MGA 2018 Exam II -Liver, Gall Bladder, Hepatic Portal System Flashcards
How do you define Cantlie’s Line on the liver?
Make a plane (line) between the Inferior Vena Cava and the gallbladder fossa
What surgical segment of the liver is the caudate lobe?
I
Which surgical segments of the liver comprise the left lobe?
II and III
Which surgical segments of the liver comprise the right lobe?
IV-VIII
How do you number the 8 surgical segments of the liver?
http://youtu.be/T5yXGzDCtZE
Starting with caudate lobe in the back (#1), move to the top left lobe and count clockwise. The falciform ligament (and ligamentum teres) at the left sagittal fissure will separate #’s 4-8 from the left lobe segments
What theoretical line separates the functional or “true” right and left lobe of the liver?
Cantlie’s Line
Of the total blood volume entering the liver, what percentage is supplied by the proper hepatic artery to feed the liver itself?
25%
Of the total blood volume entering the liver, what percentage is delivered by the hepatic portal vein for processing?
75%
What are replaced arteries?
Arteries originating from a different vessel than normal
What are accessory arteries?
An additional branch of an otherwise normal artery
A replaced right hepatic artery comes from?
Superior Mesenteric Artery
SMA
A replaced left hepatic artery comes from?
Left Gastric Artery
of Celiac Trunk
A completely replaced proper hepatic artery comes from?
Superior Mesenteric Artery
SMA
An accessory right hepatic artery comes from?
SMA
An accessory left hepatic artery comes from?
Left Gastric Artery
of Celiac Trunk
Starting from the Celiac Trunk complete the arterial branching pattern: ___?____a. –> Proper hepatic a. –> R,L hepatic aa.
- (a=artery, aa=arteries)
Hepatic
Celiac Trunk –> Common Hepatic a. –> __?__ a. –> R,L hepatic aa.
Proper Hepatic
Proper Hepatic a.–> Right Hepatic a. –> ______? a. –> Gallblader
Cystic artery
What is the hepatocystic triangle AKA Triangle of Calot?
An area bordered by the liver, cystic duct and common hepatic duct. The cystic artery is located within.
What are the 3 Hepatic veins?
Right, Middle, and Left
What segments of the liver does the right vein drain?
5,6,7,8
*directly to IVC
What segments of the liver does the left vein drain?
2 & 3
*joins with the middle v. into a common trunk and then to IVC
What segments of the liver does the middle vein drain?
4 and some overlapping 5&8
*joins with the left v. into a common trunk and then to IVC
What is the hepatic triad?
Hepatic Portal Vein, Common Bile Duct, Proper Hepatic A.
What is the relationship of the hepatic triad structures to one another? (posterior/lateral/medial)
Hepatic Portal Vein=posterior
Bile Duct=lateral
Proper Hepatic Artery=medial
What are the ligaments of the liver?
- Falciform
- Round (or ligamentum teres)
- Coronary (upper/anterior and lower/posterior)
* R/L triangular ligaments are where the edges of the coronary lig. meet.
Describe the areas of contact from other organs on the visceral surface of the liver
- suprarenal impression (right adrenal gland)
- renal impression (right kidney)
- duodenal impression
- gastric impression
* bare area is where liver contacts diaphragm
During development, the LARGER part of the liver bud is caudal or cranial?
cranial
During development, the falciform ligament is attached to the anterior body wall and is referred to as . . .?
ventral mesogastrium
During development, the SMALLER part of the liver bud is caudal or cranial?
caudal
During development the ligamentum teres (or round ligament) carries oxygenated blood from the placenta through the umbilicus and is referred to as . . .?
umbilical vein
ligamentum teres is obliterated umbilical v.
During development the stalk of the diverticulum (liver bud) will later become . . .?
cystic duct
During development the stalk connecting hepatic and cystic ducts will become the . . .?
common bile duct
Name the 5 parts of the gallbladder
- fundus
- body
- infundibulum
- neck
- cystic duct
Name the parts of the common bile duct
- supraduodenal
- retroduodenal
- pancreatic
- intramural
Common bile duct + ___?___ join to form the hepatopancreatic ampulla (of Vater); together empty to major duodenal papilla
Major pancreatic duct (of Wirsung)
The hepatopancreatic ampulla of Vater is controlled by which sphincter?
Oddi
Right hepatic duct + Left hepatic duct join to form . . .?
Common Hepatic Duct
Cystic duct meets ______ to form the Common bile duct.
Common Hepatic Duct