Why Might my Patient be Jaundiced ? Part 2 Flashcards
Where is the main site of break down of red blood cells?
The spleen
What is a normal by-product of the breakdown of red blood cells
Bilirubin
What is bilirubin used to form ? Where does this occur?
Bile in the liver
Describe the biliary tree
A set of tubes connecting the liver tot the 2nd part of the duodenum
What 3 structures make up the interlobular portal triad?
branch of the Hepatic vein, branch of the hepatic artery and a biliary duct
What is the biliary tree made up of? What do they do?
A number of ducts which transport bile
What forms the common hepatic duct
Right and left hepatic ducts
What unite to form the bile duct
Common hepatic duct and the cystic duct
Where does the bile duct drain into?
The second part of the duodenum
Where is the location of the bile duct?
Descends posteriorly to the 1st part of the duodenum
Where does the bile duct travel into?
A groove on the posterior aspect of the pancreas where it then joins with the main pancreatic duct to form the ampulla
Where does the bile duct and the main pancreatic duct drain into?
The 2nd part of the duodenum through the major duodenal papilla
Name the 3 sphincters related to the bile duct
Bile duct sphincter, pancreatic duct sphincter and the sphincter of Oddi
What investigation is used to study the biliary tree and the pancreas?
ERCP (Endoscopic Retrograde Cholangiopancreatography)
What could happen to the levels of bilirubin if there was an abstruction somewhere in the biliary tree?
Backflow of bile up to the liver.
Overspill of bile into the blood including bilirubin
What can cause an obstruction of the biliary tree?
Gallstones and carinoma at head of pancreas
Describe the panceras
Head with uncinate process Neck Body Tail Retroperitoneal organ which lies transversely across the posterior abdomen
What surrounds the head of the pancreas?
The duodenum
What is the endocrine function of the pancreas?
Islets of Lannerghans (insulin and glucagon into the bloodstream)
What is the exocrine function of the pancreas?
Acinar cell (pancreatic digestive enzymes into main pancreatic duct)
Where does the pancreas branch from?
Mainly from the splenic artery (pancreatic branches)
What is the most common cause of pain in the pancreas?
Pancreatitis
What is a cause of pancreatitis
Blockage of the ampulla by a gallstone causing bile to to be diverted into the pancreas leading to irritation and inflammation
Describe the type of organ the pancreas is
Foregut and midgut organ
Where can pancreatic pain present?
In the epigastric region / umbilical region
Radiate through to the back
What parts of the duodenum are foregut organs?
1st and 2nd parts of the duodenum
What are the rest of the small intestines?
Midgut organs
What are the 4 parts of the duodenum?
Superior
Descending
Horizontal
Ascending
What sphincter does the duodenum begin at?
Pyloric sphincter
What does the pyloric sphincter control?
The flow of chyme from the stomach to the duodenum
What is secreted by the duodenum
A number of peptide hormones into the blood (gastrin and CCK)
Where does pain from a duodenal ulcer tend to present?
Epigastric region
What does the close relationship between the pancreas and the duodenum cause?
Similarities in the blood supply
What is one of the branches of the gastroduodenal artery?
Superior pancreaticoduodenal
What is one of the brances of the superior mesenteric artery?
Inferior pancreaticodudoenal
What makes up most of the small intestines?
Jejunum and the ileum
Where does the jejunum begin?
At the duodenaljejunal flexure
Where does the ileum end?
At the ileocacal junction
Describe the folds in the jejunum?
Mucosa is highly folded
The folds are called plicae circularis
Slightly rough in texture
Is the mucosa of distal ileum smoother or rougher than the proximal end?
Smoother
What does bile help with?
The absorption of fats form the GI tract lumen into the intestinal cells
Where are fats absorbed from and where do they go?
From the intestinal cells and into specialised lymphatic vessels of the small intestine called lacteals
Where do fats eventually drain into the venous system at?
At the left venous angle
Where do lymph vessels lie in the abdomen?
Alongside arteries
What are the main 4 groups of lymph nodes drainign abdominal organs?
Celiac (foregut)
Superior mesenteric (midgut)
Inferior mesentric (hinf
Lumbar (kidneys, pelvis)
Where does the right lymphatic duct drain into?
DeeThe right venous angle (angle between the right subclavian and right internal jugular veins
Where does the thoracic duct drain lymph into?
Into the left venous angle (angle between the left subclavian and left interanal jugual veins
