Why might my patient be jaundice 2 Flashcards
What does a liver lobule contain
Central vein in the middle and an interlobular portal triad at each corner
What does an interlobular portal triad contain
Branch of hepatic artery
Biliary Duct
Branch of Hepatic Portal Vein
What is the biliary tree made up of
Right and left hepatic ducts form the common hepatic duct
common hepatic duct unites with the cystic duct forming the bile duct
Bile duct attaches to the 2nd part of the duodenum along with main pancreatic duct
What are the four parts of the duodenum called
- Superior
- Descending
- Horizontal
- Ascending
Where does the duodenum begin
pyloric sphincter - controlled flow of chime from stomach to duodenum, made of smooth muscle with autonomic nerves
Where does the duodenum end
The duodenojejunal flexure
What peptide hormones does the duodenum secrete into the blood
Gastrin, CCK
Where does pain from a duodenal ulcer present
Epigastric region
What areas make up the pancreas
Head, neck, body, tail
What surrounds the pancreas
The duodenum
What are the functions of the pancreas
Exocrine - helps digestion (acinar cell secretes pancreatic enzymes into main pancreatic duct)
Endocrine- regulates blood sugar (islets of Langerhans secrete insulin and glucagon into bloodstream)
What is an anatomical spinchter
discrete areas where muscle completely encircles the lumen of the tract
What smooth muscle spinchters are in the biliary system area
Bile duct sphincter
pancreatic duct sphincter
sphincter of Oddi
What is ERCP
Endoscopic retrograde cholangiopancreatography
investigation used to study the biliary tree and pancreas
endoscope inserted thrugh oral cavity, oesophaus, stomach and into duodenum
Radio opaque dye injected into the back of the biliary tree
how is jaundice causes (extra hepatic)
Obstruction of the biliary tree
-gallstones
- carcinoma at the head of the pancreas
Flow of pile is backed up to the liver, then overspills into the blood (contents of bile include bilirubin)
What vessels supply the duodenum and pancreas
gastroduodenal arteru superior pancreaticoduodenal artery inferior pancreaticoduodenal artery Splenic artery Dorsal pancreatic artery
What can cause pancreatitis
blockage of ampulla by a gallstone leading to bile being diverted into the pancreas
Where does pancreatic pain present
Epigastric region and/or umbilical as it is both a mid and foregut organ
All the small intestines are midgut organs true or false
False - 1st and 2nd parts of duodenum are foregut organs
Where does the jejunum begin
At the duodenaljejunal flexure
Where does the ilium end
ileocacael junction
List come differences in the jejunum and ileum
Colour- jejunum is red ilium is pink
wall - jejunum thick and heavy, ileum thin and light
vascularity - jejunum more vascular, ilium less vascular
mesenteric fat - ilium has more fat
circular folds - jejunum has large, tall closely packed folds, ilium low and sparce folds
Lymphoid tissue present in ilium
what vessels supply arterial blood to the jejunum and ileum
superior mesenteric artery via the jejunal and ileal arteries
What vessels supply venous drainage from ilium and duodenum
the superior mesenteric vein
hepatic portal vein
where are proteins and carbohydrates from the small intestine absorbed to
to the liver via portal venous system
Where do the superior mesenteric vessels (vein and artery) leave the aorta
L1 vertebral level (posterior to the neck of the pancreas)
Bile helps the absorption of fats into which cells
Intestinal cells
Fats in intestinal cells are then absorbed into what vessels
specialized lymphatic vessels called lacteals - then travel via the lymphatic system and eventually drain into venous at the left venous angle
What do lymph vessels lie alongside
arteries
What are the main lymph nodes draining the abdominal organs
Celiac
Superior mesenteric
Inferior mesenteric
Lumbar
What are the two ducts that lymph drains into
Thoracic duct (3/4 of body) Right lymphatic duct (1/4 of body)
