Liver, bile passages and portal circulation

Question 1

What separates the right lobe and left lobe of the liver?

Answer 1

Faciform ligament

Question 2

What makes up the coronary ligament of the liver?

Answer 2

Left triangular ligament
right triangular ligament
Anterior layer of coronary ligament
Posterior layer of coronary ligament

Question 3

What area of the liver has no visceral peritoneum?

Answer 3

Bare area

Question 4

What artery supplies the left lobe of the liver?

Answer 4

Left hepatic artery

Question 5

What artery supplies the right lobe of the liver?

Answer 5

Right hepatic artery

Question 6

What is a cholecto-enteric fistula?

Answer 6

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

Question 7

What makes up the gall bladder

Answer 7

fundus
body
neck
cystic duct

Question 8

Explain the bile system

Answer 8

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

Question 9

When does the common bile duct start?

Answer 9

Once common hepatic duct and cystic duct joint

Question 10

What makes up the heptaopancreatic ampulla (of vater)

Answer 10

Main pancreatic duct (of Wirsung)

Common bile duct

Question 11

What is the function of the spiral valves of the cystic duct? (spiral valves of Heister)

Answer 11

Keep the lumen of the duct constantly open

Question 12

What makes up the hepatoduodenal ligament?

Answer 12

Portal vein (posterior)
Proper hepatic artery (anterior)
Common bile duct (right)

Question 13

What is cholecystitis?

Answer 13

Inflammation of gallbladder

Question 14

What is cholelithiasis?

Answer 14

Gallbladder has gallstones

Question 15

What are the borders of the cystic triangle? (of Calot)

Answer 15

Base of the liver
common hepatic duct
cystic duct

Question 16

What runs through the Cystic triangle of calot

Answer 16

Cystic artery

Question 17

If there is a tumor at the head of the pancreas what could become compressed?

Answer 17

Common bile duct

main pancreatic duct

Question 18

During surgery to remove the gallbladder what is being cut off?

Answer 18

Cystic duct

Cystic artery

Question 19

What blood supply does the liver recieve?

Answer 19

Dual blood supply

hepatic arteries and portal vein

Question 20

What supplies the liver with the most amount of blood?

Answer 20

75% is from the portal vein

blood that supplies the liver with the most nutrients

Question 21

The hepatic arteries supply the liver with what?

Answer 21

Oxygen

Question 22

What are the liver sinusoids?

Answer 22

Where the venous blood mixes with arterial blood

Question 23

What is the portal system?

Answer 23

Vascular area composed of veins and located between two capillary beds

Question 24

Do the veins in the portal system of the liver branch?

Answer 24

YES

Question 25

What does the inferior mesenteric vein hold?

Answer 25

Blood from the hindgut region

Question 26

What does the superior mesenteric vein hold?

Answer 26

Blood from the midgut region

Question 27

What empties into the splenic vein?

Answer 27

Inferior mesenteric vein

Question 28

What empties into the portal vein?

Answer 28

Splenic vein
superior mesenteric vein
left gastric vein
right gastric vein

Question 29

What does the portal vein branch into?

Answer 29

Right and left branches of portal vein

then go through sinusoids

Question 30

What does the hepatic veins collect?

Answer 30

Blood that has gone through sinusoids

Question 31

Where do the hepatic veins empty into?

Answer 31

IVC

Question 32

How can portal hypertension happen?

Answer 32

If flow through the poral vein is impeded vein may become congested

Question 33

Where can portocaval anastamoses occure?

Answer 33

Esophagus
umbilicus
rectum and anal canal
retroperitoneal surfaces of organs

Question 34

Portocaval anastomoses at lower end of esophagus

Answer 34

systemic vessels: esophageal veins
portal vessels: left gastric vein
obstructive signs: Varices and hematemesis

Question 35

Portocaval anastomoses around umbilicus

Answer 35

Systemic vessels: superficial veins of anterior abdominal wall
portal vessels: Para-umbilica veins accompanying ligamentum teres hepatis
Obstructive signs: Venous enlargement (Caput medusae)

Question 36

Portocaval anastomoses around rectum and anal canal

Answer 36

Systemic vessels: Middle and inferior rectal veins
Portal vessels: Superior rectal vein
Obstructive signs: Hemorrhoids

Question 37

Portocaval anastamoses

Answer 37

Systemic vessels: Retroperitoneal veins
Portal veins: Tributaries of mesenteric veins
Obstructive signs: Silent

Question 38

How should you remember the spleen?

Answer 38

1, 3, 5, 7, 9, 11
1 x 3 x 5 inches in size
7 oz weight
position between 9th and 11th rib

Question 39

Hilum of spleen

Answer 39

Where splenic artery and vein go to

Question 40

Pancreas functions

Answer 40

Has endocrine and exocrine functions

exocrine secretions empty into the duodenum by pancreatic duct

Question 41

What is the largest internal organ?

Answer 41

liver

Question 42

Role of the liver?

Answer 42

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

Question 43

Function of gallbladder

Answer 43

Concentrates (removes 90% of water) and stores bile