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Block 3; Week 1 > Hulka Liver > Flashcards

Hulka Liver Flashcards

1
Q

What are the 2 surfaces of the liver?

A

diaphragmatic

visceral

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2
Q

Describe the diaphragmatic surface of the liver.

A

This is the superior & posterior section of the liver. It includes the bare area of the liver. The IVC runs thru the bare area.

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3
Q

Describe the visceral surface of the liver.

A

This is the inferior portion of the liver.

H shaped fissures are found here that mark the porta hepatis

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4
Q

What is found in the port hepatis?

A 
portal vein
hepatic artery
common bile duct
lymphatic duct
hepatic nerve plexus
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5
Q

T/F Each lobe of the liver has its own arterial, venous, & biliary system.

A

TRUE

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6
Q

T/F There are 3 lobes in the liver.

A

FALSE
There are only 2.
Right Lobe: to the right of the falciform ligament; Left lobe: to the left of the falciform ligament
BUT there are 2 smaller lobes that comprise the right lobe.

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7
Q

What are the 2 mini lobes that comprise the right lobe of the liver?

A

Quadrate Lobe
Caudate Lobe
**caudate is on top

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8
Q

What’s the deal w/ the falciform ligament?

A

develops from the umbilicus
it is attached to the anterior abdominal wall
becomes the coronary ligament in the bare area of the liver
divides the liver into L & R lobes

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9
Q

What is different about the falciform ligament before & after birth?

A

Before Birth: contains the umbilical vein

After Birth: umbilical vein becomes the ligamentum trees

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10
Q

What’s the deal w/ the coronary ligament?

A

it begins @ the superior aspect of the liver where the falciform ligament ends
surrounds the bare area of the liver
contains the left triangular ligament & right triangular ligament

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11
Q

What’s the deal w/ the hepatogastric ligament?

A

this begins @ the left triangular ligament & goes to the lesser curvature of the stomach
it is a part of the lesser omentum

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12
Q

What runs thru the hepatogastric ligament?

A

left & right gastric arteries & veins

gastric lymphatics

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13
Q

What’s the deal w/ the hepatoduodenal ligament?

A

begins @ the caudate lobe
terminates @ the C loop of the duodenum
a part of the lesser omentum

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14
Q

What runs thru the hepatoduodenal ligament?

A

peripancreatic lymphatics

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15
Q

Which 2 ligaments does the lesser omentum contain?

A

hepatogastric

hepatoduodenal

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16
Q

What runs thru/along the lesser omentum?

A

portal triad

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17
Q

Describe the dual blood supply of the liver.

A 
Hepatic Artery (responsible for 30%)
Portal Vein (responsible for 70%)
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18
Q

Where does the hepatic artery for the liver come from?

A

It comes from the common hepatic artery that was a branch off the celiac trunk.
The common hepatic branches into the gastroduodenal & right gastroepiploic branches
After it gives off these branches it is considered the proper hepatic artery

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19
Q

What does the proper hepatic artery branch into?

A

left & right hepatic arteries

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20
Q

Describe 2 weird variation of the liver arterial blood supply.

A

Replaced Left Hepatic:
10% of people will have their left hepatic arteries coming off of the left gastric artery
Replaced Right Hepatic:
1-2% of people will have their right hepatic arteries coming directly off of the SMA

21
Q

Where does the portal vein run? What does it divide into? What empties into it?

A

It runs behind the bile duct & proper hepatic artery
It divides into R & L portal veins
**SMV, IMV, & Splenic Veins all empty into it.

22
Q

Describe the venous drainage for the superior aspect of the liver.

A

there are 3 superior hepatic veins that drain the liver.
Right Vein–>Right Lobe (Quadrate?)
Middle Vein–>Caudate Lobe
Left Vein–>Left Lobe

23
Q

Describe the venous drainage for the inferior aspect of the liver.

A

this is the posterior inferior portion of the liver
drains into the IVC
6-18 branches drain the different portion of the liver

24
Q

T/F During a liver transplant the surgeon makes sure to leave the IVC w/ the donor.

A

False. They take the IVC w/ it to assure proper venous drainage.

25
Q

Where does the lymph from the superior & anterior portions of the liver drain?

A

parasternal lymph nodes

26
Q

Where does the lymph from the inferior portions of the liver drain?

A

hepatic lymph nodes (found in porta hepatis) & gastric lymph nodes (found in lesser omentum)

27
Q

What do the right & left hepatic ducts form?

A

the common hepatic duct @ the superior portion of the porta hepatis

28
Q

Once the cystic duct drains into the common hepatic duct–>what does it become?

A

the common bile duct

29
Q

Once the pancreatic duct drains into the common bile duct what does it become known as?

A

ampulla of Vater, has the sphincter of Oddi

30
Q

What are the symptoms of choledocolithiasis?

A

pain, jaundice, nausea, vomiting

31
Q

How do you evaluate if you have choledocolithiasis?

A

endoscopic retrograde cholangiopancreatogram

32
Q

What hormone stimulates the gallbladder to empty?

A

CCK

33
Q

What is the arterial supply to the gallbladder?

A

cystic artery–>from the right hepatic artery

34
Q

What is the venous drainage of the gallbladder?

A

it drains into the portal vein or liver directly

35
Q

Describe the lymphatic drainage of the gallbladder.

A

the cystic lymph node drains into the hepatic lymph node, which drains into the celiac lymph nodes.

36
Q

Where is the cystic lymph node located?

A

it is found @ the confluence of the cystic & common hepatic duct

37
Q

If you have gallstones lodging in the cystic duct…where will you feel pain?

A

right upper quadrant

38
Q

The superior mesenteric vessels cross the pancreas at which portion?

A

the neck of the pancreas

39
Q

Embryologically, the pancreas forms as 2 different buds. What are they & what do they form?

A

Dorsal Bud: becomes the main gland

Ventral Bud: forms the uncinate process (head of the pancreas)

40
Q

Explain the blood supply to the head of the pancreas.

A 
Celiac:
Common Hepatic Artery
Gastroduodenal Artery
**Superior Pancreaticoduodenal arteries
SMA: 
**Inferior Pancreaticoduodenal arteries
41
Q

Explain the blood supply to the neck, body & tail of the pancreas.

A

Celiac:
Splenic Artery
**Dorsal Pancreatic Artery

42
Q

Where does most of the pancreas drain?

A

**most of it drains into the splenic vein

43
Q

What are the 3 lymph nodes that drain the pancreas?

A

pancreaticosplenic
pyloric
celiac

44
Q

What attaches the spleen to the stomach?

A

gastrolineal ligament

45
Q

What attaches the spleen to the left kidney?

A

lienorenal ligament

46
Q

Explain the division of the spleen.

A

Divided into 2 poles, superior & inferior by the central portion w/ blood vessels

47
Q

Explain the arterial blood supply of the spleen.

A

Celiac:
Splenic Artery
3-5 branches @ hilum (all end arteries)

48
Q

Explain the venous drainage of the spleen.

A

smaller veins drain into the splenic vein

this unites w/ the SMV–>Portal Vein

Block 3; Week 1 (11 decks)

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