Topography of the Liver, Pancreas and Gallbladder (AP) Flashcards
What are absorbed nutrients conveyed to the liver via?
Hepatic portal venous system
Passage of bile from the liver
- Biliary ducts (R+L hepatic ducts)
- Common hepatic duct
- Unites with cystic duct to form bile duct
2 large and 2 smaller lobes of the liver
- Large:
> Right
> Left - Smaller:
> Caudate
> Quadrate
What is the liver covered in, and which area is the exception?
- Visceral peritoneum
- Bare area (in fossa of gallbladder)
2 parts of lesser omentum
- Hepatogastric ligament
- Hepatoduodenal ligament
What does the free edge of the hepatoduodenal ligament contain?
Structures that enter/leave at porta hepatis:
- Hepatic artery
- Hepatic portal vein
- Hepatic bile duct
What provides communication between the greater and lesser sacs of peritoneum?
Epiploic foramen
Blood supply to liver
- Portal vein
- Hepatic artery
Tributaries of the hepatic portal vein
- Splenic vein
- Superior mesenteric vein
- Inferior mesenteric vein
What is a portal-systemic shunt?
Blood that would ordinarily course through the liver finds a way back to the heart via a detour
What causes portal-systemic shunts?
Blockage within vessels of the liver (most commonly portal hypertension)
What do portal-systemic shunts occur through?
Minor collateral vessels
Clinical presentation of portal-systemic shunt
- Oesophageal varices
- Caput medusae
- Haemorrhoids
Causes of portal hypertension
- Alcohol abuse –> cirrhosis (main)
- Viral hepatitis
- Bile duct autoimmune disease
- Developmental problems
Components of porta hepatis
- Proper hepatic artery
- Portal vein
- Common bile duct
What is an abdominal ligament?
Double fold of peritoneum that connects combinations of viscera to the body wall
Which ligament attaches the liver to the anterior body wall?
Falciform ligament
4 portosystemic anastomotic sites (portal tributary + systemic tributary for each)
- Lower oesophagus
> PT = left gastric veins
> ST = lower branches of oesophageal veins - Upper part of anal canal
> PT = superior rectal veins
> ST = inferior + middle rectal veins - Umbilicus
> PT = paraumbilical veins
> ST = small epigastric veins - Region of hepatic + splenic flexure
> PT = omental + colonic veins
> ST = retroperitoneal veins
Why is the liver one of the commonest organs to harbour metastatic tumours?
Receives all blood returning from organs within the abdomen
Why does cirrhosis cause difficulty for blood to flow through the liver?
Scar tissue blocks blood from flowing through
What is Budd-Chiari syndrome?
- Hepatic veins blocked by narrow clot
- Blood backs up into liver, causing it to grow larger
5 areas of the pancreas
- Uncinate process
- Head
- Neck
- Body
- Tail
How can gallstones cause pancreatitis?
- Block pancreatic duct
- Force enzymes back up into pancreas
- Irritates cells + causes inflammation
What is a positive Murphy sign?
Patient feels pain upon inspiration with doctor palpating gallbladder
