Lecture 15 - Liver, Bile, Portal System

Question 1

Blood supply to liver?

Answer 1

1/4 Hepatic artery, 3/4 portal vein

Question 2

What things are on the posterior surface of the liver?

Answer 2

Oesophagus, stomach, duodenum, right colic flexure, right kidney, supra-renal gland, gallbladder

Question 3

Between lobes of liver?

Answer 3

Falciform ligament

Question 4

Lobes of liver?

Answer 4

Left, right, caudal (sup. post, IVC seperates from right lobe) and quadrate lobe (inf. ant. gallbladder seperates from right lobe)

Question 5

Bare area?

Answer 5

Post. sup. right, retroperitoneal due to contact with body wall

Question 6

Porta hepatis contents (left to right)?

Answer 6

Hepatic artery proper (ant.), portal vein (post.) and bile duct (ant.)

Question 7

Ligaments of liver?

Answer 7

left and right triangular, coronary ligament, falciform ligament, ligamentum teres

Question 8

Blood pathway through liver?

Answer 8

Hepatic artery proper and portal vein enter liver, branch off heaps, conducted into central vein of each lobule by sinusoids, central veins drain into right, central and left hepatic vein, all immediately draining into inferior vena cava

Question 9

Lymphatic drainage of liver?

Answer 9

Nodes at porta hepatis to coelic nodes @T12

Question 10

ANS supply to liver?

Answer 10

Parasympatheic: Vagus nerve; sympathetic: greater splanchic nerves (T5-9); pain referred to epigastric region

Question 11

Gallbladder: 3 parts and location?

Answer 11

Fundus (hangs below liver), Body (contacts visceral surface of liver), Neck (joins cystic duct) - all intraperitoneal

Question 12

Gallbladder emulsifying fat?

Answer 12

Presence of fat in duodenum causes cholecystokinin release which causes GB to contract, smooth muscle at distal end of bile duct and ampulla relax, moving bile into duodenum to emulsify fat

Question 13

Biliary tree passage?

Answer 13

Left and right hepatic duct join to form common hepatic duct, cystic duct from gallbladder joins to form bile duct, passes behind duodenum, joins w pancreatic duct forming ampulla of vater, ampulla opens into duodenum via sphincter of Oddi

Question 14

Arterial supply of gallbladder?

Answer 14

Cystic artery (from R hepatic artery) which passes through triangle of calot

Question 15

Venous drainage of gallbladder?

Answer 15

Cystic vein into portal vein

Question 16

Nerve supply of gallbladder?

Answer 16

ANS coeliac plexus, pain to epigastric region (same as liver)

Question 17

Portal system?

Answer 17

Inferior mesenteric vein branches onto plenic vein, splenic and sup. mesenteric vein form the portal vein behind the neck of the pancreas

Question 18

Porto-systemic shutdown?

Answer 18

Portal hypertension forces blood to find another path via systemic shutdown

Question 19

Oesophageal varices?

Answer 19

bottom 1/3 oesophagus route to rest of oesophagus

Question 20

Caput medusae?

Answer 20

shunt in umbilical region causing umbilical vein to flow into superficial veins

Question 21

Anorectal varices?

Answer 21

Superior rectal veins into Inf. and Mid. rectal veins