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M104 T2 > M104 T2 L1 > Flashcards

M104 T2 L1 Flashcards

1
Q

What is the largest gland in the body?

A

the skin

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2
Q

What is the second largest gland in the body?

A

the liver

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3
Q

How much does the liver weigh?

A

1.5 kg

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4
Q

What is the topography of the liver?

A

wedge shaped - it tapers off in a slightly triangular kind of shape
colour - reddish brown
the right side is taller

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5
Q

Where is the liver located?

A

below the diaphragm

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6
Q

Which quadrants does the liver encompass?

A

mostly in the right hypochondrium and epigastrium

but it extends into the left hypochondrium

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7
Q

What are the main roles of the liver?

A

detoxification
protein synthesis
production of bile – accessory GI organ
glycogen storage

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8
Q

What is the liver like in respect to tactility?

A

pliable to touch, easily lacerated

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9
Q

Why is it especially bad tha the liver is easily lacerated?

A

bc it’s highly vascularised so it will bleed a lot

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10
Q

How does the location of the liver affect the shape of the diaphragm?

A

it gives the diaphragm its domed shape on one side when it’s relaxed

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11
Q

How does the topography of the liver affect the location of the kidneys?

A

the mismatch in the shape of the liver between the left and right sides means that the right kidney sits lower in the abdomen than the left kidney does

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12
Q

What are the locational relations the liver has to other organs?

A

below diaphragm
right of the stomach
above the colon
overlies gallbladder

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13
Q

Where is the liver in relation to the ribs?

A

Usually covered by them but when breathing down and the contraction pushes the viscera down, it may not be covered by the ribs anymore

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14
Q

What are the two anterior lobes of the liver?

A

left and right

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15
Q

What are the ligaments in the liver?

A

coronary ligaments
falciform ligament
ligamentum teres

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16
Q

What ligament does the falciform ligament contain?

A

the ligamentum teres

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17
Q

What happens to the ligamentum teres after birth?

A

it isn’t needed anymore, so it obliterates and closes up

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18
Q

What are the two posterior lobes of the liver?

A

caudate lobe

quadrate lobe

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19
Q

What are the two impressions of the liver?

A

gastric impression

renal impression

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20
Q

What organ is the bare area of the liver in contact with?

A

the lower part of the diaphragm

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21
Q

Which of the four main heart vessels is in physical contact with the liver?

A

the IVC

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22
Q

Which ligaments separate the right and left lobes of the liver?

A

the falciform ligament

the lesser omentum ligament

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23
Q

What structure divides the quadrate and caudate lobes?

A

porta hepatis (fissure)

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24
Q

Which two structures does the falciform ligament link together?

A

the anterior abdominal wall to liver

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25
Q

Which two structures does the coronary ligament link together?

A

the diaphragm and the liver

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26
Q

Which two structures does the lesser omentum link together?

A

the liver to stomach

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27
Q

From where does the lesser omentum span to?

A

the lesser curvature stomach to the porta hepatis

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28
Q

What is the free margin of the lesser omentum made up of?

A

ventral mesentry

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29
Q

What does the lesser omentum enclose?

A

portal triad
lymph vessels
gastric vessels (close to stomach)

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30
Q

What structure does the coeliac trunk supply?

A

the foregut

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31
Q

What structure does the superior mesentric artery supply?

A

the midgut

32
Q

What structure does the inferior mesentric artery supply?

A

the hindgut

33
Q

What artery is the liver supplied by?

A

the hepatic artery

34
Q

What vein does the liver use?

A

IVC

35
Q

Which two veins join to make the portal vein?

A

the superior mesenteric vein

the splenic vein

36
Q

What are the branches of the coeliac trunk / artery?

A

left gastric artery - supplies the stomach
splenic artery - supplies the spleen
common hepatic artery - supplies the liver

37
Q

At what vertebral level does the coeliac artery exit the aorta?

A

T12/L1 Level

38
Q

What structures does the coeliac artery supply?

A 
liver (CHA)
stomach (LGA, r&lGEAs)
spleen (SA)
duodenum (GDA)
pancreas (SGDA)
abdominal oesophagus (OB'LGA)
39
Q

What is the statistical variation of the heptic artery?

A

40-45% of people (abnormal)

40
Q

Where are the most common cases for hepatic artery variation?

A

Type 1 - CHA trifurcation
Type 2 - LHA joined to the LGA
Type 3 - RHA joined to the SMA

41
Q

Where is the porta hepatis located?

