Why might my patient be jaundice 2

Question 1

What does a liver lobule contain

Answer 1

Central vein in the middle and an interlobular portal triad at each corner

Question 2

What does an interlobular portal triad contain

Answer 2

Branch of hepatic artery
Biliary Duct
Branch of Hepatic Portal Vein

Question 3

What is the biliary tree made up of

Answer 3

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

Question 4

What are the four parts of the duodenum called

Answer 4

1. Superior
2. Descending
3. Horizontal
4. Ascending

Question 5

Where does the duodenum begin

Answer 5

pyloric sphincter - controlled flow of chime from stomach to duodenum, made of smooth muscle with autonomic nerves

Question 6

Where does the duodenum end

Answer 6

The duodenojejunal flexure

Question 7

What peptide hormones does the duodenum secrete into the blood

Answer 7

Gastrin, CCK

Question 8

Where does pain from a duodenal ulcer present

Answer 8

Epigastric region

Question 9

What areas make up the pancreas

Answer 9

Head, neck, body, tail

Question 10

What surrounds the pancreas

Answer 10

The duodenum

Question 11

What are the functions of the pancreas

Answer 11

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)

Question 12

What is an anatomical spinchter

Answer 12

discrete areas where muscle completely encircles the lumen of the tract

Question 13

What smooth muscle spinchters are in the biliary system area

Answer 13

Bile duct sphincter
pancreatic duct sphincter
sphincter of Oddi

Question 14

What is ERCP

Answer 14

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

Question 15

how is jaundice causes (extra hepatic)

Answer 15

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)

Question 16

What vessels supply the duodenum and pancreas

Answer 16

gastroduodenal arteru 
superior pancreaticoduodenal artery 
inferior pancreaticoduodenal artery
Splenic artery 
Dorsal pancreatic artery

Question 17

What can cause pancreatitis

Answer 17

blockage of ampulla by a gallstone leading to bile being diverted into the pancreas

Question 18

Where does pancreatic pain present

Answer 18

Epigastric region and/or umbilical as it is both a mid and foregut organ

Question 19

All the small intestines are midgut organs true or false

Answer 19

False - 1st and 2nd parts of duodenum are foregut organs

Question 20

Where does the jejunum begin

Answer 20

At the duodenaljejunal flexure

Question 21

Where does the ilium end

Answer 21

ileocacael junction

Question 22

List come differences in the jejunum and ileum

Answer 22

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

Question 23

what vessels supply arterial blood to the jejunum and ileum

Answer 23

superior mesenteric artery via the jejunal and ileal arteries

Question 24

What vessels supply venous drainage from ilium and duodenum

Answer 24

the superior mesenteric vein

hepatic portal vein

Question 25

where are proteins and carbohydrates from the small intestine absorbed to

Answer 25

to the liver via portal venous system

Question 26

Where do the superior mesenteric vessels (vein and artery) leave the aorta

Answer 26

L1 vertebral level (posterior to the neck of the pancreas)

Question 27

Bile helps the absorption of fats into which cells

Answer 27

Intestinal cells

Question 28

Fats in intestinal cells are then absorbed into what vessels

Answer 28

specialized lymphatic vessels called lacteals - then travel via the lymphatic system and eventually drain into venous at the left venous angle

Question 29

What do lymph vessels lie alongside

Answer 29

arteries

Question 30

What are the main lymph nodes draining the abdominal organs

Answer 30

Celiac
Superior mesenteric
Inferior mesenteric
Lumbar

Question 31

What are the two ducts that lymph drains into

Answer 31

Thoracic duct (3/4 of body) 
Right lymphatic duct (1/4 of body)