Liver and pancreas Flashcards
What kind of gland is the liver?
Exocrine gland
Does the liver have endocrine or exocrine function?
Both but mainly exocrine
What is the endocrine function of the liver?
Production of thrombin
Why does the liver move during respiration?
Due to its relationship with the diaphragm
What kind of the organ is the liver?
A solid organ
Name of the capsule of the liver
Glisson’s capsule
What is the capsule of solid organs made of?
Fibrous tissue
Which surfaces of the liver can be grouped as the diaphragmatic surface?
The superior, anterior and right
Which surfaces of the liver can be grouped as the visceral surface?
Inferior
Aside from the capsule, what covers the liver?
The peritoneal
What is the area called which is not covered by the peritoneal and is in direct contact with he diaphragm?
The bare area
4 lobes of the liver
The left lobe
The right lobe
The caudate lobe
The quadrate lobe
Which is the biggest lobe of the liver?
The right
What does the porta hepatis of the liver correspond with?
The hilum
What attaches the liver to the diaphragm?
Coronary ligament
What separates the right lobe from the quadrate lobe?
The gallbladder
What separates the right lobe from the caudate lobe?
The inferior vena cava
Where does the round ligament go?
From umbilicus to the falciform ligament and left sagittal fissure
Where does the round ligament derive from?
The umbilical vein
Where does the ligamentum venous derive from?
Ductus venus
Different name of the 2 lesser omentum
Hepatogastric ligament
Hepatoduodenal ligament
Which part of the lesser omentum is thicker and why?
The hepatoduodenal ligament because of the vessels running inside
What is the microscopic functional unit of the liver?
Hepatic lobule
What borders lobules?
Delicate connective tissue septa (arrows) where branches of the hepatic portal vein, artery and bile duct runs
What is the portal vein, portal artery and bile duct grouped as?
The portal triad
Which is the widest vessel in the portal triad?
The portal vein
What are the capillaries called that drain from the hepatic portal vein and hepatic artery to the central vein in the hepatic lobule?
Sinusoids
What does the central vein drain into?
The hepatic vein which drains into the IVC
What drains the hepatic lobule for bile?
The bile duct
Main cells of the liver
Hepatocytes
What forms the wall of the bile ductule?
Colangiocytes
What is the gallbladder?
Storage organ for bile
What kind of functions does the pancreas perform?
Endocrine and exocrine
What is the major part of the pancreas, endocrine or exocrine?
Exocrine
5 parts of the pancreas
Tail
Body
Neck
Head
Uncinate process
Which ligament does the tip of the tail of the pancreas go into?
Splenopancreatic ligament
Is the pancreas in direct contact with the stomach?
No the ormental bursa separates them
What is the landmark for the emergence of the superior mesenteric vessels?
The uncinate process
What does the exocrine part of the pancreas produce?
Pancreatic juices
What drains the pancreatic juices?
The pancreatic duct
What does the pancreatic duct drain into?
Major duodenal papilla
Different name for accessory pancreatic duct
Duct of Santorini
What does the accessory pancreatic duct drain into?
Minor duodenal papilla
What originates behind the head of the pancreas?
The portal vein
What does the superior mesenteric artery supply?
The small bowel
What joins to form the portal vein?
The superior mesenteric vein and splenic vein
Where does the portal pass in relations to the duodenum?
Behind (posteriorly)
What does the portal vein enter after passing behind the duodenum?
The hepatoduodenal ligament
What kind of gland is the exocrine pancreas?
Branched acinar gland
What does the endocrine part of the pancreas consist of?
Pancreatic islets of langerhans
What attaches to the pancreatic duct and produced the pancreatic juices
Pancreatic acinus
What forms the wall of the acinus?
Acinar cells
What does the acinus drain into
Intercalated -> interlobular -> interlobular -> pancreatic duct
Which cells are responsible for the production of insulin?
Beta cells
Which cells are responsible for the production of glucagon?
Alpha cells
What forms the major part of the islets of langerhans?
Beta cells
What forms the central part of the islets of langerhans?
Beta cells
What forms the peripheral part of the islets of langerhans?
Alpha cells
What does delta cells produce?
Somatostatin, gastrin
What does F cells produce?
Pancreatic polypeptide
Which is the largest full organ in the body?
The liver
What kind of gland is the liver?
Amphicrine gland
What cells make up most of the hepatic parenchyma?
Hepatocytes
7 cell types in the liver
Cholamgiocytes
Endothelial cells
Kupffer cells
Ito cells
Pit cells
Stem cells
Hepatocytes
What is the capsule that covers the liver called?
Fibrous capsule of Glisson
Where on the liver does the falciform ligament originate?
Superior saggital groove
Different name for visceral surface of the liver?
Posteroinferior
Name of the 3 grooves ont he visceral surface of the liver
Right saggital groove
Left saggiato groove
Transverse groove
What separates the groove for the vena cava and the fossa for the gallbladder?
The caudate process
What is the caudate process?
Portion of hepatic parenchyma
4 impressions on the visceral surface of the right lobe of the liver
Colic
Right kidney
Right suprarenal
Duodenal
2 impressions on the visceral surface of the left lobe of the liver
Gastric
Oesophageal
What 2 impressions are on the quadrate lobe?