A

on the visceral surface of the liver’s hilum

42
Q

What’s the depth of the fissure that the porta hepatis makes?

A

5cm

43
Q

How are the liver lobes subdivided into segments (Couinaud)?

A

it is according to how the hepatic artery and portal vein subdivide

44
Q

Where do sinusoids (hepatic capillaries) receive blood from?

A

branches of the hepatic artery and the portal vein carry blood into sinusoids

45
Q

What are the three types of blood vessels in the liver?

A

continuous - keeper
fenestrated - gaps
sinusoid

46
Q

What structures does the portal triad consist of?

A

bile ducts
hepatic artery
portal vein

47
Q

What is the function of continuous sinusoids?

A

to keep the blood within the vessel

48
Q

What is different about liver transplants?

A

the liver is a regenerative organ, so only about 20% of a liver is needed for full function
the liver keeps regenerating after that, which is why people can have a portion of their liver removed to be transplanted into someone else

49
Q

What cells do lobulocytes contain?

A

hepatocytes

50
Q

What percentage of the liver is made up of hepatocytes?

A

60%

51
Q

What are the metabolic functions of hepatocytes?

A

synthesises plasma proteins and bile salts
deaminates amacs to create ammonia
converts bilirubin to bile pigment

52
Q

What happens to the blood from portal and hepatic veins in the sinusoids?

A 
passes through the hepatocytes 
onto the central vein
then the interlobular / sublobular vein
they drain into hepatic veins
which drains into the inferior vena cava

HEP - CENTRAL - INTERLOB - HEPATIC - HEART

53
Q

Where is the central vein located?

A

the center of a hepatic lobule

54
Q

Which vein do several central portal veins drain into?

A

the interlobular / sublobular vein

55
Q

What does the portal venous system involve?

A

blood draining the GI tract towards the liver

in this way, toxins, drugs, etc absorbed from the GI has to pass through the liver before reaching the heart

56
Q

What is portal hypertension caused by?

A

a blockage in the portal vein

the ics in pressure pushes against the vessel wall - hypertension

57
Q

What are the common presentation signs of portal hypertensions?

A

varicoses
oesophageal varices
caput medusa

58
Q

What were portacaval shunts originally used for?

A

to ameliorate hypertension

59
Q

What did portacaval shunts involve?

A

a connection was made between the portal vein and the IVC

60
Q

What were portacaval shunts replaced by?

A

transjugular intrahepatic portosystemic shunting

61
Q

At what rate is bile secreted by hapatocytes?

A

40 ml/ hr

62
Q

What are the two main hepatic ducts that bile canaliculi join to form?

A

the l&r hepatic ducts that drain their respective lobes

63
Q

What do the left and right hepatic duct combine to form when they emerge from the liver?

A

the common hepatic duct

64
Q

Which portal systemic anastomosis is located in the abdominal part of the oesophagus?

A

left gastric tributaries with oesophageal branches azygos

65
Q

Which portal systemic anastomosis is located in the anal canal?

A

superior rectal anastomoses with middle and inferior rectal

66
Q

Which portal systemic anastomosis is located in the umbilicus? was an example

A

paraumbilical veins with epigastric veins

67
Q

What does transjugular intrahepatic portosystemic shunting involve?

A

the gap between the portal and hepatic vein is bridged
AAR lots of the hepatic tissue trying be perfused is not included
this lessens the vasculature load
reduces hypertension

68
Q

Where are celiac lymph nodes mostly located?

A

around the porta hepatis

69
Q

Why are they called celiac lymph nodes?

A

bc they are associated with the branches of the celiac artery

70
Q

Where do the coeliac nodes drain into?

A

the cisterna chyli

71
Q

What is liver trauma likely to be caused by and why?

A

fractured ribs could penetrate the liver quite easily
bc the liver is close to the lower ribs
penetrating wounds - anything moving through the rib cage has the potential to hit the liver

72
Q

What happens if the liver is even slightly injured and why?

A

severe haemorrhage can happen

bc it’s highly vascularised

73
Q

When might portions of the liver be removed?

A

liver biopsies
metastatic spread
cirrhosis

74
Q

How can portions of the liver be removed?

A

bc the liver is segmental in nature

75
Q

What vessels are included under the portal triad?

A

hepatic artery proper
portal vein
common bile duct

M104 T2 (15 decks)

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