Lesson 5B (Part 1)

Question 1

What makes the portal venous system unique? (4)

Answer 1

1. Liver has dual blood supply
2. System includes all veins that drain blood from the spleen, pancreas, GB and GI tract
3. Supplies approximately 80% of the liver’s blood supply
4. Disruption to the flow can cause multiple adverse effects

Question 2

What happens when blood gets to the liver?

Answer 2

It goes through detoxification and metabolize

Question 3

How much oxygen is supplied to the livers blood supply?

Answer 3

About half

Question 4

What does the portal venous system include? (8)

Answer 4

1. SMV
2. IMV
3. SV
4. MPV
5. Intrahepatic portal veins
6. HVS
7. IVC
8. Tributaries

Question 5

What happens to the portal venous blood?

Answer 5

It gets filtered twice

Question 6

Where does the portal venous blood get filtered? (2)

Answer 6

1. Capillaries

2. Liver

Question 7

Where do portal veins terminate?

Answer 7

In the sinusoids of the liver

Question 8

What doe portal veins do?

Answer 8

Deliver blood to the hepatic veins and in turn to the IVC

- which then transports blood to the heart

Question 9

Is the MPV intra or extrahepatic?

Answer 9

Both

- when its not in the liver its extra and when its in the liver its intra

Question 10

How long is the MPV?

Answer 10

5-6cm long

Question 11

What is the diameter of the MPV?

Answer 11

< 13mm

Question 12

Confluence is directly posterior to which part of pancreas?

Answer 12

Neck

Question 13

What can be seen anterior to MPV near hilum?

Answer 13

CBD

Question 14

What make up the portal triad? (3)

Answer 14

1. Hepatic artery
2. Bile ducts
3. Portal veins

Question 15

Why is the MPV easy to distinguish?

Answer 15

Because it is enclosed by a sheath of connective tissue with a high collagen content that gives it a echogenic appearance

Question 16

What does the SMV drain? (4)

Answer 16

1. Small and large intestine
2. Stomach
3. Pancreas
4. Appendix

Question 17

How does the SMV run? (2)

Answer 17

1. Right lateral to SMA

2. Parallel and RT lateral to IMV

Question 18

What is rare for the SMV?

Answer 18

Thrombosis

Question 19

What can thrombosis in the SMV cause?

Answer 19

Mesenteric ischemia

- can be fatal

Question 20

How does the IMV lie?

Answer 20

Vertical oblique orientation

Question 21

How does the SMV lie?

Answer 21

Vertical oblique orientation

Question 22

What does the IMV drain? (3)

Answer 22

1. Large intestines
2. Sigmoid colon
3. Rectum

Question 23

Where does the IMV terminate?

Answer 23

Upon entry into the splenic vein

Question 24

Where does the IMV run?

Answer 24

Left lateral to SMV

Question 25

Is the splenic vein intra or retroperitoneal?

Answer 25

Intraperitoneal

Question 26

What does the splenic vein drain? (3)

Answer 26

1. Spleen
2. Branches of pancreas
3. Stomach

Question 27

Where does the splenic vein lie compared to the splenic artery?

Answer 27

Inferoposterior

Question 28

Where does the splenic vein run?

Answer 28

Medially from the spleen and unites posterior to pancreas neck with the SMV at the confluence

Question 29

Which portal vein is longer?

Answer 29

Left

Question 30

Which portal vein is larger?

Answer 30

Right

Question 31

What do the medial and lateral subdivisions of the portal vein supply in the liver? (2)

Answer 31

1. Left lobe

2. Caudate lobe

Question 32

Why does the right descending portal vein appear blue on doppler?

Answer 32

Because it is flowing away from the transducer

- but is still towards the liver so it is considered hepatopetal

Question 33

What are tributaries of the portal vein? (8)

Answer 33

1. SV
2. SMV
3. Cystic V
4. Pyloric V
5. LT and RT Gastric V
6. Pancreaticduodenal V
7. Gastroepiploic V
8. IMV