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[OS 206] 1st Exam > Trans - Liver, Gallbladder, Stomach > Flashcards

Trans - Liver, Gallbladder, Stomach Flashcards

1
Q

weight of the liver

A

male - 1400-1800g

female - 1200-1400g

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2
Q

location of the liver

A

right upper quadrant - right hypochondriac, epigastric, part of the left hypochondriac

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3
Q

connective tissue capsule of the liver

A

Glisson’s capsule

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4
Q

the liver is deep to which ribs

A

7-11

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5
Q

lower border of the liver

A

right 10th rib to left 5th intercostal space

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6
Q

upper border of the liver

A

5th intercostal space on both right and left

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7
Q

ligament extending from the umbilicus to the liver

A

falciform ligament

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8
Q

the right leaflet of the falciform ligament becomes the:

A

coronary ligament

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9
Q

the left leaflet of the falciform ligament becomes the:

A

left triangular ligament

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10
Q

what structure is embedded within the falciform ligament

A

ligamentum teres hepatis

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11
Q

the ligamentum teres hepatis is a remnant of what structure

A

umbilical vein

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12
Q

the ligamentum venosum is a remnant of what structure

A

ductus venosus

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13
Q

the superior layer of the coronary ligament is reflected onto the:

A

diaphragm

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14
Q

the inferior layer of the coronary ligament becomes the

A

hepatorenal ligament

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15
Q

what structure lies in the posterior right limb of the H fissure of the liver

A

IVC

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16
Q

what structure lies in the anterior right limb of the H fissure of the liver

A

gallbladder

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17
Q

what structure lies in the crossbar of the H fissure of the liver

A

porta hepatis

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18
Q

what structure lies in the posterior left limb of the H fissure of the liver

A

ligamentum venosum

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19
Q

what structure lies in the anterior left limb of the H fissure of the liver

A

falciform ligament

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20
Q

the H fissure divides the liver into:

A

right, left, caudate, quadrate lobes

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21
Q

the anterosuperior aspect of the liver fits into:

A

cupola of the diaphragm

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22
Q

function of the liver

A

glycogen storage, bile secretion, other metabolic functions

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23
Q

right triangular ligament is formed from the convergence of the __________

A

inferior and superior layers of coronary ligament

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24
Q

divisions of the liver anteriorly

A

right lobe and left lobe

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25
Q

T/F: the quadrate lobe is more posterior to the caudate lobe

A

F

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26
Q

difference between anatomical and functional subdivisions of the liver

A

anatomical lobes - determined by fissures

functional lobes - determined by distribution of blood vessels

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27
Q

the bare area of the liver is found in which surface

A

inferoposterior

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28
Q

subphrenic recess is divided into the left and the right subdivisions by the:

A

falciform ligament

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29
Q

the liver is covered by peritoneum except in these areas:

A
  1. bare area
  2. groove for IVC
  3. gallbladder fossa
  4. porta hepatis
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30
Q

simultaneous secondary branchings of the portal vein and hepatic artery within the liver

A

portal pedicles

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31
Q

T/F: the hepatic artery and portal vein independently supply all of the 8 surgically resectable hepatic segments

A

F, they only supply 7

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32
Q

hepatic artery is a branch of the :

A

celiac artery

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33
Q

hepatic portal vein is formed as a union of which two veins

A
  1. superior mesenteric vein

2. splenic vein

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34
Q

3 major hepatic veins

A
  1. right hepatic vein
  2. central hepatic vein
  3. peripheral hepatic vein
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35
Q

the hepatic artery supplies __% of the liver’s blood

A

20-30%

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36
Q

the hepatic portal vein supplies ___% of the liver’s blood

A

70-80%

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37
Q

difference of blood in hepatic artery and hepatic portal vein

A
  1. hepatic artery - rich in oxygen, poor in nutrients

2. hepatic portal vein - rich in nutrients, poor in oxygen

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38
Q

hepatic veins drain into the

A

IVC

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39
Q

vein that connects the intestinal veins with the IVC and its retroperitoneal branches

A

vein of Retzius

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40
Q

most of the lymph coming from the liver is formed in the:

A

perisinusoidal space of Disse

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41
Q

space of Disse - function

A

area where non-bile products of the liver are secreted

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42
Q

lymph drainage of deep liver structures

A

hepatic lymph nodes

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43
Q

lymph drainage of superficial anterior aspect of liver

A

celiac lymph nodes

44
Q

lymph drainage of superficial posterior aspect of liver

A

phrenic lymph nodes

45
Q

lymph drainage of central diaphragmatic surface of liver

A

parasternal lymph nodes

46
Q

lymph drainage along ligamentum teres

A

anterior abdominal wall lymph nodes

47
Q

innervation of the liver

A
  1. hepatic plexus
  2. left and right vagus
  3. right phrenic
48
Q

components of the hepatic plexus of nerves

A
  1. sympathetic - from celiac trunk

2. parasympathetic - from vagus

49
Q

during a liver biopsy, the needle is directed through where

A

through the right 10th intercostal space in the midaxillary line

50
Q

hepatic enlargment caused by congestive heart failure, tumors, and bacterial/viral diseases (e.g. hepatitis)

A

hepatomegaly

51
Q

progressive destruction of hepatocytes and replacement by fat and fibrous tissue

A

cirrhosis

52
Q

subphrenic abscesses often drain into the:

A

hepatorenal recess / pouch of Morison

53
Q

difference of liver lobectomy and segmentectomy

A

lobectomy - entire left or right lobe removed, without excessive bleeding

segmentectomy - removal of severely injured segments using cauterizing scalpel or laser surgery

