Liver and hepatobiliary system

Question 1

Location of the liver

Answer 1

R hyperchondrium, protected by ribcage under diaphragm, under costal margin
Epigastric and L hyperchondrium
Deep to rectus abdominus

Question 2

Functions of the liver

Answer 2

Bile production
Glucose => glycogen
Cholesterol production
Fat and amino acid regulation
Stored ion
Detoxification
Manufactures blood proteins in plasma
Immunity, immune factor

Question 3

Purpose of bile production

Answer 3

Breaks down fats in small bowel, secreted into duodenum

Question 4

Purpose of glucose => glycogen production

Answer 4

Conversion of excess glucose in blood for storage, from hepatic portal vein

Question 5

Purpose of cholesterol production

Answer 5

Help carry fats through body

Question 6

Purpose of fat and AA regulation

Answer 6

For protein building

Question 7

Purpose of immunity, immune factors

Answer 7

Remove pathogens that travel from intestines to liver

Question 8

Relations of the liver

Answer 8

Intraperitoneal organ but has bare area
Surfaces in contact w ribcage and diaphragm
2 recesses in peritoneum, subphrenic, sub hepatic/hepatorenal

Question 9

Anatomical liver lobes

Answer 9

Separated by falciform ligament, R and L lobes

Round ligament, remnant of umbilical vein

Question 10

Liver segments

Answer 10

8 segments based on venous drainage of liver via hepatic vein

Question 11

Functional lobes of the liver

Answer 11

L = anatomical L + caudate and quadrate, separated by ligament venosum and ligamentum teres 
R = remainder of R

Caudate separated by porta hepatis

Question 12

Peritoneal reflections of the liver

Answer 12

Hepatocolic flexure
Kidney
Duodenal
Stomach
Oesophagus

Question 13

Ligaments on the posterior side

Answer 13

Coronary ligament
Anterior leads to falciform, posterior leads to lesser omentum
R and L triangular ligament

Question 14

Porta hepatus

Answer 14

Hepatic portal vein

Proper hepatic artery (splits into L and R, goes to each functional division) R has cystic duct

Common hepatic duct (Convergence of R and L hepatic duct)

Question 15

Hepatic portal system

Answer 15

Foregut, drains through splenic vein
Midgut, drains from superior mesenteric vein
Hindgut, drains from inferior mesenteric vein into splenic

Question 16

Systemic venous drainage

Answer 16

Oesophagus drains via azygos up to superior vena cava, porto systemic anastomoses

Question 17

Portal blockage

Answer 17

If blocked up, swells with blood, round ligament opens up, blood flows into paraumbilical veins
Flow from PU into thoracoepirgastric, into L/R thoracic into superior VC

Flow from PU down into femoral veins => IVC

Question 18

IVC blockage

Answer 18

Superficial veins swell up, blood can only travel upwards via SVC

Question 19

Location of the gall bladder and biliary tract

Answer 19

Behind the anterior face of the liver

Question 20

Structure of the biliary tract

Answer 20

Common hepatic duct formed from L and R hepatic ducts
Cystic duct comes off common bile duct
Common bile duct joins with pancreatic duct, surrounded by the sphincter of Oddi at the ampulla of Vater

Question 21

Function of the gall bladder and biliary tract

Answer 21

Bile constantly being produced, sphincter contracts so duct fills up with bile
Bile stored in gall bladder
Gall bladder contracts to release contents via cystic duct

Question 22

Pancreas location and function

Answer 22

Retroperitoneal
Head, curve of duodenum
Neck, body, uncinate process
Tail, extends to spleen
Has exocrine glands (digestive enzyme release)
Endocrine glands (insulin, glucagon release)

Question 23

Pancreatic arterial supply

Answer 23

Superior mesenteric passes under pancreas and over duodenum

Hepatic artery => gastroduodenal => ant and post sup pancreaticoduodenal
Splenic => dorsal pancreatic => transverse pancreatic
Transverse pancreatic anastomosed several times with splenic

Question 24

Ducts of the pancreas

Answer 24

Uncinate process = ventral process
Each pancreas has own ductal drianage
2 ductal systems fused to form main pancreatic duct
Accessory duct made up of original duct from dorsal pancreas