
Q

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

A

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

59
Q

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

A

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

60
Q

HOw does the SMA supply the pancreas?

A

SMA-> inferior pancreaticduodenal artery

supplies head of pancreas

61
Q

HOw does the splenic artery supply the pancreas?

A

splenic->dorsal pancreatic artery

supplies neck, body and tail of pancreas

62
Q

HOw is the pancreas drained (venous drainage)?

A

into the splenic vein

63
Q

what lymph nodes drain the pancreas and what parts?

A

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

64
Q

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

A

spleen

65
Q

Where is the spleen located?

A

left upper abdomen, against diaphragm, behind stomach

66
Q

What ligaments attach the spleen to the stomach?

to the left kidney?

A

gastrolienal ligament

lienorenal ligament

67
Q

HOw is the spleen divided and by what?

A

into 2 poles the superior and inferior

hilum (where BV enter and exit)

68
Q

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

A

splenic artery

69
Q

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

A

splenic vein

Block 3 Week 1 (18 decks)

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