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Abdomen > Liver and Gall Bladder > Flashcards

Liver and Gall Bladder Flashcards

1
Q

Which abdominal regions is the liver situated in

A

Right Hypochondrium
Epigastrium
Right Lumbar
Left Hypochondrium (sometimes)

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2
Q

What is the weight of the liver?

A
  1. 4 - 1.8kg ::: males

1. 2 - 1.4kg ::: females

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3
Q

What are the surfaces of the liver?

A

Diaphragmatic and Visceral

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4
Q

What are the relations of the anterior diaphragmatic surface of the liver

A

Diaphragm separates it from:

  • 6-10 costal cartilages on Right
  • 7-8 costal cartilages on Left

Has falciform ligament

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5
Q

What are the relations of the superior diaphragmatic surface of the liver

A

Diaphragm separates it from:

  • Lung on Right
  • Heart on Left

Has:

  • Bare area
  • IVC
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6
Q

What are the relations of the posterior diaphragmatic surface of the liver

A

Lies against vertebral column

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7
Q

What are the main features on the visceral surface of the diaphragm

A 
Porta hepatis
Gall bladder
IVC
Fissure for Ligamentum Teres Hepatis
Fissure of Ligamentum Venosum
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8
Q

What are the structures going through the Porta Hepatis

A 
Hepatic A (Right and Left)
Portal V
Hepatic Ducts (Right and Left)
Lymphatics
Hepatic nerve plexus
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9
Q

What does the ligamentum teres hepatis develop from?

A

Remnant of Umbilical Vein

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10
Q

What does the ligamentum venosum develop from?

A

Remnant of Ductus Venosus

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11
Q

What are the anatomical lobes as seen on the visceral surface of the liver?

A

Right
Left
Caudate
Quadrate

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12
Q

Which side of the liver does the Gall Bladder lie

A

In a fosssa on the anterior side of the liver

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13
Q

Regarding the caudate and quadrate lobes of the liver, which lies posterior and which lies anterior

A

cadate - posterior

quadrate - anterior

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14
Q

Which is the line that divides the liver into left and right functional halves?

A

cholescysto-vena-caval line

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15
Q

Describe the functional division system of the liver?

A

Couinaud’s segments divide the liver into independent functional lobes.

Each lobe has an independent:

  • Bile Duct
  • Portal Vein
  • Hepatic Artery
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16
Q

What are the impressions of the visceral surface of the liver?

A

Impressions for:

Stomach
Pyloric
Duodenum (1st/sup. part)
Transverse Colon
Rt Colic (hepatic) Flexure
Rt kidney and adrenal gland
17
Q

What are the ligaments that attach to the liver?

A

Falciform ligament

Round ligament of liver (Ligamentum teres hepatis)

Coronary Ligament (Ant. and Post.)

Triangular Ligaments (Right and Left)

18
Q

Describe the Ligamentum Teres Heaptis

A

AKA Round ligament of liver

1: Runs on the lateral side of the caudate lobe
2: Runs to Umbilicus

19
Q

Describe the course of the Falciform Ligament

A

1: Runs on Ant. surface of Liver
2: Splits Liver into Medial and Lateral surfaces
3: Encloses Round Ligament along its margin
4: Runs along inner/posterior Right RA sheath
5: Ends at Umbilicus

20
Q

Describe the blood supply of the Liver

A 
Left and Right Hepatic Artery (20%)
Portal Vein (80%)

Right and Left Hepatic Vein (runs in Parenchyma to connect with IVC)

IN 25% OF CASES, SMA CONTRIBUTES TO ARTERIAL SUPPLY OF THE LIVER

21
Q

Explain the lymphatic drainage of the liver

A 
Superficial vessels: (in sub-serosa areolar tissue)
-hepatic LN
-coeliac LN
-para-aortic LN
ALL DRAIN INTO THORACIC DUCT

Deep vessels:
-End in nodes around the IVC

22
Q

Explain the nerve supply of the liver and its course

A

Nerve supply comes from: Hepatic Plexus (from Coeliac Plexus)

This plexus accompanies hepatic artery and its branches

23
Q

What shape is the Gallbladder

A

Piriform-shaped

24
Q

What is the size of the Gallbladder

A

Length: 7-10cm
Breadth: 3cm (at widest point)
Capacity: 30-50ml

25
Q

What are the parts of the gallbladder? Also, explain their relations

A

Fundus:

  • Projects beyond inferior border of liver
  • Related to Ant. Abd. Wall
  • Posteriorly, related to Transverse Colon

Body:

  • Upper surface related to liver
  • Underside related to Transverse Colon and Duodenum

Neck:
-Sometimes, a small pouch projects at the junction between the Neck and Cystic Duct called “Hartmann’s Pouch”

26
Q

Describe the anatomy of the cystic duct

A

3-4cm long

Runs inferio-posteriorly from Neck of GB to join Common Hepatic Duct forming the Bile Duct

Mucous membrane from Neck to Bile Duct contains 5-6 oblique projections into lumen
-Called “Spiral Folds” or “Valves of Reister”

27
Q

Describe the arterial supply of the Gallbladder

A 
Cystic Artery (from Right Hepatic A. - or Common Hepatic A. or Gastroduodenal A.):
-Supplies Gallbladder and Cystic Duct

Right Hepatic Artery
-Supplies Hepatic Ducts and upper part of Common Bile Duct

28
Q

Describe the venous drainage of the Gallbladder

A

Cystic Veins:

-Run into Liver directly
OR
-Run into Hepatic Vein
OR
-Run into veins draining upper part of Bile Duct
29
Q

What is the nerve supply to the Gallbladder

A

Coeliac Plexus

30
Q

What is the lymphatic drainage of the Gallbladder

A

Hepatic LN

Cystic LN

31
Q

What is the failure of canalization of the Bile Duct called?

A

Congeintal Atresia
OR
Stenosis

32
Q

What can cause obstruction of the Gallbladder

A

Tunours in Pylorus or Pancreas causing Pressure

Gallstone formation

33
Q

Which part of the duodenum does the Bile Duct drain?

A

Descending (2nd part)

Abdomen (10 decks)

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