portal venous system/liver/gallbladder Flashcards

1
Q

what does the portal venous system drain?

A

gastrointestinal tract, spleen, pancreas and gallbladder

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2
Q

what does the caval (systemic) venous system drain?

A

everything else

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3
Q

describe the blood flow of portal venous system

A
from abdominal organs
to tributaries of portal vein
then to portal vein, divides into L and R branches 
liver sinusoids
inferior vena cava via hepatic veins
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4
Q

the union of the splenic vein and superior mesenteric vein form the?

A

portal vein

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5
Q

what are the 4 tributaries of the portal vein?

A

splenic
superior mesenteric
left gastric
paraumbilical

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6
Q

all of the tributaries of the portal vein accompany arteries of the same name except for?

A

paraumbilical vein

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7
Q

what is a condition characterized by destruction of hepatic cells and their replacement of tissue and fat?

A

cirrhosis of the liver- liver becomes nodular and hard and tends to constrict portal vein causing PORTAL HYPERTENSION

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8
Q

what is a condition with abnormal elevation of pressure within the portal system often due to cirrhosis of the liver?

A

portal hypertension

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9
Q

describe portal hypertension

A

portal vein constricted and because it has no valves, flow is reversed causing a back up to occur. veins become varicose and may rupture

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10
Q

what are the 2 surfaces of the liver?

A

diaphragmatic and visceral

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11
Q

the porta hepatis is the hilum of the liver and contains?

A

common hepatic duct
hepatic artery proper
portal vein

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12
Q

when does the bile duct become the common hepatic duct?

A

prior to passing through the porta hepatis

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13
Q

what are the 4 lobes of the liver?

A

right- largest
quadrate- front
caudate- tail
left - smaller and flat

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14
Q

where would a functional division of the liver be made?

A

to the right of the falciform ligament- divides liver into equal right and left halves

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15
Q

what are the 8 hepatic segments?

A

I-IV left functional

V-VIII right functional

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16
Q

the caudate lobe is supplied by what?

A

left branches of things

17
Q

what are the 4 structures that distribute to the right and left functional halves of the liver?

A

common hepatic duct
hepatic artery
hepatic veins
portal vein

18
Q

where does the liver maintain contact with the diaphragm?

A

bare area

19
Q

what lies within the bare area?

A

inferior vena cava

20
Q

what are the 6 ligaments of the liver?

A
falciform ligament
coronary ligament
R and L triangular ligament
ligamentum teres
ligamentum venosum 
ligament of the inferior vena cava
21
Q

what are the fissures of the liver?

A
fissure for the ligamentum teres
fissure for the ligamentum venosum 
fossa for the GB
fissure for IVC
porta hepatis
22
Q

what is the blood supply to the liver?

A

portal vein-75%

hepatic artery- 25%

23
Q

what is the innervation of the liver?

A

autonomic and pain fibers from the hepatic plexus

24
Q

what hormone contracts the gallbladder?

A

CCK

25
Q

what is the blood supply to the GB?

A

cystic artery from hepatic artery

26
Q

what is the innervation of the GB?

A

autonomic and pain fibers from the celiac plexus

27
Q

what are the ducts of the GB?

A
right and left hepatic
common hepatic
cystic- drains GB 
bile 
hepatopancreatic ampulla- union of bile and pancreatic duct
28
Q

GB drains into?

A

cystic duct

29
Q

what are the sphincters of the GB?

A

sphincter of ampulla
sphincter of bile duct
sphincter of pancreatic duct
spiral folds

30
Q

where are gallstones most commonly impacted?

A

distal end of the hepatopancreatic ampulla- causes backup of bile and acute pancreatitis

31
Q

in 30% of patients, pain from gallbladder attack refers to?

A

right sub scapular region of back

32
Q

upper abdominal diseases of Liv, GB or St may be from sublux of

A

T8-T12