Why Might my Patient be Jaundiced? Flashcards
What are 3 symptoms/ signs of jaundice?
Yellowing of the sclera/ skin
Caused by an increase in the blood levels of bilirubin
What is bilirubin
A normal by-product of the break down of red blood cells
Where does the breakdown of red blood cells mainly occur?
Spleen
What is bilirubin used to form and where?
Bile in the liver
What is the bilary tree and what does it do?
It transports bile
It is a set of tubes connecting the liver to the 2nd part of the duodenum
What is the role of the gallbladder?
Storage and concentration of bile
What is the main function of bile?
Normal absorption of fats from the small intestine
What does the pancreas do? and why is this necessary?
It excretes digestive enzymes into the 2nd part of the duodenum.
Necessary for digestion of food
Where is the portal triad found?
In the free edge of the lesser omentum
What does the portal triad consist of?
Hepatic artery, Heaptic portal vein and the common bile duct
What do the 3 tubes supply?
Blood supply to and drainage to the liver
What else is found in the portal triad?
Nerves and lymphatics
What is the first of the three midline branches of the abdominal aorta called?
The celiac trunk
The celiac trunk is retroperitoneal, define this
Situated or occuring behind the peritoneum
Where does the celiac trunk arise?
T12
What organs do the celiac trunk supply
All of the organs of the foregut
The celiac trunk trifurcates into what 3 branches?
Splenic artery, hepatic artery and the left gastric artery
Describe the course of the splenic artery
Very tortuous course
Where does the splenic artery run?
Along the superior border of the pancreas
What type of organ is the spleen?
Intraperitoneal organ within the hypochondrium
What is the main function of the spleen?
Break down red blood cells to produce bilirubin
What ribs protect the spleen?
Ribs 9-11
Where does the blood supply to the stomach come from?
RIght and left gastric arteries and the right and left gastro-omental arteries
Where do the gastric arteries run?
Along the lesser curvature
Where do the gastro-omental arteries run?
Along the greater curvature
What would happen if one of the blood supplies was cut off?
Blood would still be delivered from the other supply
Where does the blood supplying the liver come from?
Hepatic Artery
How much blood arrives from the hepatic artery?
20-25%
What other vessel delivers the rest of the blood to the liver?
Hepatic Portal Vein
What type of blood does the hepatic portal vein carry
Nutrient rich, oxygen poor blood
Where does the liver lie?
Upper right quadrant
What is the main function of the liver
Major metabolic organ which converts bilirubin to bile
What ribs protect the liver?
Ribs 7-11
What are the 4 anatomical segments of the liver?
Right and Left lobes, Caudate lobe and Quadrate lobe
How many functional segments does the liver have?
8
What does each segment possess?
Its own portal triad
How many veins drain blood from the liver?
3 Hepatic Veins
A rise in Central Venous Pressure would result in what?
Hepatomegaly as the liver would engorge in blood and the change in pressure is directly transmitted to the liver
What is the function of the sinusoids?
To clean the blood (nutrients are removed)
What is being produced in the hepatocytes?
Bile
Name the 2 clinically important areas of the peritoneal cavitiy related to the liver
Hepatorenal recess (Morrison's Pouch Subphrenic recess
Where are the recesses of the liver located?
Within the greater sac
What could a collection of puss in the recess lead to?
Abscess formation
Where does the hepatic portal vein act?
Drains blood from the foregut, midgut and hindgut to the liver for first pass metabolism (cleaning)
What does the inferior mesenteric vein drain blod
Drains the blood from the hindgut to the splenic vein
What does the splenic vein do?
drains the blood From the foregut to the hepatic portal vein
What does the superior mesenteric vein do?
Drains the blood from the midgut to the hepatic portal vein
What does the IVC do?
Drains the cleaned blood from the hepatic veins into the right atrium
What ligaments attach the liver to the diaphragm?
Coronary ligaments
What ligaments attach the liver to the anterior abdominal wall?
Falciform ligament
What is the name of the remnant of the embryological umbilical vein?
Ligamentum teres / round ligament
What does the gallbladder do?
Stores and concentrates bile in between meals
What is the name of the narrowing of the gall bladder/?
Cystic duct
What is the narrowing a potential site for
Gallstone impaction
How does the blood reach the gallbladder?
Through tthe cystic artery which is a branch of the right hepatic artery
What can cause gallbladder pain
Inflammation of the gallbladder or cystic duct following irritations from or ompaction of a gallstone
What type of organ is the gallbladder?
A foregut organ
Visceral afferents enters the spinal cord between which 2 verticbrae?
T6 and T9
Where else can pain be found form the gall bladder?
Hypochondriium Right shoulder (as a result of diaphrmatic irritation)
What is a cholescystectomy
Surgical removal of a gall bladder
