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Maris anatomy 1 > liver and gallbladder > Flashcards

liver and gallbladder Flashcards

1
Q

largest visceral organ in body

A

liver

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2
Q

largest organ

A

skin

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3
Q

location of liver

A

right hypochondrium extding to left hypocho

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4
Q

functions of liver

A

chief site of intermediary metablism, secretes bile, syntehsize serum proteins and lipids, processes endogenous and exogenous substances, participates in elimantion of senescent cells and particulate matter, fetal life hematopoiesis

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5
Q

bile does what

A

emulsifies fat into miceles (cause fat insoluble in water)

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6
Q

if liver cant produce bile or backed up by gall stone you could get

A

fatty stool/greasy diarreha

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7
Q

greasy diarehea aka

A

setatorrhea

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8
Q

serum proteins include

A

albumin (maintins osmotic pressure in blood) fibrinogen (blood clot) aminoglobun

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9
Q

senescent cells

A

aging cells

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10
Q

what cells line liver sinusoids and engulf stuff

A

von kuffer cells

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11
Q

hematopoiesis

A

formation of blood

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12
Q

how palpate liver

A

put finger under right costal margin and ask patient to inhale and then u acn feel inferior edge of liver

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13
Q

surfaces of liver

A

diapragmatic (subphrenic and hepatorenal) and visceral

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14
Q

visceral surface is covered by ( ) except in the ( ) and ( )

A

visceral peritoneum, except fossa for GB and porta hepatis

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15
Q

porta hepatis is related to

A

r anterior part of stomach, superior part of duodenum, lesser omentum, gallbladder, r colic flexure, r transverse colon, r suprarenal gland and kidney

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16
Q

structually caudate and quadrate apart of

A

right lobe

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17
Q

functionally caudate and quadrate part of

A

left lobe

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18
Q

what goes through porta hepatis (hilum)

A

r/l hepatic arteries, r/l hepatic ducts, portain vein, sp and ps nerve fibers, lymphatics

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19
Q

what is between quadrate and right lobe of liver

A

fossa of gallbladder

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20
Q

caudate looks

A

elongated and superiorly

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21
Q

quadrate looks

A

like a cube and inferiorly

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22
Q

why functionally with left lobe

A

same blood supply, venous drainalge and and bile drainage (left hepatic duct)

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23
Q

falciform ligament

A

wide membranous lig that extends from diapraghm to umbilicus,

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24
Q

what serves as devercation between right and left lobe

A

falciform lig

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25
Q

where do you find the hilum/porta hepatis

A

Posterior inferrior side (visceral surface)

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26
Q

ligamentum venosum is remnant of

A

ductus venosum

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27
Q

round ligament is remnant of

A

umbilical vein

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28
Q

what to ligaments run together

A

falciform and round lig

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29
Q

round lig aka

A

teres hepatis

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30
Q

the round lig extends all teh way to the

A

umbilicus

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31
Q

r and l ( ) lig attach the liver to the diapragm

A

r and l triangular lig

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32
Q

the triangular ligs are extensions of the

A

peritoneum

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33
Q

the triangular ligs all around liver combine to make the

A

coronary lig

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34
Q

bare area is surrounded by

A

coronary lig

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35
Q

what is the bare area

A

where diapragm touches liver, visceral peritoneum dissapears

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36
Q

falciform lig attaches liver to

A

diapgram, ant abd wall, umbilicus

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37
Q

at inferior edge of falciform is the

A

round lig

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38
Q

inferior border is usually

A

sharp

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39
Q

if inferior border is rounded it menas the liver is

A

enlarged

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40
Q

ligament of vena cava holds what in place

A

inferior vena cava b/w caudate and right lobe

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41
Q

b/w caudate and left lobe find

A

ligamentum venosum

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42
Q

whats b/w right and caudate lobe

A

inferior vena cava

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43
Q

what two make common hepatic duct

A

right adn left hepatic duct

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44
Q

b/w right and quadrate

A

gallbladder

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45
Q

b/w quadrate and left

A

round lig

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46
Q

right hepatic vein carries blood FROM

A

right lobe of liver (deox)

47
Q

left hepatic vein carries blood from

A

left lobe, caud, quad, to inferioir v.c

48
Q

porta vein carries

A

de ox blood rich with nutrients TO LIVER from intestines stomach

49
Q

why is liver chief intermediate in digestion

A

cuase blood from portal vein carries nutrient sfrom stomach

50
Q

hepatic artery carries

A

oxygenated blood

51
Q

radiating from lobule and arranged into cords is

A

hepatocytes

52
Q

in between cords are modified capillaries called

A

liver sinusoids

53
Q

sinusoids are surrounded by

A

reticuloendothelial cells aka von kuppfer cells

54
Q

flow chart of blood for the liver

A

portal vein, portal venioles, sinusoids, central veins, sublobar veins, hepatic veins, inferior v.c

55
Q

basic idea behind liver cerosis

A

sinusoids are ablitereated, liver becoems smaller and contraacted and cells replaced by fibrocysts so now blood cant go through liver -> portal hypertension

