SEM2: Abdo III

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Where in the abdomen is the liver positioned
right hypochondriac
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what are the anatomical lobes of the liver
right, left, caudate (upper), quadrate (lower)
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what are the functional lobes of the liver
right, left, caudate (upper)
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how does the falciform ligament relate to the liver
Separates the left and right lobes of the liver and attaches to the anterior abdominal wall
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how does the round ligament relate to the liver
thickening of the falciform ligament adjacent to the quadrate lobe, embryological remnant of the umbilical vein carrying oxygenated blood
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what is the ligamentum venosum
remnant of ductus venosum - a shunt for umbilical blood into IVC.
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what is the porta hepatis
a transverse fissure between the caudate and quadrate lobes that allows the entry/exit of the portal triad
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what structures run in the portal triad
common bile duct, proper hepatic artery, hepatic portal vein, vagus N., lymphatics
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where does the portal triad run?
hepatoduodenal ligament of the free edge of the lesser omentum
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what is the coronary ligament
a triangular ligament continuous with the falciform ligament, that marks the diaphragmatic surface of the liver
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what are the liver recesses
subphrenic, hepatorenal, subhepatic
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where is the subphrenic recess
between the diaphragm and the liver
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where is the hepatic renal pouch
between the liver and kidney
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what is the lesser omentum
a double fold of peritoneum connecting the liver to the lesser curvature of the stomach
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what is the Pringles manoeuvre
when blood flow to the liver is stopped by clamping the hepatoduodenal ligament using a haemostat
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what vessels make up the dual blood supply of the liver
hepatic artery and hepatic portal vein
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how many hepatic veins drain into the IVC
3
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what is the function of the hepatic portal vein
carries blood from GIT for detoxification and removal of intestinally absorbed bacteria
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what veins unite to form the hepatic renal vein
inferior mesenteric -> splenic, superior mesenteric
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why is the coronary surface of the liver bare?
massive embryological growth pushed the liver out of its visceral peritoneum
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what is the clinical relevance of the bare surface
infections can spread from the abdomen to the thorax through this point
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what is the clinical relevance of the peritoneal recesses of the liver
infection can collect in these areas causing an abscess
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outline the pathway of bile
liver -> right or left hepatic duct -> common hepatic duct. storage : cystic duct -> neck of gall bladder -> body and fungus of gall bladder. excretion: common bile duct -> heptaopancreatic amupulla (fusion of common bile duct and main pancreatic duct) ->
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what are gall stones
cholesterol/pigmented crystals commonly found at the hepatopancreatic ampulla, cystic duct and infundibulum (dilation of the neck of the gall bladder)
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what are the three types of jaundice?
pre-heptatic (excessive RBC breakdown), hepatocellular (dysfunction of liver cells) and post-hepatic (obstruction of billiary drainage)
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what is the medical term for inflammation of the gallbladder?
cholecystitis
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What is Murphy’s sign?
pain when palpating the right subcostal whilst there patient is holding their breath after breathing in
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when looking into a cadaver, what is the order (left to right) of the structure of the pancreas
uncinate process inferior (superior mesenteric artery and vein anterior), head superior (portal vein posterior), body, tail
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what is the relation of the pancreas to the peritoneum
retroperitoneal apart from tail (intraperitoneal)
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what is the function of acinar cells
produces pancreatic juice
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what is the function of islets of Langerhans
produces glucagon and insulin
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what is the blood supply to the pancreas?
splenic + pancreaticoduodenal
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what is clinically important about the development of the pancreas
develops as two buds which usually move in the same direction but of the ventral bud moves in the opposite direction, it constricts the duodenum (know as anular pancreas)
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what is the Whipple procedure?
pancreaticoduodenectomy - removal of the head of the pancreas, duodenum, gall bladder and bile duct due to cancer
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what is the order of flow of chyme through the structure of the duodenum
superior (transpyloric plane), descending (l2/l3), inferior/horizontal (L3),ascending
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what is the epiploric foramen and what forms its boundaries
a communication between the greater and lesser omentum, ant. hepatoduodenal ligament, post. IVC, sup. caudate lobe of liver, inf. superior part of duodenum
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what is the duodenal cap/ampulla?
the first part of the duodenum after the pyloric sphincter. its dilated and has SM. Site where ulcers occur
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what structures enter into the minor and major duodenal papillae
major - hepatopancreatic ampulla (major pancreatic duct + common bile duct) , minor - minor/accessory pancreatic duct
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what landmarks shows when the duodenum moves from the foregut to the midgut
major papilla
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what is the blood supply to the duodenum
foregut - coeliac a., midgut - superior mesenteric a.
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where do the lymphatics of the duodenum drain
superiorly: pancreaticoduodenal -> gastroduodenal -> coeliac nodes. inferiorly: pancreaticoduodenal -> mesenteric nodes.
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where is the spleen
left hypochondrium under 9-11th ribs
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what is the blood supply of the spleen
splenic artery arising from the coeliac trunk
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what is the blood drainage of the spleen
inferior mesenteric -> splenic (+ superior mesenteric) -> hepatic portal vein
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what is the case of splenomegaly and where would you palpate
portal hypotension, palpable in right iliac fossa
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when is the spleen a surgical emergency
rupture of the spleen (causes massive internal bleeding)
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Other cards in this set

Card 2

Front

what are the anatomical lobes of the liver

Back

right, left, caudate (upper), quadrate (lower)

Card 3

Front

what are the functional lobes of the liver

Back

Preview of the front of card 3

Card 4

Front

how does the falciform ligament relate to the liver

Back

Preview of the front of card 4

Card 5

Front

how does the round ligament relate to the liver

Back

Preview of the front of card 5
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