MIDTERMS - Plating 3 (Part 1)

Covers: Liver, gallbladder, pancreas, spleen

Liver

Largest gland in the body

Bile secretion

Carbohydrate metabolism & fat and protein synthesis

Heparin formation

Detoxification

Glycogen and vitamin storage

Vitamin D activation

At least 3 functions of liver

Right hypochondrium

Area of the abdomen where the liver is located, specifically the upper right quadrant

Visceral peritoneum

Liver covering

Glisson’s capsule

Liver covering beneath the visceral peritoneum

Quadrate lobe

Lobe of liver located beside the gallbladder

Caudate lobe

Lobe of liver located beside the IVC

Bare area

Area of liver where there is no peritoneum covering

Bile production

Exocrine function of liver

Synthesizes albumin, prothrombin, fibrinogen

Endocrine function of liver

Diaphragm

Pleura & lung

Pericardium and heart

Superior surface of liver (at least 3)

Diaphragm

Right & left pleura

Costal cartilage

Xiphoid process

Anterior abdominal wall

Anterior surface of liver (at least 3)

Right kidney

Suprarenal gland

Hepatic flexure

Duodenum

Gallbladder

IVC

Esophagus

Fundus of stomach

Posterior surface of liver (at least 3)

Right sagittal fossa

Groove for IVC and gallbladder of liver

Left sagittal fossa

Groove for ligamentum venosum and round ligament of liver

Porta hepatis / hilum of liver

Another term for transverse fissure

Bile ducts

Portal vein

Hepatic arteries

Portal triad

Right lobe

Largest lobe of liver that occupies the right hypochondrium

Riedel’s lobe

Extends as far caudally as the iliac crest from right lobe

Left lobe

Lobe of liver that occupies the left hypochondrium

Falciform ligament

Remnant of umbilical vein

Falciform ligament

Ligament that separates left and right lobe

Ligamentum venosum

Remnant of ductus venosus

Round ligament / ligamentum teres

Obliterated left umbilical vein

True

True or false: Liver is covered by peritoneum except for its bare area

False

True or false: Liver is a retroperitoneal organ

Left hepatic vein

Vein that divides left lobe of liver into lateral and medial segments

Right hepatic vein

Vein that divides right lobe of liver into anterior and posterior segments

Coronary ligament

Ligament of liver that contracts with diaphragm

Left and right triangular ligaments

Ligament of liver formed by left and right extremity of coronary ligament

Hepatogastric ligament

Hepatoduodenal ligament

Ligaments of liver located in the lesser omentum

Portal vein

Vessel that provides 70% of liver’s blood supply

Proper hepatic artery

Vessel that provides 30% of liver’s blood supply

Hepatic veins

Venous drainage of liver that drain into IVC

Portal vein

Venous drainage of liver that divides into right and left terminal branches that enter porta hepatis behind adrteries

Endoscopic retrograde cholangiopancreatography / ERCP

Technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of biliary or pancreatic ductal systems

D2

Organ insertion of ERCP

Liver cirrhosis

Liver disease where healthy liver tissue is replaced by permanent scar tissue

Gallbladder

Pear-shaped green muscular organ; capacity of 40-60 cc

Bile

Function of gallbladder (essential for fat digestion)

Hartmann’s pouch

Lies between body and neck of gallbladder

Common bile duct / CBD

The common hepatic duct joins with the cystic duct to form the?

R + L hepatic ducts → common hepatic duct → cyctic duct → CBD → MDP

Biliary pathway

Ampulla of Vater

Where common bile duct and pancreatic duct merge to enter small intestine

Sphincter of Oddi

Muscle that opens and closes to allow bile and pancreatic juice to flow into small intestine

Cystic artery

Blood supply of gallbladder

Cystic vein / portal vein

Venous drainage of gallbladder

Cystic node

Lymphatic drainage of gallbladder

Common bile duct

Binds to become major duodenal papilla

Bile

Washes away fatty foods like soap

Cholelithiasis

Gallstone common with females

Choledocholithiasis

Stone in CBD; obstruct jaundice → pancreatitis

Cholecystitis

Inflammation of gallbladder

Murphy’s sign

Positive tenderness in RUQ / RUQ pain on pressure in acute cholecystitis

Ultrasound

Diagnostic standard for stones in gallbladder

Pancreas

Organ that shares the same blood supply with duodenum

Whipple procedure / pancreaticoduodenectomy

Surgery of pancreas removal

Epigastric / Left hypochondrium

Location of pancreas in the abdomen

Transverse colon

Transverse mesocolon

Lesser sac

Stomach

Anterior relations of pancreas

Bile duct

Portal vein

IVC

Left psoas muscle

Left suprarenal gland

Left kidney

Splenic hilum

Posterior relations of pancreas

Head of pancreas

Part of pancreas that is disc-shaped lying within concavity of duodenum

Uncinate process

Extension to the left behind SM vessels of head of pancreas

Neck of pancreas

Constricted portion of pancreas, connecting the head and body

Tuber omental

Where anterior surface of pancreas join the neck

Posterior surface

Surface of pancreatic body that is devoid of peritoneum

Tail of pancreas

Part of pancreas beside the kidney and comes in contact with splenic hilum

Duct of Wirsung

Main duct of pancreas

Santorini

Accessory duct of pancreas that opens at minor duodenal papilla

Splenic artery

Blood supply of pancreas

Splenic vein

Venous drainage of pancreas

Celiac and superior mesenteric lymph nodes

Lymphatic drainage of pancreas

Annular pancreas

Rare congenital defect of pancreas; pancreas encircle duodenum

Ectopic pancreas

Very common congenital defect of pancreas; outside GI tract

Acute pancreatitis

Inflammation of pancreas

Cancer head of pancreas / pancreatic head cancer

Obstruction jaundice of pancreas

Cancer body pancreas

Pressure of IVC and portal vein of pancreas

Spleen

Reddish and oval-shaped organ; largest single mass of lymphoid tissue in body

R9-R11

What ribs cover the spleen

Left hypochondrium

Abdominal location of spleen

Splenic artery

Thick anterior vessel in hilum of spleen

Splenic vein

Thin posterior vessel in hilum of spleen; thinner

Gastrosplenic ligament

Ligament between spleen and greater curvature of stomach

Splenicorenal ligament

Ligament between spleen and kidney

Gastric surface

Splenic surface that extends forward, upward, medialward; broad and concave; related to stomach

Renal surface

Splenic surface directed medialward and downward; flattened; related to left kidney

Splenic artery

Blood supply of spleen

Splenic vein

Venous drainage of spleen

Splenectomy

Surgical procedure to remove heavy bleeding spleen