Liver, bile passages and portal circulation Flashcards
What separates the right lobe and left lobe of the liver?
Faciform ligament
What makes up the coronary ligament of the liver?
Left triangular ligament
right triangular ligament
Anterior layer of coronary ligament
Posterior layer of coronary ligament
What area of the liver has no visceral peritoneum?
Bare area
What artery supplies the left lobe of the liver?
Left hepatic artery
What artery supplies the right lobe of the liver?
Right hepatic artery
What is a cholecto-enteric fistula?
an ulceration of tissue adjacent to an inflamed gallbladder
superior part of duodenum and transverse colon are near gallbladder
adhesion can develop between gallbladder and other viscera in cases of inflamed gallbladder
What makes up the gall bladder
fundus
body
neck
cystic duct
Explain the bile system
Right and left hepatic duct form the common hepatic duct
once cystic duct joints the common hepatic duct then turns into the common bile duct
common bile duct joins with main pancreatic duct to form hepatopancreatic ampulla (of vater)
This empties into major duodenal papilla on descending part of duodenum
When does the common bile duct start?
Once common hepatic duct and cystic duct joint
What makes up the heptaopancreatic ampulla (of vater)
Main pancreatic duct (of Wirsung)
Common bile duct
What is the function of the spiral valves of the cystic duct? (spiral valves of Heister)
Keep the lumen of the duct constantly open
What makes up the hepatoduodenal ligament?
Portal vein (posterior)
Proper hepatic artery (anterior)
Common bile duct (right)
What is cholecystitis?
Inflammation of gallbladder
What is cholelithiasis?
Gallbladder has gallstones
What are the borders of the cystic triangle? (of Calot)
Base of the liver
common hepatic duct
cystic duct
What runs through the Cystic triangle of calot
Cystic artery
If there is a tumor at the head of the pancreas what could become compressed?
Common bile duct
main pancreatic duct
During surgery to remove the gallbladder what is being cut off?
Cystic duct
Cystic artery
What blood supply does the liver recieve?
Dual blood supply
hepatic arteries and portal vein
What supplies the liver with the most amount of blood?
75% is from the portal vein
blood that supplies the liver with the most nutrients
The hepatic arteries supply the liver with what?
Oxygen
What are the liver sinusoids?
Where the venous blood mixes with arterial blood
What is the portal system?
Vascular area composed of veins and located between two capillary beds
Do the veins in the portal system of the liver branch?
YES
What does the inferior mesenteric vein hold?
Blood from the hindgut region
What does the superior mesenteric vein hold?
Blood from the midgut region
What empties into the splenic vein?
Inferior mesenteric vein
What empties into the portal vein?
Splenic vein
superior mesenteric vein
left gastric vein
right gastric vein
What does the portal vein branch into?
Right and left branches of portal vein
then go through sinusoids
What does the hepatic veins collect?
Blood that has gone through sinusoids
Where do the hepatic veins empty into?
IVC
How can portal hypertension happen?
If flow through the poral vein is impeded vein may become congested
Where can portocaval anastamoses occure?
Esophagus
umbilicus
rectum and anal canal
retroperitoneal surfaces of organs
Portocaval anastomoses at lower end of esophagus
systemic vessels: esophageal veins
portal vessels: left gastric vein
obstructive signs: Varices and hematemesis
Portocaval anastomoses around umbilicus
Systemic vessels: superficial veins of anterior abdominal wall
portal vessels: Para-umbilica veins accompanying ligamentum teres hepatis
Obstructive signs: Venous enlargement (Caput medusae)
Portocaval anastomoses around rectum and anal canal
Systemic vessels: Middle and inferior rectal veins
Portal vessels: Superior rectal vein
Obstructive signs: Hemorrhoids
Portocaval anastamoses
Systemic vessels: Retroperitoneal veins
Portal veins: Tributaries of mesenteric veins
Obstructive signs: Silent
How should you remember the spleen?
1, 3, 5, 7, 9, 11
1 x 3 x 5 inches in size
7 oz weight
position between 9th and 11th rib
Hilum of spleen
Where splenic artery and vein go to
Pancreas functions
Has endocrine and exocrine functions
exocrine secretions empty into the duodenum by pancreatic duct
What is the largest internal organ?
liver
Role of the liver?
Uptake, storage, and distribution of nutrients
produces majority of circulating plasma proteins, stores iron, converts vitamins, degrades drugs and toxins
Exocrine organ (produces bile) and performs endocrine-like fucntions
Function of gallbladder
Concentrates (removes 90% of water) and stores bile
