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MRCS: Abdomen and Pelvis Anatomy > Liver, Portal Circulation, Billiary System and Spleen > Flashcards

Liver, Portal Circulation, Billiary System and Spleen Flashcards

1
Q

What ligaments can the lesser omentum be divided into?

A

Hepatoduodenal Ligament

Gastrohepatic Ligament

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2
Q

Which ligaments suspend the spleen?

A

Splenorenal ligament and Gastrosplenic ligament

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3
Q

In which mesentery does the liver develop?

A

Ventral mesentery

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4
Q

What connects the liver to the anterior abdominal wall?

A

Falciform Ligament

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5
Q

What connects the liver to the lesser curvature of the stomach?

A

Lesser Omentum

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6
Q

What is the region of the liver that makes direct contact with the diaphragm called?

A

Bare area of the liver

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7
Q

Which ribs are the liver deep to?

A

Deep to ribs 7-11

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8
Q

Which abdominal regions do the liver extend across?

A

The top three: right hypochondriac, epigastric and left hypochondriac

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9
Q

What is the structure at the end of the falciform ligament called and how did it originate?

A

Ligamentum Teres - it is a remnant of the umbilical vein

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10
Q

What are the ligaments on the superior surface of the liver called?

A 
Coronary Ligament (anterior and posterior) 
Left and Right Triangular Ligaments
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11
Q

What defines the anatomical boundary (dividing the liver into anatomical lobes)?

A

The fissures of the foetal veins

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12
Q

What are the two accessory lobes of the liver and where are they located?

A

Quadrate - located between the gallbladder and the fissure of the ligamentum teres
Caudate - located between the IVC and the fissure of the ligamentum venosum
The porta hepatis divides the caudate and quadrate lobes.

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13
Q

What is the ligament on the posterior end of the inferior aspect of the liver?

A

Ligamentum venosum - remnant of the ductus venosum

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14
Q

What divides the liver into right and left functional lobes?

A

A line between the gallbladder and the IVC

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15
Q

What is special about the caudate lobe?

A

It is functionally independent - its blood supply is separate to the two main lobes

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16
Q

What vessels make up porta hepatis?

A

Common hepatic bile duct
Hepatic artery
Hepatic portal vein

17
Q

What are the two parts of the coronary ligament?

A

Anterior and Posterior

18
Q

What is the space between the superior surface of the liver and the diaphragm called?

A

Subphrenic Space

19
Q

What are the branches of the coeliac trunk?

A

Left Gastric Artery
Splenic Artery
Common Hepatic Artery

20
Q

What are the branches of the common hepatic artery?

A

Right gastric artery
Gastoduodenal Artery (branches into the anterior and posterior superior pancreaticoduodenal arteries and the right gastro-omental artery)
Supraduodenal Artery
Cystic Artery
Hepatic Artery Proper
NOTE: Superior Pancreaticoduodenal Arteries anastomose with the inferior pancreaticoduodenal arteries (which come off the superior mesenteric artery)

21
Q

What connects the venous drainage of the liver to the IVC?

A

Three short hepatic veins

22
Q

What are the four sites of portal-systemic anastomosis?

A

Oesophageal Veins - Left Gastric Vein
Inferior Rectal Vein - Superior Rectal Vein
Epigastric Veins - Paraumbilical Vein
Retroperitoneal Veins - Visceral Veins

23
Q

What is the significance of these sites?

A

If there is a blockage causing hepatic portal tension, these sites of porto-systemic anastomoses could dilate and possibly bleed

24
Q

At which of these anastomoses is haemorrhage common?

A

Oesophagus

Rectum

25
Q

Describe the structure of the biliary tree.

A

The cystic duct from the gallbladder joins the hepatic duct (from the right and left hepatic ducts) to form the common bile duct

26
Q

Where does the common bile duct and pancreatic duct enter into the duodenum?

A

Major Duodenal Papilla

NOTE: the pancreatic duct joins the common bile duct at a dilation in the common bile duct called the Ampulla of Vater

27
Q

What is the clinical significance of the proximity of the gallbladder to the first part of the duodenum?

A

Gallstones can press on the duodenum and ulcerate causing a cholecystoduodenal fistula

28
Q

The spleen lies on the underside of which ribs?

A

9-11

29
Q

What are the two ligaments at the hilum of the spleen?

A

Splenorenal and Gastrosplenic

MRCS: Abdomen and Pelvis Anatomy (11 decks)

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