Pyloric impressions from stomach and duodenum
Name of the 2 process on the caudate lobe of the liver
Papillary process
Caudate process
Different name for inferior border of the liver
Acute or sharp border
Where on the liver is the vertebral notch found?
Posterior border
2 major attachments of the liver to the diaphragm
Inferior vena cava
Connective tissue
Where does the falciform ligament originate?
Superior saggiato groove of the diaphragmatic surface of the liver
Where does the falciform ligament insert?
Inferior surface of the diaphragm
Supraumbilical portion of the anterior abdominal wall
Is the falciform ligament considered a suspensory ligament?
No
What does the left surface of the falciform ligament face?
Diaphragmatic surface of the liver
What does the right surface of the falciform ligament face?
Inferior surface of the diaphragm
Which is the true suspensory ligament of the liver?
Coronary ligament
Where is the coronary ligament placed?
Between the posterior border of the liver and the inferior surface of the diaphragm
Where does the lesser omentum extend?
From the transverse groove of the visceral surface of the liver to the lesser curvature of he stomach and superior part of duodenum
2 parts of the lesser omentum
Hepatogastric ligament
Hepatoduodenal ligament
Which 2 afferent vessels does the liver receive blood?
Hepatic portal vein
Hepatic artery proper
How many efferent vessel systems does the liver have?
1
Name of the efferent vessel system of the liver
Hepatic veins
What does the hepatic veins pour into=
Inferior vena cava
Where do the afferent vessels enter the liver?
Porta hépatisations
Where does the hepatic veins leave the liver?
At the posterior border
Where does the hepatic artery proper originate?
Continuation of the common hepatic artery
Where does the common hepatic artery originate?
Celiac trunk
Where does the hepatic artery proper bifurcate?
Porta hepatis
Which of the branches of the hepatic artery proper is larger, left or right?
Right
Where does the hepatic portal vein form?
Behind the head or neck of the pancreas
What comes together to form the hepatic portal vein?
Superior mesenteric, inferior mesenteric and splenic veins
Where does the hepatic portal vein bifurcate?
Porta hepatis
Do the accessory hepatic portal veins join the main trunk of the hepatic portal vein?
No, they enter the intraparenchymal hepatic circulation directly
What are the hepatic veins?
The emissary veins of the hepatic circulation that drain blood into the IVC
Are there lymphatic vessels in the lobules?
No
How many functional (surgical and radiological) subdivisions are there of the liver?
8
What does the functional subdivisions of the liver follow?
The hepatic veins
Are each of the functional subdivisions of the liver individually drained?
Yes they have individual venous drainage
Where does the majority (75%) of the blood that reaches the liver come from?
The hepatic portal vein
Which cells represent 80% of the liver cell population?
Hepatocytes
What are the sinusoids in the liver?
Special modified blood capillaries which are richly anastomosed to each other and form a complex interlobular network that bring blood from the periphery to the central vein
Which 2 types of cells are found in the space of Disse?
Kupffer cells and Hepatic stellate cells
Name of the duct that connects the common bile duct and the gallbladder?
Cystic duct
What connects to form the common bile duct?
Left and right hepatic duct
Which septic duct is longer, left or right?
Left
4 portions of the gallbladder
Fundus
Body
Infundibulum
Neck
Where does the cystic artery originate?
The hepatic artery proper
Structure of the gallbladder
Mucosa
Mucosolaris externa
Serosa
Is the serosa of the gallbladder complete or incomplete?
Incomplete
What kind of epithelium is found in mucosa of the gallbladder?
Single layer cuboidal epithelium with microvilli
Does the mucosa of the gallbladder have a basal membrane?
Yes
2 layers of the muscolaris external of the gallbladder?
Internal longitudinal layer
External oblique layer
2 parts of the cystic duct
Spiral fold
Smooth part
How does the gallbladder concentrate the bile?
Through reabsorption of water and solutes
Type of muscles cells the the muscle layer of the gallbladder
Smooth muscle cells (not densely packed and alternate with elastic fibers)
Relations of the gallbladder
Liver
Duodenum
What does bile consist of?
Water
Bile acids
Bilirubin
Cholesterol
Phopholipids
Electrolytes
Proteins
Other organic solutes
What is the main component of bile?
Bile acids
IS water actively or passively absorbed in the gallbladder?
Passively
What happens to the concentration of bile in the gallbladder during fasting?
It is increasing (and then decreased due to absorption of water) and stored
What happens to the concentration of bile in the gallbladder during digestion?
It is secreted to the duodenum
Where is the pancreas located in relation to the stomach?
Posterior
2 excretory ducts of the pancreas
Accessory pancreatic duct
Main pancreatic duct
Why does the pancreas go from greyish to pinkish during digestion?
Increased vascularisation
Does the head of the pancreas adhere to the duodenal loop?
Yes
From where does the accessory pancreatic duct originate?
Main pancreatic duct
Where on the main pancreatic duct does the accessory pancreatic duct originate?
Point where it changes direction at the level of the neck of the pancreas
What part of the pancreas are relatively mobile?
Apex of the tail
Branches from which 3 arteries supply the pancreas?
Common hepatic artery
Splenic artery
Superior mesenteric artery
Which nervous systems is the pancreas innervated by?
Both the sympathetic and parasympathetic
