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Gastrointestinal > Why might my patient be jaundice? > Flashcards

Why might my patient be jaundice? Flashcards

1
Q

What is jaundice?

A

Yellowing of the sclera (white of the eye) and skin

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2
Q

What causes jaundice?

A

Increase in the blood levels of bilirubin

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3
Q

What is bilirubin?

A

Normal by-product of the breakdown of red blood cells

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4
Q

Where does the breakdown of red blood cels mainly occur?

A

Spleen

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5
Q

What is bilirubin used to form in the liver?

A

Bile

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6
Q

Where does bile travel when leaving the liver?

A

Through the biliary tree

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7
Q

What is the biliary tree?

A

A set of tubes connecting the liver to the second part of the duodenum

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8
Q

What is the role of the gallbladder?

A

Important role in the storage and concentration of bile

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9
Q

What is the function of bile in the body?

A

Important for the normal absorption of fats from the small intestine

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10
Q

What other organ secretes digestive enzymes into the second part of the duodenum for food digestion?

A

Pancreas

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11
Q

Where is the portal triad found?

A

Free edge of the lesser omentum

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12
Q

What does the portal triad consist of?

A

Hepatic artery
Hepatic portal vein
Common bile duct
Nerves and lymphatics

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13
Q

What is the celiac trunk?

A

First branch of the abdominal aorta

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14
Q

At what level does the celiac trunk arise?

A

T12

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15
Q

Is the celiac trunk intra- or retroperitoneal?

A

Retroperitoneal

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16
Q

What organs does the celiac trunk supply?

A

The organs of the foregut

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17
Q

What are the three divisions of the celiac trunk?

A

Left gastric artery
Hepatic artery
Splenic artery

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18
Q

Name two further branches of the divisions of the celiac trunk

A

Gastroduodenal

Superior pancreatico-duodenal

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19
Q

Describe the course of the splenic artery

A

Very tortuous

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20
Q

What is the relationship between the spleen and the peritoneum?

A

Intraperitoneal

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21
Q

What abdominal region is the spleen in?

A

Hypochonridum

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22
Q

What is the spleen anatomically related to?

A

Diaphragm posteriorly
Stomach anteriorly
Splenic flexture inferiorly
Left kidney medially

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23
Q

What ribs protect the spleen?

A

9-11

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24
Q

Why do the spleen and liver move with respiration?

A

They are anatomically linked to the diaphragm

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25
Q

What is the main blood supply to the stomach?

A

Right and left gastric arteries

Right and left gastro-omental arteries

26
Q

Where do the right and left gastric arteries run?

A

The lesser curvature of the stomach, then anastomose

27
Q

Where do the right and left gastro-omental arteries run?

A

The greater curvature of the stomach, then anastomose

28
Q

What is the blood supply to the liver?

A

Hepatic artery, branches into the right and left hepatic arteries

29
Q

The liver has a dual blood supply. What percentage of the liver’s blood supply comes from the hepatic arteries?

A

20-25%

30
Q

Where does the remaining 75-80% of blood come from?

A

Hepatic portal vein

31
Q

Which quadrant does the liver mainly lie in?

A

In upper right

32
Q

What ribs protect the liver?

A

7-11

33
Q

How the liver be described in terms of segments?

A

4 anatomical segments

8 functional segments

34
Q

What are the anatomical segments of the liver?

A

Right lobe
Left lobe
Caudate lobe
Quadrate lobe

35
Q

Each of the liver’s functional segments has its own blood supply. What does this include?

A

Hepatic artery
Hepatic portal vein
Hepatic vein
Bile drainage

36
Q

What is the name of the removal of a liver segment?

A

Liver segmentectomy

37
Q

What is the difference between hepatic veins and hepatic portal veins?

A

Hepatic veins carry cleaned blood, from the liver to the IVC

Hepatic portal veins, carry nutrient rich blood that in uncleaned, to the liver from the small intestine

38
Q

Why does a rise in central venous pressure directly transmit to the liver?

A

The hepatic veins and IVC lack valves

39
Q

What is the term for an enlarged liver due to being engorged with blood?

A

Hepatomegaly

40
Q

What is the cellular structure of the liver?

A

It is made up liver lobules that have a central vein and interlobular portal triads at each corner

41
Q

What makes up the interlobular portal triad?

A

Branch of HPV
Branch of HA
Biliary duct

42
Q

What is the name for small, irregularly shaped blood vessels that lead from the portal triad to the central vein in a liver lobule?

A

Sinusoid

43
Q

What are liver cells called?

A

Hepatocytes

44
Q

What are the two clinically important areas of the peritoneal cavity related to the liver?

A 
Hepatorenal recess (Morison's pouch)
Subphrenic recess
45
Q

What can peritonitis result in in the recesses of the peritoneal cavity?

A

Collection of pus in the recesses leading to abscess formation

46
Q

When the patient is supine what such is one of the lowest parts of the peritoneal cavity?

A

Hepatorenal recess

47
Q

What does the hepatic portal vein drain?

A

Drains blood from the foregut, midgut and hindgut to the liver for first pass metabolism (cleaning)

48
Q

Where does the splenic vein drain blood from?

A

Drains blood from the foregut to the hepatic portal vein

49
Q

Where does the inferior mesenteric vein drain blood from?

A

Drains blood from the hindgut to the splenic vein

50
Q

Where does the superior mesenteric vein drain blood from?

A

Drains blood from the midgut to the hepatic portal vein

51
Q

Where does the IVC drain blood from?

A

Drains cleaned blood from the hepatic veins to the right atrium

52
Q

What ligaments attach hold the liver in place?

A 
Coronary ligaments (attach to diaphragm)
Falciform ligament (attaches to anterior abdominal wall)
Ligamentum terers/round ligament (remnant of the embryological umbilical vein)
53
Q

Where does the gallbladder lie?

A

Posterior aspect of the liver

Anterior to the duodenum

54
Q

What is the structure of the gallbladder?

A

It has a head and neck that narrows to become the cystic duct

55
Q

What does bile flow into and out of the gallbladder via?

A

Cystic duct

56
Q

What is the blood supply to the gallbladder?

A

Cystic artery (branch of the right hepatic artery in 75% of people)

57
Q

What causes gallbladder pain?

A

Inflammation of the gallbladder or cystic duct following irritation from/impaction of a gallstone

58
Q

What part of the gut is the gallbladder in?

A

Foregut

59
Q

At what level do the visceral afferents enter the spinal cord?

A

T6 and T9

60
Q

Where would early gallbladder pain be felt?

A

Epigastric region
Hypochondrium
Referral to the right shoulder

61
Q

Why can gallbladder pain be felt in the hypochondriac?

A

Anterior diaphragmatic irritation

62
Q

What is the term for the surgical removal of the gallbladder?

A

Cholecystectomy

Gastrointestinal (11 decks)

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