liver, GB, pancreas and spleen

Question 1

What is the function of the liver and what region is it located in?

Answer 1

Function - produces bile, stores glycogen, detoxification

Location - right hypochondriac region

Question 2

describe the two surfaces of the liver

Answer 2

Diaphragmatic surface (smooth and convex) meets the diaphragms inferior surface

Visceral surface - moulded by the impressions of the related organs like stomach and kidneys.
This is the posterior surface of the liver. Left lobe has gastric impression, right lobe has the renal impression, duodenal and colic impression (so this region has the hepatic fletcher)

Question 3

explain the different lobes of the liver

Answer 3

mainly divided into right and left lobe with the right being the larger

the right lobe is further divided into anterior and posterior segments

the caudate lobe is on the upper aspect of the visceral surface of the liver, between the IVC and the venous ligament

below this is the hilum of the liver, below which is the quadrate lobe

Question 4

explain/describe the different ligaments of the liver (x6)

Answer 4

falciform ligament - at anterior surface, running down the middle separating right and left lobe

round ligament/ligamentum teres = a remanent of the foetal umbilical vein, it is the loose bit at the end of the falciform ligament

coronary ligament = lines the top/superior surface of the liver, its like the two branches the falciform ligament branches into

triangular ligament = there is a right and a left one, its just the corners of the coronary ligament

ligamentum venosum = only seen from posterior on the visceral surface, kind of divides right and left

hepatocaval ligament = short and thick ligament on posterior surface, looks like a bridge under which the IVC passes

Question 5

what is the bare area of the liver?

Answer 5

the liver is an intraperitoneal organ, but has an area that is not

this is the posterior aspect of the diaphragmatic surface, kind of outlined by the coronary ligament ish

Question 6

what is the porta hepatis?

Answer 6

transmits all vessels, nerves and ducts entering/leaving the liver (so heaptic ducts, hepatic arteries, and portal vein), except the hepatic veins as these drain directly into the IVC

Question 7

describe the blood supply of the liver

Answer 7

right and left proper hepatic arteries from coeliac trunk supply 25%, 75% is supplied by nutrients-rich venous blood from the gut in the hepatic portal vein

Question 8

what is the function, location and structure of the gallbladder?

Answer 8

Function - stores bile

Location - the posteroinferior of the liver (at the back on the visceral surface, just next to the quadrate lobe, in the gallbladder fossa)

Features - fundus (round part/bottom of the sac), body (main bit) and neck

Question 9

explain the branches of the biliary tree

Answer 9

from the liver, the right and left hepatic ducts join to form the common hepatic duct

this gives rise to the cystic duct, which is continuous with the neck of the gall bladder so the gallbladder can receive bile to store, and release it when needed

once the common hepatic duct has branched into the cystic duct, it continues on as the common bile duct, this descends through the pancreas/behind head of the pancreas and enters the 2nd part of the duodenum at the ampulla of vater

the pancreatic duct = not exclusive to the biliary tree but is closely associated
it carries digestive enzymes produced by the pancreas and typically joins the common bile duct before entering the duodenum

Question 10

what are gallstones?

Answer 10

made of bile salts and cholesterol, they are very common and usually asymptomatic

they can be associated with pain, jaundice and inflammation of the abdomen

Question 11

what are the functions and location of the pancreas?

Answer 11

Function - endocrine (hormonal secretion) and exocrine (enzyme secretion) organ
Location - mostly in epigastric region, but tail lies in left hypochondriac region
it lies along the transpyloric plane (L1)
Behind the stomach
The head sits in this cute lil C-shape of the duodenum

Question 12

describe the structure and features of the pancreas

Answer 12

Retroperitoneal except the tail (which is intraperitoneal as it is in close contact with the spleen)
Pancreatic duct merges with common bile duct at the hepatopancreatic ampulla
Head, body, tail and uncinate process - a little hook coming from the head of the pancreas

*Major duodenal papilla is same as ampulla of Vater

forms bed of stomach, common bile duct is posterior to it, mostly retroperitoneal, is enclosed by the duodenum

Question 13

what are the functions and location of the spleen?

Answer 13

Functions:
The spleen is a vital organ with various functions, including:
Immune Function: filtering blood and removing damaged/old blood cells.
Blood Storage: stores platelets and red blood cells, releasing when needed.
Hematopoiesis (limited)

Location:
The spleen is located in the upper left quadrant, left hypochondriac region
Protected by ribs 9th to 11th

lies in mesentery connecting it to the stomach and the posterior abdominal wall

Question 14

describe the surfaces of the spleen

Answer 14

Diaphragmatic Surface: The smooth, faces the diaphragm and ribs.kind of psoterior surface

Visceral Surface: irregular surface, has an impression of the stomach, is in contact with left kidney, and tail of the pancreas. has a hilum for blood vessels

Question 15

what are the three borders of the spleen?

Answer 15

Superior Border: The upper border, in contact with the diaphragm (has notches)

Inferior Border

Anterior Border: The border between the diaphragmatic and visceral surfaces (has notches)

Question 16

coeliac trunk?

Answer 16

arises from the abdominal aorta at T12, it’s branches supply the foregut

Question 17

what are the branches of the coeliac trunk?

Answer 17

common hepatic artery on the right

left gastric artery (looks like it goes upwards). supplies left aspect of the lesser curvature of the stomach

splenic artery - runs behind the stomach, has lots of bends and curves, supplies the spleen

Question 18

what are the branches of the common hepatic artery?

Answer 18

proper hepatic artery (supplies lobes of the liver)
which itself gives rise to the right gastric artery (supplies right side of the lesser curvature of stomach

gastroduodenal artery - supplies pyloric part of the stomach (clue in names)
gives rise to right gastroepiploic (supplies right side of greater curvature) and the superior pancreaticoduodenal artery - supplies superior aspect of the duodenum and the head of the pancreas

Question 19

what does the left gastric artery give rise to?

Answer 19

oesophageal branches

Question 20

what are the branches of the splenic artery?

Answer 20

short gastric artery - supplies fundus of the stomach

pancreatic branches

left gastroepiploic - supplies left side of the greater curvature

Question 21

what blood vessels supply the pancreas?

Answer 21

coeliac trunk - splenic artery - pancreatic branches

coleiac trunk - common hepatic - gastroduodenal - superior pancreaticoduodenal artery

inferior pancreato-duodenal artery from superior mesenteric artery

Question 22

what are the tributaries of the hepatic portal vein?

Answer 22

● The splenic vein is a major tributary of the hepatic portal vein

● The splenic vein is joined by the inferior mesenteric vein (behind the tail of the pancreas) before joining with the superior mesenteric vein (behind the head of the pancreas) to form the hepatic portal vein

Question 23

what’s important about the L and R gastric arteries, and the L and R gastroepiploic arteries?

Answer 23

they anastomose with each other (respectively)