liver gallbladder and pancreas anatomy Flashcards
where does tge ampulla of vater empty into ?
major duodenal papilla
what is the anatomical transition between the embryological foregut and midgut ?
the major duodenal papilla
what is the point where the celiac trunk transitions into the SMA ?
major duodenal papilla
what are the causes of sphincter of oddi dysfunction and what is the presentation?
can occur after pancreatitis and gallstone disease
episodes of RUQ pain
abnormal LFTs hyperbilirubinemia
recurrent pancreatitis
what is the treatment for sphincter of oddi dysfunction ?
smooth muscle relaxants
endoscopic sphincterectomy
what is believed to cause sphincter of oddi spasm ?
certain opioids such as morphine
which is why the drug of choice with pancreatitis is meperidine
what are the contents of the portal triad ?
portal venule
portal arteriole
bile duct
what is at the centre of the liver lobule ?
the central vein
what are the two blood supplies of the liver lobules ?
portal veins
hepatic artery
what is the drainage vessel of the loiver lobule ?
hepatic veins
what are the zones associated with the liver lobules ?
the 1st zone is the one closest to the portal triad
the 3rd zone is the one closest to the central vein
1st zone - periportal zone
2nd zone - mid zone
3rd zone - centrilobular zone
what are the different diseases associated with each zone ?
zone 1 - viral hepatitis first
zone 2 - yellow fever
zone 3 - most vunlerable to ischemia and alcoholic liver disease
what is the alternative pathway in which pancreatic secretions can reach the duodenum without using the ampulla of vater ?
through the accessory pancreatic duct
what is the embryology associated with the pancreas ?
formed off of two buds - one ventral and one dorsal
ventral- forms the main pancreatic duct
dorsal bud - forms the body, tail and accessory duct
what is annular pancreas ?
when the ventral bud of the pancreas doesn’t fuse within itself properly and instead fuses around the duodenum causing bowel obstruction
what is pancreas divisium ?
where the dorsal and the ventral buds of the pancreas dont fuse
results in the formation of two separate ducts
often asymptomatic
what are the macrophages in the liver cells called ?
kupffer cells
what is the function of hepatic stellate cells ?
formation of scar tissue
storage of vitamin A
which of the hepatic zones is most sensitive to metabolic toxins ?
zone 3 , highest concentration of p450 enzyme
what is courvoisier sign ?
enlarged non tender gall bladder with jaundice
what is courvoisier sign often associated with ?
cancer of the head of the pancreas - causing obstruction on the common bile duct
