why might my patient be jaundiced Flashcards
what is an ERCP
endoscopic retrograde cholangiopancreatography
> used to study the biliary tree and pancreas
biliary tree is filled with dye
what causes jaundice
increased levels of bilirubin in the blood
what are the two main extra-hepatic causes of obstruction in the biliary tree
> gallstones
>carcinoma at head of pancreas
how do extra-hepatic obstructions of the biliary tree cause jaundice
> there is a flow of bile back up to the liver
>overspills into the blood of its constituents
where can the pancreas be found
- posteriorly to stomach
- duodenum surrounds the head of the pancreas
- the splenic nerves can be found superoposteriorly to the pancreas
what is the exocrine secretion of the pancreas
acinar cells secrete digestive enzymes into the main pancreatic duct
-‘pancreatic juice’
what does the endocrine pancreas secrete
islets of langerhans secrete insulin and glucagon into the bloodstream
what is a cause of pancreatitis
blockage of the ampulla by a gallstone
where might patients find pancreatic pain
**pancreas is a foregut and midgut organ - so there may be pain found
> in the epigastric region and/or the umbilical region
can also radiate through to the patient’s back
what is the duodenum
the first part of the small intestine
> split into 4 parts; superior descending horizontal ascending
> begins at the pyloric sphincter
what does the duodenum secrete
peptide hormones (into blood)
how might an ulcer in the duodenum present
pain in the epigastric region
characteristics of the jejunum and ileum
> makes up most of the intestines
found in all 4 quadrant
jejunum begins at the duodenaljejunal flexure and ileum ends at the ileocaecal valve
is the mucosa different between the jejunum and the ileum
yes !
> jejunum lumen is quite wide - end of ileum quite narrow
> mucosa of jejunum has place circulares
mucosa of distal ileum is much smoother
where does the jejunum and ileum gets its blood from
arterial :
SMA - superior mesenteric artery
venous drainage from : -jejunal and ileal veins
-superior mesenteric vein
-hepatic portal vein
>vessels travel within the mesentery
the role of bile in absorption of fat
bile helps absorption of fats from the GI tract lumen into the intestinal cells
what are lacteals
specialised lymphatic vessels of the small intestine that drain fatty fluid into the lymphatic plexus which then drain into lymphatic vessels found within the mesentery (travel via the lymphatic system to eventually drain into the venous system)
what are the main groups of lymph nodes draining abdominal organs
> coeliac - foregut organs
superior mesenteric - midgut organs
inferior mesenteric - hindgut organs
lumbar - kidneys, posterior abdominal wall, pelvis, lower limbs
______lymph vessels drains into ______ lymph vessels
superficial
deep
what will lymph (in the abdomen) either drain into
thoracic duct
or
right lymphatic duct
(depends where it originated in the body)
what happens at venous angles
lymph will drain into venous system for recycling
> is the junction between subclavian and internal jugular veins
