Hulka: Liver, Pancreas, Spleen Flashcards by Megan Foggia

Largest gland in the body

Liver

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Functions of the liver

Glycogen stores
Produces bile
Protein production
Filter of enteric circulation

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The liver has two surfaces

diaphragmatic

visceral

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Superior, posterior and right lateral aspect of the liver that lay next to diaphragm

Diaphragmatic surface

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Part of the diaphragmatic liver, where the liver is in direct contact with the diaphragm

“Bare area” of liver, posterior liver

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What vein runs through the bare area?

inferior vena cava

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Inferior portion of the liver

visceral surface

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What does the visceral surface of the liver lie upon?

Anterior surface of the stomach
First and second portion of the duodenum
Gallbladder
Lesser omentum
Right colic flexure of colon

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What is the fissure called in the center of the inferior liver?

Porta hepatis

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What is contained in the porta hepatis?

Portal vein
Hepatic artery
Common bile duct
Lymphatics
Hepatic nerve plexus

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How many definitive lobes does the liver have?

Two

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What ligament separates the right lobe of the liver from the left?

Falciform ligament

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What are the two smaller lobes within the right lobe of the liver?

Quadrate lobe

Caudate lobe

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Which lobe lies between the gallbladder and the falciform ligament, inferior to the porta hepatis?

Quadrate

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Which lobe lies between the inferior vena cava and the ligamentum venosum, superior to the porta?

Caudate

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The falciform ligament develops from the (blank) and is attached to the (blank) abdominal wall.

umbilicus; anterior

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The falciform ligament terminates in the bare area as what structure?

coronary ligament

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Before birth, the falciform ligament contains what structure? What structure does this become after birth?

Umbilical vein

Ligamentum teres

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What does the falciform ligament do?

Divides the liver into the left and right lobes

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Where does the coronary ligament begin?

Begins at the superior aspect of the liver where the falciform ligament terminates

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What is the left later aspect of the coronary ligament? What is the right lateral aspect of the coronary ligament?

Left triangular ligament; right triangular ligament

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Where does the hepatogastric ligament begin and where does it end?

Hepatogastric ligament begins at the left triangular ligament and terminates in the lesser curvature of the stomach

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What vessels and lymphatics does the hepatogastric ligament contain?

The left and right gastric arteries and veins, and the gastric lymphatics

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What two ligaments make up the lesser omentum?

Hepatogastric and hepatoduodenal

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Through what opening can you enter the lesser sac of the stomach?

Epiploic foramen

Where does the hepatoduodenal ligament begin and end?

It begins along the caudate lobe and terminates along the C loop of the duodenum

What lymphatics are contained in the hepatoduodenal ligament?

peripancreatic lymphatics

What runs along the free edge of the lesser omentum?

the portal triad

What is contained in the portal triad?

