liver and hepatobiliary tract Flashcards
where is the liver found ?
- upper quadrant
how much does the liver weigh ?
1500 grams
how many lobes does the liver have ?
what divides them ?
2
left and right
falciform ligament
what type of organ is the liver ?
intraperitoneal
what is the bare area ?
part of liver not covered by peritoneum
what is found in the bare area ?
reflections of the bare area called the coronary ligament
describe the coronary ligament :
has anterior + posterior ligaments that meet laterally as the right and left triangular ligaments
what is the top and bottoms of the liver bound to ?
what does it form ?
bounded by reflections of the peritoneum
form sub-phrenic space above
form sub-hepatic / hepatorenal pouch below
what is the hepatorenal pouch
potential space bounded by the liver, the right kidney, the colon and the duodenum
what is the subphrenic space
space on each side of the falciform ligament
between under side of the diaphragm and upper side of liver
what happens if there is an infection in the sub-phrenic space ?
- can cause irritation of the diaphragm = interrupted breathing
- can irritate parietal layer = feelings of pain on shoulders
what are the 2 main cell types found in the liver ?
- hepatocytes
- kupffer cells
what are kupffer cells function ?
involved in breakdown of red blood cells
what are some functions of the liver ?
- produce bile
- regulate blood constituents + chemical level
- regulates glucose levels
- produces cholesterol
- breakdown old blood cells
where is the round ligament found ?
what is it ?
- lower edge of falciform liagment
- remnant of the umbilical vein
what is another division of the liver ?
how is it done ?
divided into 8 segments - Couinaud segment
done by vascular divisions of the liver
where is the coronary ligament found ?
- surrounds bare area
- anteriorly left + right leaflets of ligament form the falciform ligament
- posteriorly left + right leaflets form the lesser omentum
what is the porta hepatis ?
point of entry + exit for the hepatic portal vein, hepatic arteries, hepatic bile ducts
what are the triangular ligaments ?
junctions of the anterior + posterior leaflets
what is the visceral surface of the liver ?
- posterior surface of liver
- closely related to other organs
what is the ductus venosus ?
where is it found ?
- a bypass channel that connects the left portal vein to the left hepatic vein
- found at the base of the lesser omentum
what does the ductus venosus become after birth ?
ligamentum venosum
what are 2 other lobes of the liver ?
what is important to note about them
- caudate + quadrate lobe
makes right lobe bigger
what is portal hypertension ?
blockage of roots involved in liver drainage
what are the 4 possible sites of the portal systemic anastomoses ?
- lower esophagus
- anal canal
via recanalized umbilical vein to anterior abdominal wall
via recanalized ductus venosus to inferior vena cava - posterior abdominal wall
what are esophageal varcies ?
dilated thin walled veins in the esophagus
what are varicose veins in the anal canal known as ?
hemorrhoids / pile
what are cause of portal hypertension ?
- cirrhosis : scar tissue blocks blood flow organ
- hepatitis
how does alcohol damage to the liver ?
blocks normal metabolism of proteins , fats and carbs
what is a common complication of liver disease ?
ascites
what is jaundice ?
system of excreting bilirubin is disrupted
blood has high bilirubin levels
what is the key symptom of jaundice ?
yellow pigment of skin and eye
also has pale coloured poo and dark urine
how does the gallbladder receive artery supply ?
from right hepatic artery via the cystic artery
describe venous drainage in gallbladder ?
directly into liver through fossa
describe the lymphatics of the gallbladder :
via hepatic nodes which drain into the celiac nodes
describe innervation of the gallbladder :
receives sympathetic + parasympathetic via celiac plexus
sympathetic from T7 and T9 + vasomotor
parasympathetic = inhibit contraction of sphincter
what hormone influences contraction in gall bladder ?
cholecystokinin
from duodenum
what is Calot’s triangle ?
triangle formed by the cystic duct, hepatic duct and cystic artery
sometimes formed by inferior margin of the liver
how is bile released ?
functional lobes secrete bile into there respective ducts constantly
common hepatic duct to common bile duct to cystic duct than gallbladder
what are the 4 parts of the gall bladder ?
- a fundus
- a body
- infundibulum
- neck
what is the infundibulum expanded to ?
hartmans poach
what are the spiral valves of heister ?
prominent concentric folds in the cystic duct
what is the hepatopancreatic ampulla of Vater ?
the entering of the bile causing the duodenum to bulge
what is the sphincter of oddi ?
muscle surrounding the lower end of the bile duct
what does bile contain ?
- bile salts
- electrolytes
- cholesterol
what are the 2 types of gallstones ?
- cholesterol stones 90%
- pigment stones 10%
what type of gland is the pancreas ?
endocrine + exocrine
what is the exocrine function of the pancreas ?
release enzymes + salts to help digestion
what is the endocrine function of the pancreas ?
hormonal control of blood glucose levels
what are the 5 parts of the pancreas ?
- head
- neck
- body
- tail
- uncinate process
where is the head + uncinate process found ?
in c shape of duodenum
where is the neck found ?.
right side of aorta
where is the body found
across the aorta
where is the tail found ?
hilum of the spleen
what supplies the pancreas with blood ?
splenic artery divides into the dorsal/superior pancreatic artery and the arteriole pancreatic
head receives supply from superior pancreaticoduodenal artery
