Liver and Spleen

Question 1

Answer 1

Question 2

Answer 2

Question 3

• Liver develops in the ……….. ………. ……..
• Connected to anterior abdominal wall by ………………… ……………….
• Connected to stomach by …………. …………………
• Direct contact with part of Diaphragm (……….. ………. …….. …………..)

Answer 3

• Liver develops in the ventral foregut mesentery
• Connected to anterior abdominal wall by Falciform Ligament
• Connected to stomach by Lesser Omentum
• Direct contact with part of Diaphragm (Bare Area of Liver)

Question 4

What does the porta carry

Answer 4

Question 5

Describe the surface anatomy of the liver

Answer 5

Question 7

The Visceral Surface of the Liver

• …….. …………. and…….. ………….………… mark the separation into functional R and L lobes
• Grooves for …….. …………. mark out minor parts of functional L lobe (quadrate and caudate Lobes)
• ………… of the liver separates quadrate and caudate lobes.
• Porta carries the 1) Hepatic Artery 2) Portal Vein 3) Common bile duct, and lymphatics

Answer 7

The Visceral Surface of the Liver

• Gall bladder and inferior vena cava mark the separation into functional R and L lobes
• Grooves for foetal veins mark out minor parts of functional L lobe (quadrate and caudate Lobes)
• Porta of the liver separates quadrate and caudate lobes.
• Porta carries the 1) Hepatic Artery 2) Portal Vein 3) Common bile duct, and lymphatics

Question 8

• Covered by costal margin except in upper epigastrium
• Convex diaphragmatic surface
• Complex visceral surface in contact with ……..

name the 4 structures

Answer 8

• Covered by costal margin except in upper epigastrium
• Convex diaphragmatic surface
• Complex visceral surface in contact with stomach, duodenum, right kidney and colon

Question 9

Answer 9

Question 10

Answer 10

Question 11

• Hepatic artery, derived from the …………….. axis, supplies arterial blood to the liver
• …………… vein drains, venous blood from the GI tract and spleen, into the liver
• Venous blood from the liver drains directly into the …………… …………… …………… via … short hepatic veins

Answer 11

• Hepatic artery, derived from the coeliac axis, supplies arterial blood to the liver
• Portal vein drains, venous blood from the GI tract and spleen, into the liver
• Venous blood from the liver drains directly into the inferior vena cava via 3 short hepatic veins

Question 12

Hepatic Portal Vein

Blood from …………… vein, …………… and …………… …………… vein

Answer 12

Hepatic Portal Vein

Blood from splenic vein, inferior and superior mesenteric vein

Question 13

•Coeliac Trunk

• Common Hepatic Artery
• Cystic Artery
• Right hepatic artery
• Left hepatic artery

Answer 13

Question 14

Portosystemic anastamoses

List 4

Answer 14

1. Oesophageal vein (sys) and left gastric vein (port)
2. Inferior rectal vein (sys) and superior rectal vein (port)
3. Epigastric vein (sys) and paraumbilical vein (port)
4. Retroperitoneal vein (sys) and visceral vein (port)

Question 15

What is the relation between liver disease and Porto-systemic anastomoses

Answer 15

• Fibrotic livers have high vascular resistance
• Porto-systemic anastomoses therefore dilate due to volume overload
• E.g.
• Oesophageal varices
• Rectal varicies
• Para-umbilical veins

Question 16

Portal-Systemic Anastomoses

• May become dilated if portal blood flow through the liver is obstructed in liver disease.
• Important sites of PSA are lower oesophagus, rectum, and para-umbilical veins
• Haemorrhage is common from the first two sites

Answer 16

Question 17

Answer 17

Question 18

• Pancreatic duct and bile duct join to form the ……………… ……….. ……………..
• Sphincter of Oddi guards the ……………… ……….. ……………..
• There are separate sphincters for the bile duct and the pancreatic duct
• Neoplasms of head of pancreas can obstruct the ducts here

Answer 18

• Pancreatic duct and bile duct join to form the hepatopancreatic ampulla (of Vater)
• Sphincter of Oddi guards the ampulla of Vater
• There are separate sphincters for the bile duct and the pancreatic duct
• Neoplasms of head of pancreas can obstruct the ducts here

Question 19

Answer 19

Question 20

• L and R hepatic ducts form the ……………. …………… duct
• ……………. …………… from the gall bladder joins the common hepatic duct and becomes the (common) ……. duct.
• (Common) bile duct passes behind 1st part of duodenum and head of pancreas to enter the 2nd part of duodenum at the major papilla, usually joining the ……………. …………… duct.

Answer 20

• L and R hepatic ducts form the common hepatic duct
• Cystic Duct from the gall bladder joins the common hepatic duct and becomes the (common) bile duct.
• (Common) bile duct passes behind 1st part of duodenum and head of pancreas to enter the 2nd part of duodenum at the major papilla, usually joining the major pancreatic duct.

Question 21

Answer 21

Question 22

Spleen

Posteriorly on left side under ribs …-…

What has the spleen got realtions to

Answer 22

• Posteriorly on left side under ribs 9-11
• Relations to stomach, left kidney, splenic flexure of colon and pancreatic tail
• Can rupture and haemorrhage in trauma cases

Question 23

Answer 23

Question 24

Answer 24