MGA 2018 Exam II -Liver, Gall Bladder, Hepatic Portal System

Question 1

How do you define Cantlie’s Line on the liver?

Answer 1

Make a plane (line) between the Inferior Vena Cava and the gallbladder fossa

Question 2

What surgical segment of the liver is the caudate lobe?

Answer 2

I

Question 3

Which surgical segments of the liver comprise the left lobe?

Answer 3

II and III

Question 4

Which surgical segments of the liver comprise the right lobe?

Answer 4

IV-VIII

Question 5

How do you number the 8 surgical segments of the liver?

http://youtu.be/T5yXGzDCtZE

Answer 5

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

Question 6

What theoretical line separates the functional or “true” right and left lobe of the liver?

Answer 6

Cantlie’s Line

Question 7

Of the total blood volume entering the liver, what percentage is supplied by the proper hepatic artery to feed the liver itself?

Answer 7

25%

Question 8

Of the total blood volume entering the liver, what percentage is delivered by the hepatic portal vein for processing?

Answer 8

75%

Question 9

What are replaced arteries?

Answer 9

Arteries originating from a different vessel than normal

Question 10

What are accessory arteries?

Answer 10

An additional branch of an otherwise normal artery

Question 11

A replaced right hepatic artery comes from?

Answer 11

Superior Mesenteric Artery

SMA

Question 12

A replaced left hepatic artery comes from?

Answer 12

Left Gastric Artery

of Celiac Trunk

Question 13

A completely replaced proper hepatic artery comes from?

Answer 13

Superior Mesenteric Artery

SMA

Question 14

An accessory right hepatic artery comes from?

Answer 14

SMA

Question 15

An accessory left hepatic artery comes from?

Answer 15

Left Gastric Artery

of Celiac Trunk

Question 16

Starting from the Celiac Trunk complete the arterial branching pattern: ___?____a. –> Proper hepatic a. –> R,L hepatic aa.

• (a=artery, aa=arteries)

Answer 16

Hepatic

Question 17

Celiac Trunk –> Common Hepatic a. –> __?__ a. –> R,L hepatic aa.

Answer 17

Proper Hepatic

Question 18

Proper Hepatic a.–> Right Hepatic a. –> ______? a. –> Gallblader

Answer 18

Cystic artery

Question 19

What is the hepatocystic triangle AKA Triangle of Calot?

Answer 19

An area bordered by the liver, cystic duct and common hepatic duct. The cystic artery is located within.

Question 20

What are the 3 Hepatic veins?

Answer 20

Right, Middle, and Left

Question 21

What segments of the liver does the right vein drain?

Answer 21

5,6,7,8

*directly to IVC

Question 22

What segments of the liver does the left vein drain?

Answer 22

2 & 3

*joins with the middle v. into a common trunk and then to IVC

Question 23

What segments of the liver does the middle vein drain?

Answer 23

4 and some overlapping 5&8

*joins with the left v. into a common trunk and then to IVC

Question 24

What is the hepatic triad?

Answer 24

Hepatic Portal Vein, Common Bile Duct, Proper Hepatic A.

Question 25

What is the relationship of the hepatic triad structures to one another? (posterior/lateral/medial)

Answer 25

Hepatic Portal Vein=posterior Bile Duct=lateral Proper Hepatic Artery=medial

Question 26

What are the ligaments of the liver?

Answer 26

1. Falciform 2. Round (or ligamentum teres) 3. Coronary (upper/anterior and lower/posterior) * R/L triangular ligaments are where the edges of the coronary lig. meet.

Question 27

Describe the areas of contact from other organs on the visceral surface of the liver

Answer 27

1. suprarenal impression (right adrenal gland) 2. renal impression (right kidney) 3. duodenal impression 4. gastric impression * bare area is where liver contacts diaphragm

Question 28

During development, the LARGER part of the liver bud is caudal or cranial?

Answer 28

cranial

Question 29

During development, the falciform ligament is attached to the anterior body wall and is referred to as . . .?

Answer 29

ventral mesogastrium

Question 30

During development, the SMALLER part of the liver bud is caudal or cranial?

Answer 30

caudal

Question 31

During development the ligamentum teres (or round ligament) carries oxygenated blood from the placenta through the umbilicus and is referred to as . . .?

Answer 31

umbilical vein | ligamentum teres is obliterated umbilical v.

Question 32

During development the stalk of the diverticulum (liver bud) will later become . . .?

Answer 32

cystic duct

Question 33

During development the stalk connecting hepatic and cystic ducts will become the . . .?

Answer 33

common bile duct

Question 34

Name the 5 parts of the gallbladder

Answer 34

1. fundus 2. body 3. infundibulum 4. neck 5. cystic duct

Question 35

Name the parts of the common bile duct

Answer 35

1. supraduodenal 2. retroduodenal 3. pancreatic 4. intramural

Question 36

Common bile duct + ___?___ join to form the hepatopancreatic ampulla (of Vater); together empty to major duodenal papilla

Answer 36

Major pancreatic duct (of Wirsung)

Question 37

The hepatopancreatic ampulla of Vater is controlled by which sphincter?

Answer 37

Oddi

Question 38

Right hepatic duct + Left hepatic duct join to form . . .?

Answer 38

Common Hepatic Duct

Question 39

Cystic duct meets ______ to form the Common bile duct.

Answer 39

Common Hepatic Duct