liver,gall bladder, pancreas and spleen! Flashcards
what is the ligament of treitz an extension of?
the diaphrgram, AKA the suspensory muscle
What does the ligament of treitz do?
suspends the 4th part of the duodenum from the right crus of the diaphragm
What part of the pancrease is NOT retroperitoneal
the tail-lies within the hilus of the spleen
the neck of the pancreas lies at what level
L1-L2
body and tail of the pancreas extend into what?
left hypochondrium.
what are some symptoms of pancreatic disease?
backache, recent onset diabetes
how is the pancreas both a exocrine and endocrine organ?
exocrin- secretes alkaline pancreatic juices wth enzymes into the duodenum. Endocrine- produces insulin, glucagon and somatostain
Cancer of the pancreas is usually in what area
the head, mostly adenocarcinomas of exocrine cells, neuroendorcrine tumors can occur in iselt cells
what are signs of pancreatic cancer?
Upper abdominal pain, jaundice and loss of appetite
What is the common terminus of the bile duct and pancreatic duct?
hepatopancreatic ampulla (ampulla of Vater)
hepatopancreatic ampulla (ampulla of Vater) enters where?
the second part of duodenum posteriorly
what controls bile secretion into the duodenum
Choledochal sphincter
what controls pancreatic secretions into the duodenum
Pancreatic sphincter
The combined opening into the duodenum is controlled by>
sphincter papillae (sphincter if Oddi) surrounds the ampulla of Vater
what artery is most at risk for a cholecystectomy.
right hepatic artery
If a gallstone is passing down the bile duct- where might it get stuck?
in the hepatopancreatic ampulla- where it opens to major duodenial papilla- bile backup! pancreatitis!
whats the purpose of the spiral folds of the cystic duct
valve to keep the duct open
How does bile pass into the gallbladder
by the choledochal sphincter if the bile duct is closed
How does bile pass into the duodenum
gallbladder contracts and the choledochal spincter is open
Other places gallstones may be found?
where cystic duct narrows- in the fundus, or lodged at the gall bladder neck or just proximal to the hepatopancreatic ampulla
what is biliary colic and where is it felt
is an intense spasmodic pain felt in the epigastric region or the right upper quadrant.
how do you remove the gallbladdeR?
Laparoscopic cholecystectomy
what is the new imaging technique to visular the WHOLE biliary tree?
Magnetic Resonance Cholangiopancreatography (MRCP)
ligamentum teres was what fetal structure?
umbilical vein
ligamentum venosum was what fetal structure
ductus venosus
Functionall, the caudate and quadrate are part of what lobe?
LEFT! but really part of the right anatomically
Do the R and L hepatic arteries and ducts communicate?
Nope
Where are most injuries to the liver?
the right lobe
Blood passing through the liver is via what?
sinusoids instead of capillaries
The hepatocytes of the liver do what?
extract nutrients, toxins and oxygen
Where does the spleen lie?
LUQ against ribs 9-11, largest lympoid tissue in the body
Functions of spleen>
antibodies from B cells, filter blood, blood resvourice, early live makes the blood
most frequent injured organ in teh body?
spleen
Is a splenetctomy compatble with life?
yes, functions assumed by other reticuloendothelial organs
what is the bare area of the liver?
where there is no peritoneum bwtn the liver and the diapgragm
what is the exit/entry of the blood vessels/bile duct called?
porta hepatis
what is in the hepatic pedicle?
heptaci artery, portal vein, bile duct, enclosed in the free edge of hepatiduodenal ligament
What can be done to the pedicle during sugery?
can be clamped to minize blood loss
Hepatic artery is a branch of? what kind of blood does it deliver?
celiac trunk, delivers OXY blood to the liver, 20-30% total blood
What is the portal vein formed from?
SMV, IMV, splenic vein
what forms the common hepatic duct?
L and R hepatic ducts that join at the porta hepatis
What makes up the common bile duct
common hepatic duct joins the cystic duct
What joins the common bile duc at the hepatopancreatic amupulla?
pancreatic duct
why is the liver special
only organ in the body that can regenerate itself
