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Anatomy (JC2) > Liver and Extrahepatic Biliary System > Flashcards

Liver and Extrahepatic Biliary System Flashcards

1
Q

Where is the Liver?

A

Right Hypocondrium and Epigastric Regions, from the 4th intercostal space to the costal margin, lying deep to ribs 7 to 11

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2
Q

What are the functions of the Liver?

A

Stores Glycogen and Secretes Bile, as well as other metabolic functions

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3
Q

What are the surfaces of the liver?

A
  1. Diaphragmatic Surface

2. Visceral Surface

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4
Q

Which surfaces of the liver make up the Diaphramatic surface?

A
  1. Anterior
  2. Superior
  3. Posterior
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5
Q

Which surface of the Liver makes up the Visceral Surface?

A

Posters-Inferior Surface

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6
Q

What shape is the diaphragmatic surface of the liver?

A

Convex

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7
Q

What shape is the visceral surface of the liver?

A

Concave

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8
Q

Where is the Subphrenic Recess?

A

Between diaphragm and the superior and anterior surface of liver

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9
Q

Where is Morison’s pouch?

A

Between the right surface of liver and kidney and suprarenal gland–> Hepatorenal recess

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10
Q

Where is the Bare Area of the Liver?

A

Where the liver lies in direct contact with the diaphragm

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11
Q

Is the Visceral Surface of the liver covered with peritoneum?

A

Yes, except for the fossa for gallbladder and portal hepatis

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12
Q

What is Porta hepatis?

A

The ‘hilum’ of the liver–> contains the hepatic portal vein, hepatic artery, lymphatic vessels, hepatic nerve plexus and hepatic duct

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13
Q

What forms the H-Shaped Pattern on the posterior surface of the liver?

A
  1. Right Sagittal Fissure
  2. Porta Hepatis
  3. Left Sagittal Fissure
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14
Q

What makes up the Right Sagittal Fissure of the H-shaped pattern in the liver?

A
  1. Fossa of Gallbladder

2. Inferior Vena Cava

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15
Q

What makes up the Left Sagittal Fissure of the H-shaped pattern in the liver?

A
  1. Fissure of Ligamentum Venosum (Superior)

2. Fissure of Round Ligament–> Also known as Ligament Teres (Inferior)

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16
Q

What are the Ligaments of the Liver?

A
  1. Coronary Ligament
  2. Left Triangular Ligament
  3. Right Triangular Ligament
  4. Falciform Ligament
  5. Round Ligament of Liver
  6. Hepatogastric Ligament of Lesser Omentum
  7. Hepatoduodenal Ligament of Lesser Omentum
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17
Q

What is the Coronary Ligament of the Liver?

A

Ligament that attaches the Superior Surface of Liver to Inferior Surface of Diaphragm, and demarcates the bare area of the Liver

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18
Q

What are the Right and Left triangular ligaments formed by?

A

They are formed by the union of the Anterior and Posterior layers of the Coronary Ligament on each side

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19
Q

What is the Falciform Ligament?

A

It attaches the liver to the anterior abdominal and diaphragm, and divides the Liver into 2 anatomical Lobes

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20
Q

What is the Round Ligament of the Liver?

A

It is the fibrous remnant of the umbilical vein at the free edge of the falciform ligament

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21
Q

Where is the Hepatogastric Ligament attached to?

A

Lesser Curvature of Stomach to Liver

22
Q

Where is the Hepatoduodenal Ligament attached to?

A

From Portal Hepatis to the First part of Duodenum

23
Q

What is enclosed within the free edge of lesser omentum?

A

The Portal Triad–> Bile duct, Hepatic Artery and Hepatic Portal Vein

24
Q

What are the 2 anatomical lobes of the Liver?

A

Right lobe and Left lobe

25
Q

What are the 2 Accessory lobes of the Liver?

A
  1. Caudate

2. Quadrate

26
Q

What are the 2 Accessory lobes of the liver separated by?

