Jaundice 2

Question 1

how is common hepatic duct formed

Answer 1

right and left hepatic ducts unite

Question 2

how is bile duct formed

Answer 2

common hepatic duct unties with cystic duct

Question 3

where does bile duct drain into

Answer 3

2nd part of duodenum

Question 4

describe the course of the bile duct

Answer 4

descends posteriorly to the 1st part of duodenum
travels into a groove on the posterior aspect of pancreas
joins with main pancreatic duct
they both then drain into 2nd part of duodenum

Question 5

what is formed as bile duct joins with main pancreatic duct

Answer 5

ampulla of Vater/hepatopancreatic ampulla

Question 6

how does the bile duct drain into duodenum

Answer 6

via major duodenal papilla

Question 7

what are anatomical sphincters

Answer 7

discrete areas where muscle completely encircles the lumen of the tract

Question 8

smooth muscle sphincters in the biliary tract

Answer 8

bile duct sphincter
pancreatic duct sphincter
sphincter of Oddi

Question 9

function of anatomical sphincters

Answer 9

prevent reflux of digestive secretions and duodenal content

Question 10

specific function of bile duct sphincter

Answer 10

controls flow of bile into duodenum

Question 11

investigation to study biliary tree and pancreas

Answer 11

endoscopic retrograde cholangiopancreatography (ERCP)

also treats pathologies!!!

Question 12

extra hepatic obstructive causes of jaundice

Answer 12

obstruction of biliary tree
flow of bile back up to the liver
overspill into blood

Question 13

how may the biliary tree be obstructed

Answer 13

gallstones

carcinoma at head of pancreas

Question 14

describe the structure of the pancreas

Answer 14

head (with uncinate process)
neck
body
tail

Question 15

describe the uncinate process

Answer 15

small projection from inferior part of the head of the pancreas and lies posterior to the superior mesenteric artery

Question 16

describe the pancreas and its location

Answer 16

retroperitoneal organ

lies transversely across posterior abdomen

Question 17

what lies posterior to the pancreas

Answer 17

the right kidney and adrenal gland
IVC
bile duct
abdominal aorta
superior mesenteric vessels
left kidney and adrenal gland
part of the portal venous system

Question 18

what lies anterior to pancrwas

Answer 18

stomach

Question 19

what surrounds the head of the pancreas

Answer 19

duodenum

Question 20

what lies superoposteriorly to pancreas

Answer 20

splenic vessels

Question 21

parasympathetic nerves of pancreas

Answer 21

vagus

Question 22

sympathetic nerves of pancreas

Answer 22

abdominopelvic splanchnic nerves

Question 23

blood supply of pancreas

Answer 23

mainly branches from splenic artery - pancreatic branches
close relationship to duodenum and so similar blood supply;
gastroduodenal artery
superior mesenteric artery

Question 24

describe the gastroduodenal artery

Answer 24

superior pancreaticoduodenal

Question 25

describe the superior mesenteric artery

Answer 25

inferior pancreaticoduodenal

Question 26

inflammation of the pancreas

Answer 26

pancreatitis

Question 27

causes of pancreatitis

Answer 27

blockage of the ampulla by a gallstone - bile diverted into pancreas leading to irritation and inflammation

Question 28

radiation of pain in the pancreas

Answer 28

felt in epigastric and/or umbilical region | may radiate to patient's back

Question 29

4 parts of duodenum

Answer 29

``` 25cm in length; superior (intraperitoneal) - duodenal cap descending (retroperitoneal) horizontal (retroperitoneal) ascending (retroperitoneal) ```

Question 30

where does duodenum begin

Answer 30

at pyloric sphincter

Question 31

describe the pylroic sphincter

Answer 31

anatomical sphincter controlling the flow of chyme from stomach to duodenum

Question 32

what does duodenum secrete

Answer 32

peptide hormones into the blood; gastrin CCK

Question 33

where is pain from a duodenal ulcer felt

Answer 33

epigastric region

Question 34

sympathetic innervation of pyloric sphincter

Answer 34

promotes contraction

Question 35

parasympathetic innervation of pyloric sphincter

Answer 35

promotes relaxation

Question 36

blood supply of duodenum

Answer 36

gastroduodenal artery | superior mesenteric artery

Question 37

which abdominal quadrant are jejunum and ileum found

Answer 37

all quadrants jejunum - mainly upper left ileum - mainly lower right

Question 38

where does jejunum begin

Answer 38

duodenaljejunal flexure

Question 39

where does ileum end

Answer 39

ileocaecal junction

Question 40

what is the duodenal-jejunal flexure

Answer 40

the junction between duodenum and jejunum

Question 41

mucosa in jejunum

Answer 41

highly folded - plicae circularis wider thick walled less fat

Question 42

mucosa in distal ileum

Answer 42

smooth narrow thin walled more fatty

Question 43

arterial blood supply of jejunum and ileum

Answer 43

superior mesenteric artery via jejunal and ileal arteries

Question 44

venous drainage of jejunum and ileum

Answer 44

from jejunal and ileal veins to superior mesenteric vein and hepatic portal vein

Question 45

protein and carbohydrate absorption in small intestine

Answer 45

aborbed from small intestine into portal venous system to be taken into liver

Question 46

how do vessels travel in jejunum and ileum

Answer 46

within mesentery

Question 47

how is fat absorbed from the GI tractl lumen

Answer 47

bile helps absorption into intestinal cells

Question 48

where are fats absorbed from intestinal cells

Answer 48

absorbed into specialised lymphatic vessels of small intestine - lacteals

Question 49

course of lacteals

Answer 49

travel via lymphatic system to drain into venous system at left venous angle

Question 50

where are lymph vessels located in the abdomen

Answer 50

lie alongside arteries

Question 51

main groups of lymph nodes draining abdominal organs

Answer 51

celiac - foregut organs superior mesenteric - midgut organs inferior mesenteric - hingut organs lumbar - kidneys, posterior abdo wall, pelvis and lower limbs

Question 52

where do superficial lymph vessels drain into

Answer 52

deep lymph vessels dependent on where they originate from; thoracic duct or right lymphathtic duct and then into venous system

Question 53

venous angles

Answer 53

junction between subclavian and internal jugular veins

Question 54

what drains into left venous angle

Answer 54

thoracic duct

Question 55

what drains into right venous angle

Answer 55

right lymphatic duct drainage