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104:theme 1 > The alimentary sytem-the liver > Flashcards

The alimentary sytem-the liver Flashcards

1
Q

what is topography

A

The appearance/location of something

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2
Q

What is the topography of the liver?

A 
Below the diaphragm 
From t4/5 -right stomach 
above colon 
has a left lobe and larger right lobe
Falciform ligament
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3
Q

What are the 4 main functions of the liver

A

1-Detoxification
2-Prosynthesis/ metabolism-portal system
3- bile production-GI organ
4-Glycogen storage

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4
Q

Describe topography posteriorly

A

Inferior vena cava seen laterally, and gall bladder

2 add lobes- Quadrate and caudate lobe

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5
Q

What is the lesser omentum and functions

A

Ligament from liver to stomach
Encloses: Hepatic artery, portal vein, bile duct, lymph nodes
Its medial
origins- lesser curvature- Porta hepatis

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6
Q

What’s the porta hepatis

A

The porta hepatis is a deep fissure in the inferior surface of the liver through which all the neurovascular structures
right and left hepatic ducts
right and left branches of hepatic artery
portal vein
Inferiorly- divides caudate and quadrate lobe

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7
Q

whats the bare area

A

No peritoneum- matt and opaque

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8
Q

Falciform ligament

A

Links diaphragm and abdominal wall to upper liver

Teres @ lower end

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9
Q

What is the round ligament

A

extends to umbilicus

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10
Q

Coronary ligament

A

to inferior surface of diaphragm

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11
Q

Blood supply

A

As its in foregut
Coelic artery supplies a lot- divides into- hepatic, splenic and left gastric
@t12/L1

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12
Q

Porta hepatis -topography

A

@hilum of liver- visceral surface

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13
Q

What are the entries and exit to porta hapatis

A

Hepatic portal vein- deoxy blood, nutrients, drugs and toxins-from intestines

Hepatic artery proper- brings O2 blood

Common hepatic duct

lymph and nerves

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14
Q

Liver lobules-

A

according to how the hepatic portal veins and artey divide liver

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15
Q

Coinauds segments

A

Hepatic vein and artery subdivide liver

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16
Q

Portal triad

A

Hepatic artery
Portal vein
Bile duct

17
Q

What does central vein drain

A

THe portal triads contents

18
Q

Functions of hepatic cells

A

Synthesis & release plasma proteins into blood albumin, ie clotting factors

De-aminates amino acids-urea in blood

Bilirubin- Bile pigment & breakdown of the haemoglobin

Bile salts- Emulsification of fats

19
Q

Venous drainage: ( portal vein next to hepatic artery)

A

Liver sinusoid- (disc epitheium and fenestrated)- serves as a location for mixing of blood from hepatic artery and portal vein
These drain into central veins
@ centre of hepatic lobule
These drain into sublobular- hepatic- IVC

20
Q

Portal system anastomoses

A

Communications between some branches of portal and systemic systems- portocaval anastomosis

Allows collateral return of blood to heart

21
Q

Portal hypertension

A

Portal vein blocked- varicoses and caput medusa- oesophageal varices

22
Q

Name some vessel anstamoses

A
  • Abdominal part of oesophagus: branches from the azygos vein (which is systemic) around the oesophagus link with some from the left gastric (portal)
  • Upper abdomen: veins draining the kidneys (renal), diaphragm (phrenic) and lumbar area (lumbar) join with some from the colon, duodenum, pancreas and liver (portal)
  • Umbilicus: epigastric veins (systemic) draining this area of the anterior wall join the paraumbilical veins (portal)
  • In the anal canal region: the middle and inferior rectal veins (systemic) link with the superior rectal (portal)
23
Q

Portacaval shunt- functions

A

Reduce hypertension

  • Diverting blood from portal to systemic system
  • From portal to IVC
24
Q

Portal vein converys what % to liver

A

70

25
Q

Bile secreted by

A

Hepatocytes to canaliculi

26
Q

Bile from canaliculi to

A

Bile is initially secreted from hepatocytes and drains from both lobes of the liver via canaliculi, intralobular ducts and collecting ducts into the left and righthepatic ducts. These ducts amalgamate to form thecommon hepatic duct- join onto the cystic duct to form common bile duct and joins pancreatic duct
ampulla of vater
closed sphincter oddi
- duodenum and then to gall bladder

27
Q

Right and left hepatic ducts supply

A

Relevant lobes and emerge from porta hepatis to form common hepatic ducts

28
Q

Lymphatic drainage- where are lymph nodes

A

In porta hepatis

29
Q

Where does lymph pass to from porta hepatis

A

to coelic nodes

30
Q

Where does lymph drain to from coelic nodes

A

Cisterna chyli

31
Q

Liver trauma- caused by what & solution & similar cases

A

Fractured ribs/penetrating wounds
bleeding exacerbated by- High vascularisation of liver-leading to severe haemorrhage

Resolve by- Removing segmental portions

Similar cases- liver biopsies, metastases, cirrhosis

104:theme 1 (6 decks)

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