Why might my patient be jaundice Flashcards
What links the liver, spleen, gallbladder, pancreas and small intestine
The formation of bilirubin, then bile and the clinical condition of jaundice
What is jaundice
a yellowing of the sclera (whites of eyes) and skin due to excess bilirubin in the blood
What is bilirubin
A normal product from the breakdown of red blood cells which mainly occurs in the spleen
Used to form bile in the liver
What is the ‘Biliary Tree’
Tubes connecting the liver to the second half of the duodenum allowing bile to travel through
Where is bile formed
In the liver (from bilirubin)
what role does the Gallbladder play
stores and concentrates bile
Why is bile important
Is important in allowing the normal absorption of fats from the small intestine
What other organ excretes digestive enzymes into the 2nd hald of the duodenum
The pancreas (necessary for food digestion)
What organ is the largest in the body
The liver
What are the main functions of the liver
Receives nutrients absorbed from GI tract
Glycogen storage
Bile secretion
Other metabolic functions
What is the location of the liver
Right Upper Quadrant
Protected by ribs 7-11
Location changes with breathing
What are the 4 anatomical lobes of the liver
Right Lobe
Left Lobe
Caudate Lobe (next to IVC)
Quadrate Lobe (next to gallbladder)
What is the Porta Hepatis
site of entrance for portal triad structures
how many functional segments are there in the liver
8
what does each functional liver segment contain
A branch of the hepatic artery
A branch of a hepatic portal vein
Bile drainage (to bile duct)
Venous drainage (to IVC)
Why is an increase in central venous pressure directed to the liver
IVC and hepatic veins lack valves
Describe the pathway of the hepatic veins
The hepatic veins carrying deoxygenated blood from the liver come together to form three veins, before joining the vena cava
What does the Portal Triad contain
Hepatic portal vein
Hepatic artery proper
Bile duct
(main structures entering/leaving the liver)
What are the two ligaments from the liver in the lesser omentum
Hepatoduodenal
Hepatogastric
What is the coeliac trunk
First of three midline branches of the aorta, leaves the aorta at T12 vertebral level supplying the organs of the foregut
What 3 branches does the coeliac trunk split into
Splenic artery
Left gastric artery
Common hepatic artery
The splenic artery has a torturous course true/false
True - splenic artery is an end artery so if it ruptures the spleen will become neurotic, torturous course attempts to increase flexibility and reduce the chance of rupture
What anatomical area contains the spleen
Left hypochondrium
Protected by ribs 9-11
What is the function of the spleen
Breaks down read blood cells to produce bilirubin
How do you palpate the spleen
Time it with the patients breathing as both the liver and the spleen are diaphragm so move with anatomically related to the respiration
What are the major blood supplies to the stomach
RIGHT AND LEFT GASTRIC ARTERIES (along the junction of the lesser curvature and the lesser omentum, they also anastomose together)
RIGHT AND LEFT GASTRO-OMENTAL ARTERIES (along junction of greater curvature and greater omentum, also anastomose together)
What are the minor blood supplies to the stomach
Posterior gastric artery (from splenic)
Short gastric arteries (from splenic)
Where does the blood supply to the liver come from
Right and left hepatic arteries
Rest is from the hepatic portal vein
Liver has a dual blood supply
What are the two clinically important areas of the peritoneal cavity related to the liver
Hepatorenal recess
Sub-phrenic recess
(both within greater sac, peritonitis results in a collection of pus in these recesses)
What is the lowest part of the peritoneal cavity when patient is supine (pus often collects here)
Hepatorenal recess
What is the role of the Hepatic Portal Vein
Drains blood from foregut, midgut and hindgut to the liver for first pass metabolism (cleaning)
What vessels from the hepatic portal vein
Splenic vein (drains foregut)
Superior mesenteric vein (midgut)
Inferior mesenteric vein (hindgut) - comes off splenic
What vessel drains cleaned blood from liver back to the right atrium
Inferior vena cava
What is the function of the Gallbladder
Stores and concentrated bile between meals
What supplies blood to the gallbladder
The cystic artery (branch of right hepatic artery) located in triangle of calot
What vessels allows bile to flow out of the gallbladder
The cystic duct
What causes gallbladder pain
Inflammation of the gallbladder or cystic duct following irritation from gallstone
Where will gallbladder pain present
The epigastric region as visceral afferents entre the spinal cord between T6-T9 for the foregut
What is the name of the surgical removal of the gallbladder
Cholecysectomy