56
Q

portal hypertension

A

the bp of portal vein increases

57
Q

what comes off of hte abdominal aorta

A

celiac trunk

58
Q

celiac trunk breaks into these 3 thigns

A

left gastric, splenic arter, common hepatic

59
Q

splenic artery goes behidn () and goes to ()

A

behind stomach and spleen

60
Q

common hepatic splits into two

A

proper hepatic a (goes to liver) and gastric duodenal

61
Q

proper hepatic artery splits into two

A

r and l hepatic a

62
Q

portal vein made from two

A

splenic and superior mesentery

63
Q

sometimes see this v join portal vein (normal variation)

A

inferior mesenteric v

64
Q

hepatorenal shunt

A

make a connection b/w portal and renal vein so blood can go out and relieves pressure of liver

65
Q

left gastric vein anastomes with

A

esophageal tributaries of azygos system

66
Q

consequences of anastomes with esophageal trib

A

get varicose veins (esophageal varices with the esophageal tributary), get metalic taste in mouth cause blood rich in iron, ruptures so throw up blood

67
Q

paraumbilical veins anastome with

A

superficial abdominal veins/ superficial epigastric veins

68
Q

paraumbilical veins run along side

A

ligamentum teres

69
Q

consequences of paraumb anastomes

A

engorge and dialte and are visible (tortuos)

70
Q

capit madusa

A

when superficial abdominal veins are visible, winly and snake like see in pregnant woman

71
Q

superior rectal veins anastome with

A

middle and inferior rectal veins

72
Q

consequence of superior anastome with rectal vein

A

engorge and get internal hemaroids

73
Q

tributaries of celiac, super and inferior mesenteric veins anastome with

A

renal phrenic and lumbar veins

74
Q

retroperitoneal veins with increase portal vein pressure start to

A

ooze out ultrafiltrate of blood so get peritoneal fluid in cavaity aka ascites

75
Q

lymphatic drainage of liver

A

hepatic nodes, then celiac nodes, then cisterna chyli

76
Q

nerve supply of liver is

A

celiac plexus

77
Q

celiac plexus is intermingling of

A

gva, preg para, post symp

78
Q

hepatic enchepalopathy

A

brain damage from liver, if liver not working amonia goes to brain cause it wasnt converted to urea

79
Q

sign have hepatic enchepalopathy

A

have problems with concentrastion and asterectis (hold hand out and flop down)

80
Q

prevertebral ganglion around celiac trunk called

A

celiac ganglion

81
Q

post gang symp fiber cell bodies located in

A

celiac ganglion

82
Q

pregang symp cell bodies foudn in

A

lateral horns of t5-9 cause of greater splanchnic nerve

83
Q

vagus nerve carrys

A

gva nad pre gang para

84
Q

vagus just passes

A

celiac ganglia

85
Q

sympathetic afferent fibers

A

gva accompaning sympathetic (the gva is not part of ans cause ans only has visceral motor)

86
Q

() can send pain to skin, right shoulder

A

parietal peritoneum

87
Q

the bilary system consists of

A

r/l hepatic ducts, common hepatic duct, gallblad and cystic duct, common bile duct

88
Q

bilirubin

A

byproduct of rbc metabolism and in bile

89
Q

liver cells make bile and it goes through () to ducts

A

bile caniliculi

90
Q

the hepatic duct and cystic duct combine to make

A

common bile duct

91
Q

common bile duct enters teh second portion of the

A

duodenum

92
Q

before common bile duct enters second port of duodenum () joins it

A

pancreatic duct

93
Q

duct can hold how much bile

A

30-50ml

94
Q

fundus

A

rounded and projects beyond inferior margin of liver

95
Q

body of gb

A

lies in contact with visceral surface of lvier

96
Q

neck of gb

A

continuous with cystic duct

97
Q

gb relases bile when stimulated by

A

cholecystokinin

98
Q

blood supply of gb

A

cystic a

99
Q

nerve supply of gb

A

celiac plexs

100
Q

what keeps cystic duct lumen open

A

spiral folds

101
Q

how long i s cystic duct

A

1.5 in

102
Q

cystic a is a branch of

A

r hepatic a

103
Q

colesectomy

A

remove gb

104
Q

hepatopancreatic ampulla

A

dialted opening found in major duodenum papilla where comon bile duct enters

105
Q

surrounding hepatopancreatic ampulla is

A

smooth muscle called hepatopancreatic sphincter or sphincter oddi

106
Q

sphincter oddie does what

A

regulates amount of bile entering duode.

107
Q

hepatomegaly

A

enlargement of liver due to metastatic carcinoma or lvier cirrhosis

108
Q

jandice

A

yellowish discoloration of skin and sclera due to hyperbilirubinemia

109
Q

alcohol cirrhosis

A

progressive destruction of hepatocytes and replacement of them by fibrous tisse, leads to portal hypertension

110
Q

cholelithiasis (gallstones)

A

due to crystallization of bile salts and cholesterol 5F’s

111
Q

5F’s are

A

points prone to cholelithiasis, female, fat, forties, fertile, flattus (gassy)

112
Q

laparoscopic cholecystectomy

A

incision near umbilicus

113
Q

ERCP

A

endoscopic retrograd cholangiopancreatopgrahy: endoscopic through mouth to bile duct to crush gallstone

Maris anatomy 1 (18 decks)

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