54
Q

rupture of the liver is often caused by:

A

broken ribs perforating the liver

55
Q

maximum capacity of gallbladder

A

50ml of bile

56
Q

parts of the gallbladder

A
  1. fundus
  2. body
  3. infundibulum
  4. neck
57
Q

tapering transitional area between gallbladder body and neck

A

infundibulum

58
Q

attaches the infundibulum of the gallbladder to the duodenum

A

cholecystoduodenal ligament

59
Q

bulging interior surface of gallbladder infundibulum

A

Hartman’s pouch

60
Q

valve formed by gallbladder neck mucosa

A

spiral valve of Heister

61
Q

function of spiral valve of Heister

A
  1. keeps cystic duct open to divert bile into gallbladder when hepatopancreatic sphincter is closed
  2. provides additional resistance to sudden release of bile due to increased intraabdominal pressure
62
Q

clinical importance of proximiity of gallbladder to right colon and hepatic flexure

A

easy spread of malignancies

63
Q

arterial supply of gallbladder

A

cystic artery

64
Q

venous drainage of gallbladder

A

no major cystic vein, venous drainage is accomplished by small veins that drain into the portal capillary system

65
Q

lymph drainage of gallbladder

A

hepatic lymph nodes

66
Q

innervation of gallbladder

A
  1. celiac plexus - sympathetic
  2. vagus nerve - parasympathetic
  3. right phrenic nerve - sensory
67
Q

pain in the gallbladder is referred to:

A

ipsilateral shoulder and neck (dermatomes of C3 C4 C5)

68
Q

2 perihepatic spaces

A
  1. suprahepatic - between liver and diaphragm

2. infrahepatic - between visceral surface of liver and transverse colon

69
Q

gallbadder inflammation

A

cholecystitis

70
Q

location of the stomach

A

epigastric, umbilicial, left hypochondriac regions

71
Q

anterior relations of the stomach

A

diaphragm, left lobe of liver, anterior abdominal wall

72
Q

posterior relations of the stomach

A

omental bursa, pancreas

73
Q

wide part of the pylorus

A

pyloric antrum

74
Q

narrow part of the pylorus

A

pyloric canal

75
Q

pyloric region is divided into smaller subregions by:

A

sulcus intermedius

76
Q

pyloric canal and sphincter lie in what level

A

L1 L2

77
Q

temporary longitudinal folds formed when gastric mucosa is contracted

A

rugae

78
Q

T/F: rugae are formed when the stomach is distended

A

F

79
Q

structure temporarily formed during swallowing between the longitudinal gastric folds of the mucosa of the lesser curvature

A

gastric canal

80
Q

clinical significance of proximity of heart and stomach

A

sharp objects swallowed may perforate the stomach wall and the adjacent pericardium and ventricle

81
Q

blood supply of lesser curvature

A

left gastric artery and right gastric artery

82
Q

origin of left gastric and right gastric arteries

A
  1. left gastric - from celiac trunk

2. right gastric - from gastroduodenal artery

83
Q

blood supply of greater curvature

A

left gastroepiploic and right gastroepiploic

84
Q

origin of left gastroepiploic and right gastroepiploic arteries

A
  1. left gastroepiploic - from splenic artery

2. right gastroepiploic - from superior pancreaticoduodenal

85
Q

3 primary branches of the celiac trunk

A
  1. left gastric artery
  2. splenic artery
  3. common hepatic artery
86
Q

main draining vein of the stomach

A

portal vein

87
Q

the short gastric and left gastroomental veins drain into the

A

splenic vein

88
Q

the right gastroepiploic vein drains into

A

superior mesenteric vein

89
Q

vein that ascends over the pylorus to drain into the right gastric vein

A

prepyloric vein

90
Q

arterial supply of the fundus

A
  1. short gastric artery

2. posterior gastric artery

91
Q

lymph drainage of superior 2/3 of stomach

A

gastric lymph nodes

92
Q

lymph drainage of fundus and superior part of the body

A

pancreaticosplenic lymph nodes

93
Q

lymph drainage of right 2/3 of the inferior 1/3 of the stomach

A

pyloric lymph nodes

94
Q

lymph drainage of left 1/3 of the greater curvature

A

pancreaticoduodenal lymph nodes

95
Q

anterior vagal trunk is derived from:

A

left vagus

96
Q

posterior vagal trunk is derived from:

A

right vagus

97
Q

anterior vagal trunk supplies:

A

liver and duodenum

98
Q

posterior vagal trunk supplies:

A

anterior and posterior surfaces of the stomach, celiac plexus

99
Q

referred pain in epigastric region indicates a problem in the:

A

stomach

100
Q

referred pain in umbilicus indicates a problem in the:

A

small intestine

101
Q

referred pain in the right upper quadrant + neck + shoulder + scapula indicates a problem in the:

A

gallbladder

102
Q

referred pain in the right lower quadrant indicates a problem in the:

A

appendix

103
Q

how do abdominal muscles respond to abnormal stimuli in viscera

A

they become rigid and shield the abdominal wall and parietal peritoneum from painful movement

104
Q

ulcers of the anterior wall of the stomach may perforate into the:

A

greater sac

105
Q

ulcers of the posterior wall of the stomach may perforate into the:

A

omental bursa

106
Q

the parietal peritoneum and skin in the area of the umbilicus is sensorily innervated by the

A

10th intercostal nerve

107
Q

sharp pain that is well-localized in the epigastric region would involve which nerves

A

6th to 9th intercostal nerves

[OS 206] 1st Exam (12 decks)

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