Portal vein Common bile duct Proper hepatic artery

What three veins make up the portal vein

Superior mesenteric Inferior mesenteric Splenic

Two blood supplies to the liver

``` Hepatic artery (30%) Portal vein (70%) ```

This artery branches off of the celiac trunk and gives off gastroduodenal and right gastroepiploic brances, eventually becoming the proper hepatic artery

Common hepatic artery

This artery ascends along the free edge of the lesser omentum as a part of the portal triad

Proper hepatic artery

What does the proper hepatic artery branch into?

Right and left hepatic arteries

What does the portal vein divide into?

Right and left portal vein

How many superior hepatic veins are there? Where do they drain into?

Three: right, middle, and left | Drain into inferior vena cava

The right, middle, and left superior hepatic veins drain which lobes of the liver?

Right: right Middle: caudate Left: left

How many branches are there of the inferior hepatic veins? Where do they drain into?

6 to 18 branches | Inferior vena cava

When removing the liver in a liver transplant, you take this entire vein

Inferior vena cava

The superior and anterior portions of the liver drain to which nodes?

parasternal lymph nodes

The inferior portion of the liver drains to the (blank) lymph nodes in the porta hepatis, and the (blank) lymph nodes in the lesser omentum.

hepatic; gastric

Bile is made in the (blank) and drains through this system

liver; biliary system

The common hepatic duct becomes the common bile duct after joining with this duct.

Cystic duct

The common bile duct travels down into the head of the pancreas where it joins this duct

Pancreatic duct

Where does the common bile duct drain? What sphincter is involved?

Into the second portion of the duodenum through the sphincter of Oddi

Where is the gallbladder attached to the liver?

At the right lobe

What are two functions of the gallbladder?

stores bile | drains when stomach stimulates it to empty via CCK

Four portions of the gallbladder

1. fundus 2. body 3. neck 4. cystic duct

This artery supplies the gallbladder. It arises from the right hepatic artery and has multiple variations in position in relation to the cystic duct

Cystic artery

Where does the gallbladder drain its blood?

Into the portal vein or the liver directly

What lymph node, found at the confluence of the cystic and common hepatic duct, drains the gallbladder?

cystic lymph node (Node of Cliquot)

term used to describe a type of pain related to the gallbladder that occurs when a gallstone transiently obstructs the cystic duct and the gallbladder contracts.

Biliary colic

Describe how the pancreas functions as an endocrine and exocrine gland.

Endocrine: secretes insulin/glucagon directly into bloodstream Exocrine: secretes pancreatic enzymes into duodenum thru pancreatic duct

lies in the retroperitoneum, behind the stomach in the lesser sac, over the spine

Pancreas

Where does the tail of the pancreas end?

In the hilum of the spleen, left upper quadrant

This portion of the pancreas lies within the C loop of the duodenum

Head of the pancreas

Posteriorly, the head of the pancreas lies on these two vessels

IVC | right renal vessels

The (blank) enters the head of the pancreas

Common bile duct

Part of the head of the pancreas; | Lies inferior to the superior mesenteric vessels and rests against the aorta posteriorly

uncinate process

Four portions of the pancreas

Head, Neck, Body, Tail

The pancreas develops as two separate buds. Which bud becomes the main gland? Which bud forms the uncinate process?

The dorsal bud; vental bud

In what part of the pancreas does the main pancreatic duct begin?

In the tail

The main pancreatic duct joins with the common bile duct to form this

hepatopancreatic ampulla

Where does the main pancreatic duct drain? What sphincter is involved?

Into the duodenum through the Sphincter of Oddi

This structure is usually connected to the main pancreatic duct

accessory pancreatic duct

In what portion of the pancreas does pancreatic cancer usually develop? What are its symptoms?

head of the pancreas; back pain, jaundice, weight loss

3 sources of blood supply to the pancreas (CGS)

superior pancreaticoduodenal artery (from the common hepatic artery) inferior pancreaticoduodenal artery (from the SMA) dorsal pancreatic artery (from the splenic artery)

Into which vein does most of the pancreas drain?

splenic vein

Pancreas drains to three lymph nodes

Pancreaticosplenic (superiorly) Pyloric (head) Celiac (draining veins)

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 the diaphragm, behind the stomach

What ligament attaches the spleen to the stomach?

gastrolienal ligament

What ligament attaches the spleen to the left kidney?

lienorenal ligament

How many poles is the spleen divided into? What is the central portion of the spleen called?

2, superior and inferior; hilum

What artery supplies the spleen? What is unique about this artery?

splenic artery; it is an end artery, no collateral circulation

What vein drains the spleen? What vein does it meet up with to form the portal vein?

splenic vein; superior mesenteric

Which lobe of the right liver is superior to the porta hepatis?

Caudate

Trace the cystic artery of the gallbladder back to the aorta

Cystic artery-->right hepatic artery-->proper hepatic artery-->common hepatic artery-->celiac trunk-->aorta

The common bile duct enters the (blank) of the pancreas, joins with the (blank) and then enters the (blank)

head; pancreatic; duodenum