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Digestive MBChB 2 > Lecture 14 (Part A): Liver and Biliary system > Flashcards

Lecture 14 (Part A): Liver and Biliary system Flashcards

1
Q

Whats the diverse function of the liver?

A
  • Detoxification - CHO and glucose regulation - Bile drainage - Blood circulation and filtration - Synthesis and storage of acids/proteins/fats and vitamins. Endocrine/exocrine function
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2
Q

What is the dual blood supply of the liver?

A

1/4 Hepatic artery 3/4 Portal vein

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3
Q

Describe the location of the liver using surface anatomy;

A
  • R hypochondrium into epigastric region - Sup. boundary Ribs 5/6 level - Gall bladder = 9th costal cartilage level mid clavicular line - Post. surface = Oesophagus, stomach, duodenum, R. colic flecture, R. kidney, suprarenal gland, gall bladder.
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4
Q

What is the legimentum teres (liver) a remnant of?

A

Umbilical vein

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5
Q

Whats the bare area of the liver?

A

No peritoneum

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6
Q

What are the lobes present on the posterior surface?

A

Left lobe Right lobe Caudate lobe (sup) Quadrate lobe (inf)

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7
Q

What attaches to the porta hepatis?

A

Free edge of lesser omentum attaches here and carries structures with it

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8
Q

Describe the structures found in the porta hepatis;

A

Artery; Ant. and LHS Bile duct; Ant. and RHS Portal vein; Posterior (inbetween)

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9
Q

Describe the portal vein;

A

Largest in porta hepatis - Divides in liver into R and L portal vein

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10
Q

Describe the common hepatic duct;

A

Splits into R and L hepatic duct in liver

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11
Q

Describe the proper hepatic artery;

A

Splits into R and L hepatic artery

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12
Q

Are there hepatic veins coming from the liver?

A

No. Theres direct drainage into the IVC.

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13
Q

Describe the peritoneum of the liver;

A

The liver is covered in visceral peritoeum except; - Fossa of gall bladder - Area attached to diaphragm (bare area) Peritoneum folds back on itself to form the falciform and R+L triangular ligaments

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14
Q

What are the ligaments of the liver?

A
  • R+L triangular ligaments - Anterior/posterior coronary ligament - Falciform ligament -> Ligamentum teres
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15
Q

Describe the the blood passing to the liver;

A

25% Hepatic art. proper = Oxygenated 75% Portal vein = Nutrient rich

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16
Q

Describe the blood flow within the liver;

A

Arterial and venous blood are conducted to central vein of each liver lobule by sinusoids

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17
Q

Where do the veins drain to?

A

Central veins drain to R, L and central hepatic veins. Then directly into the IVC.

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18
Q

What generates the physiological lobes?

A

Each physiological lobe gets its own branch of the portal triad. This means each lobe can preserve function

19
Q

Is there arterial/venous communication between the right and left halves of the liver?

A

No arterial communication between left and right halves of liver

20
Q

How much does the liver contribute to lymph?

A

1/3-1/2 of total body lymph comes from the liver

21
Q

Where does liver lymph go to?

A

Nodes at porta hepatis to coeliac nodes @ T12.

22
Q

Whats the neural supply to the liver?

A

Visceral supply from celiac plexus - Parasymp via Vagus - Symp via greater splenic nerve (T5-9)

23
Q

Where is liver pain referred to?

A

Referred to epigastric region (Small amount via diaphragm to right shoulder/chest)

24
Q

Describe the gross morphology of the gall bladder;

A

Fundus hangs below the liver Body contacts visceral surface of the liver Neck joins the cystic duct

25
Q

What does the gall bladder store?

A

Stores and concentrates bile (Folds and microvilli)

26
Q

What causes the gall bladder to contract?

A

Fat in the duodenum causes CCK release and GB contraction

27
Q

How does gall bladder contraction occur?

A

Smooth muscle at distal end bile duct and ampulla relax = Bile into duodenum to emulsify fat.

28
Q

What is the source of bile?

A

Bile is secreted by the liver and stored in the gall bladder. Releases into second part of duodenum

29
Q

Where does the common bile duct go?

A

Common bile duct joins main pacnreatic duct and opens into heapatopancretic ampulla (of vater). This opens into duodenum via major duodenal papilla (spincter of oddi)

30
Q

What is the blood supply of the gall bladder?

A

Art. = Cystic artery (from R hep. art) (passes through traingle of calot) Venous = Cystic vein (Into portal vein)

31
Q

What is the nerve supple of the gall bladder? and pain referral?

A

ANS via the coeliac plexus (same as liver) Pain is referred to the epigastric region

32
Q

What are gall stones also known as?

A

Cholelithiasis Choledocolithiasis = gall stones in bile duct.

33
Q

What are different gall stones?

A

Cholesterol = Green or yellow/white Pigment = Bilirubin and calcium salts usually small and dark

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Digestive MBChB 2 (31 decks)

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