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Gastrointestinal system > Liver and biliary tree > Flashcards

Liver and biliary tree Flashcards

1
Q

Functions of liver

A 
Hormone production/breakdown
RBC breakdown
Detoxification 
Bile production 
Glycogen storage 
Albumin production
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2
Q

Where is the liver?

A 
RHS of abdomen
Below diaphragm (at T7/8)
Protected by 7-10th ribs
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3
Q

Inferior to liver

A

On RHS is superior pole of right kidney and hepatic colon flexure and adrenal gland

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4
Q

Where is IVC in relation to liver?

A

Posterior

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5
Q

4 lobes of liver

A

Right
left
Caudate
Quadrate

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6
Q

Arterial supply to liver

A

Left gastric, splenic and common hepatic from celiac flexure at T12

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7
Q

Function of hepatic portal vein

A

Transport venous blood to liver

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8
Q

Function of hepatic veins

A

Drain liver of blood

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9
Q

Where do hepatic veins drain to?

A

IVC

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10
Q

3 fissures in liver

A

Left and right sagittal, connected by aorta hepatis

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11
Q

Where is the bile duct?

A

From liver to duodenum

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12
Q

Portal triad

A

Portal vein, hepatic artery and bile duct

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13
Q

How does ductus venous form?

A

Umbilical vein + hepatic portal vein

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14
Q

What does umbilical vein form?

A

Round ligament and ductus venous -> ligamentum venous

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15
Q

How does bile reach its site of action?

A

Channels through r and l hepatic duct to reach common hepatic duct
Common hepatic duct through portal hepatic
Hepatic duct + cystic duct -> common bile duct

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16
Q

Lesser momentum

A

Hepatic vein and artery

17
Q

What is the bare area of the liber?

A

No peritoneum

18
Q

Clinical relevance of hepatorenal and subphrenic recesses

A

Collect fluid
Ascitis - fluid builds up in peritoneal space
Albumin increases oncotic pressure of blood

19
Q

Where does the falciform ligament run?

A

Abdominal wall to liver

20
Q

Where are the triangular ligaments?

A

They travel towards diaphragm

21
Q

Where are the coronary ligaments?

A

From peritoneum to diaphragm

22
Q

Liver failure sx

A
  • Clubbing
  • Spider neavi
  • Palmer erythema
  • Encephalopathy
  • Asterixis
  • Gynecomastica
  • Bruising
  • Xanthoma
23
Q

Gall stones

A
  • Gall stones: collection of cholesterol in gall bladder
  • Normally gall bladder squeezes stones towards duodenum and scrape lining of biliary tree
  • Gall stones have normal obs, just pain in RUQ
  • If stone lodges in cystic duct forms back up of bile into gall bladder, distending it and causing bacteria to grow (cholecystitis)
24
Q

What is cholecystitis

A

Gall stone lodges in cystic duct and creates back up of bile into gall bladder

25
Q

Is there jaundice with cholecystitis and why

A
  • Cholecystitis unlikely to be jaundiced
  • Bilirubin is breakdown product and excreted in bile fluid
  • Bilirubin can be excreted in cystitis so no jaundice
26
Q

Ascending cholangitis

A

Ascending cholangitis: stone blocked in bile duct - bile builds up in liver and bilirubin builds up in blood causing jaundice

27
Q

Charcot’s triad

A

Fever, jaundice, abdominal pain

28
Q

Symptoms of pancreatic cancer

A

Painless jaundice

29
Q

What shape are liver lobules?

A

Hexagonal

30
Q

Which three things are found between liver lobules

A

Portal vein, artery and bile duct

31
Q

What is found in the centre of liver lobules?

A

Central vein

32
Q

What communicates between the centre and edge of lobules

A

Sinusoids and hepatocytes

33
Q

Where does bile move in the liver lobules?

A

To bile duct in portal triad

34
Q

Function of stellate cells

A

Stellate cells secrete collagen (hepatocytes damaged in cirrhosis for example)

35
Q

Asterixis

A

Liver failure due to build up of toxins = flapping hands

36
Q

Does oestrogen increase or decrease in liver failure?

A

Increase

37
Q

Why is collagen bad?

A
  • Collagen narrows channels to stop blood running to central vein → build up of bile
  • Blood can’t get through liver - back up of blood in portal venous system

Gastrointestinal system (27 decks)

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