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Abdomen > Lecture 27. Liver, gallbladder, pancreas, spleen. Portocaval anastomoses > Flashcards

Lecture 27. Liver, gallbladder, pancreas, spleen. Portocaval anastomoses Flashcards

1
Q

The liver is predominantly located in (1)____ and ___ and extends into (2)___ as well.

A
  1. theright hypochondrium and epigastricareas

2. the left hypochondrium

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2
Q

Border of Epiploic foramen (Winslow):

A

ant. : hepatoduodenal lig.
post. : hepatorenale lig.
inf. : duodenorenal lig.
sup. : liver (caudate lobe)

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3
Q

Identify

A
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4
Q

What are Subphrenic spaces?

A

between the anterior and superior aspects of the liver and the diaphragm; (right and left spaces divided by the falciform ligament)

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5
Q

What is Subhepatic space?

A

between the transverse colon and the inferior surface of the liver

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6
Q

Identify

A

Morison’s pouch– a potential space between the visceral surface of the liver and the right kidney

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7
Q

What is special about Morison’s pouch?

A

Morison’s pouch– a potential space between the visceral surface of the liver and the right kidney; the deepest part of the peritoneal cavity lying position

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8
Q

Hepatic recesses and position of the liver

-> the liver is an intraperitoneal organ (except: ___)

A

bare area

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9
Q

Identify liver lobes

A
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10
Q

Liver covered by a fibrous layer, known as___

A

Glisson’s capsule

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11
Q

two further liver ‘accessory‘ lobes

A

Caudate lobe

Quadrate lobe

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12
Q

which surface of liver is this?

A

Diaphragmatic surface

  • anterosuperior surface of the liver
  • smooth and convex, fitting snugly beneath the curvature of thediaphragm
    the posterior aspect is not covered by visceral peritoneum: known as bare area (area nuda)
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13
Q

Which surface of liver is this?

A

Visceral surface: posteroinferior surface of the liver

(it is moulded by the shape of the surrounding organs, making it flat but irregular
relations: right adrenal gland, rightkidney, right colic flexure, transverse colon, superior part of the duodenum,gallbladder,esophagus and stomach)

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14
Q

Name the impressions and groove of liver

Visceral surface of liver

A
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15
Q

Sagittal section from the liver

-> Identify

A
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16
Q

The role of Lesser omentum

A

attaches the liver to the lesser curvature of the stomach and superior part of the duodenum;

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17
Q

3 ligaments you can find in lesser omentum

A

hepatoduodenal ligament (portal triad!)
hepatogastric ligament
The hepatoduodenal ligament surrounds the portal triad.

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18
Q

Innervation of the liver

The parenchyma of the liver is innervated by _____.

A

thehepatic plexus: it contains sympathetic (coeliac plexus) and parasympathetic (vagus nerve) nerve fibres

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19
Q

anterior aspect: lymphatic vessels drain into____; these lie along the hepatic vessels and ducts in the lesser omentum, and empty in the colic lymph nodes which in turn, drain into the cisterna chyli

posterior aspect: lymphatic vessels drain into___,which join the right lymphatic and thoracic ducts

A

hepatic lymph nodes

phrenicandposterior mediastinal nodes

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20
Q

Identify

A
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21
Q

Identify

A
22
Q

Identify

A
23
Q

Identify

A
24
Q

Identify the white space and name the borders

A

CALOT’s trigone

-> Borders: liver; common hepatic duct; cystic duct

25
Q

Innervation of the gallbladder

sympathetic and sensory innervation: ___
parasympathetic innervation: ___

A

coeliac plexus

vagus nerve

26
Q

lymph drains into the___ which are situated close to the neck of the gallbladder
-> empties into __ and ___

A

cystic lymph nodes

the hepatic lymph nodes and the coeliac lymph nodes

27
Q

Relations of pancreas

A 
duodenum
transverse mesocolon
 common bile duct
 stomach
spleen
28
Q

identify parts of pancreas

A
29
Q

Identify

A
30
Q

Arterial supply of pancreas

A

pancreatic branchesof thesplenic artery

31
Q

Innervation of the pancreas

parasympathetic innervation: ___
sympathetic innervation: ___

A

vagus nerve

greater and lessersplanchnic nerves(T5-T12)

32
Q

Lymphatic drainage of the pancreas

  • the lymphatic vessels follow the arterial supply
  • > empty into___ and __, which in turn drain into __ and ___
A

thepancreaticosplenal nodesand the pyloric nodes

the superior mesenteric and coeliac lymph nodes

33
Q

Identify

A
34
Q

Identify

A

Lesser omentum

35
Q

Peritoneal relation of spleen

A

intraperitoneal organ

36
Q

What are the 2 ligaments of spleen?

A
  1. gastrosplenic ligament

2. splenorenal ligament

37
Q

Identify and describe (position) this ligament

A

gastrosplenic ligament

- anterior to the splenic hilum

38
Q

The role of gastrosplenic ligament

A

connects the spleen to the greater curvature of the stomach

39
Q

Identify and describe (position) this ligament

A

Sphenorenal ligament

- posterior to the splenic hilum

40
Q

The role of Sphenorenal ligament

A

connects the hilum of the spleen to the left kidney

41
Q

The splenic vessels and tail of the pancreas lie within ___

A

Splenorenal ligament

42
Q

5 organs or structures in relation with spleen

A

(1) Stomach
(2) Diaphragm
(3) Left colic flexure
(4) Left kidney
(5) Tail of pancreas

43
Q

Describe blood supply of spleen

A

Splenic artery and vein

44
Q

innervation of spleen

A

coeliac plexus

45
Q

What is portocaval anastomosis

A

venous anastomoses between the portal system and vena cava system
Clinical significance! – liver cirrhosis

46
Q

What are the 4 portocaval anastomoses? (1 -> 4)

A
47
Q

portocaval anastomoses

Identify and describe anastomosis 1

A

(1) Anastomosis of esophageal veins
- Portal vein - Left gastric vein
- Systemic vein - Esophageal branch of azygos vein

48
Q

Identify and describe anastomosis 2

A

(2) Anastomosis of paraumbilical veins
- Portal vein - para umbilical vein
- Systemic vein - Superficial epigastric vein

49
Q

Identify and describe anastomosis 3

A

(3) Anastomosis of colonic (retroperitoneal) veins
- Portal vein - Colic veins
- Systemic vein - veins of posterior abdominal wall (retroperitoneal veins)

50
Q

Identify and describe anastomosis 4

A

(4) Anastomosis of rectal veins
- Portal vein - superior rectal vein
- Systemic vein - middle and inferior rectal vein

Abdomen (32 decks)

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