A

The Right and Left Sagittal Fissure, and the Transverse Porta Hepatis

27
Q

How is the Liver divided into functional lobes?

A

On the basis of basic biliary drainage and blood supply–> The branches of the Hepatic Vein runs between the eight hepatic segments

28
Q

What is the blood supply to the liver?

A

25%–> Hepatic Artery proper

75%–> Portal Vein

29
Q

What is the venous drainage of the liver?

A

Hepatic Veins drain into the Inferior Vena Cava

30
Q

What makes up the Portal Vein?

A

Superior Mesenteric Vein and Splenic Vein

31
Q

How many Hepatic Veins drain into the Inferior Vena Cava?

A

3 Hepatic Veins

32
Q

What is the Porto-Systemic Anastomosis?

A

Communication between the portal venous system and the systemic system

33
Q

What is the function of Porto-Systemic Anastomoses?

A

If the Portal vein are blocked/ have high pressure, the blood can be redirected to systemic circulation to bypass the portal system

34
Q

What is the nerve supply to the liver?

A
  1. Hepatic Nerve Plexus from the Coeliac Plexus
  2. Sympathetics from Coeliac Plexus
  3. Parasympathetics from Vagus Nerve
35
Q

What is the Lymphatic Drainage of the Liver?

A

Superior Lymphatics from anterior diaphragmatic and visceral surface drain into 3 or 4 Hepatic Lymph Nodes at the Porta Hepatis, which then drain into Coeliac Lymph Nodes and then Cisterna Chyli

36
Q

What Hepatic Ducts make up the Extrahepatic Biliary System?

A
  1. Gallbladder
  2. Cystic Duct
  3. Bile Duct
37
Q

Where is the fungus of the Gallbladder?

A

The fundus of the Gallbladder projects on the lower border of the liver and touches the parietal peritoneum at the tip of the 9th costal cartilage

38
Q

Where is the body of the Gallbladder?

A

Gallbladder fossa on the visceral surface of the right lobe of the liber, adjacent to the quadrate lobe

39
Q

What is the function of the Gallbladder?

A

Storage and Concentration of bile secreted by the liver

40
Q

What are the parts of the Gallbladder?

A
  1. Fundus
  2. Body
  3. Neck
41
Q

Describe the pathway bile takes to move from the Gallbladder to the Duodenum

A

Bile moves from the Gallbladder into the Cystic Duct, which joins with the common hepatic duct to from the common bile duct. The common bile duct the joins with the Pancreatic duct at the Ampulla of Vater and enters the 2nd part of duodenum at the Major duodenal papilla, modulated by the Sphincter of Oddi

42
Q

What is Calot’s Triangle?

A

Anatomical Space where the cystic artery lies

43
Q

What makes up the borders of Calot’s Triangle?

A
  1. Visceral Surface of Liver
  2. Common Hepatic Duct
  3. Cystic Duct
44
Q

What is the blood supply to the Gallbladder?

A

Cystic Artery

45
Q

What is Hepatomegaly?

A

Liver Enlargement

46
Q

What causes Hepatomegaly?

A
  1. Rise in central venous pressure
  2. Tumours
  3. Bacterial and viral disease such as Hepatits
47
Q

What is Cirrhosis of the Liver?

A

Chronic liver disease characterised by the replacement of liver by fibrosis, scar tissue and regenerative nodules–> leads to Jaundice

48
Q

What is a clinical sign of Cirrhosis and Portal Hypertension?

A

Caput Medusae–> Dilated para-umbilical veins

49
Q

How do you clamp the portal triad to disrupt portal circulation during surgery?

A

Pringle’s Manoeuvre

50
Q

What is Pringle’s Manoeuvre?

A

Clamping of the free border of lesser omentum

51
Q

What are Gallstones?

A

Obstruction to the biliary system by cholesterol crystals

Anatomy (JC2) (20 decks)

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