Term
| What vessels and fluid enter the liver, and which ones leave? |
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Definition
| Portal vein, hepatic artery proper, bring blood into the liver, while the IVC, bile, and lymph all leave the liver. |
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Term
| What creates the subphrenic recess and the hepatorenal recess? |
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Definition
| Folding back of the peritoneum. In these areas, where the parietal peritoneum becomes continuous with the visceral peritoneum, it's called the coronary ligament. |
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Term
| Which portion of the liver is the bare area? |
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Definition
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Term
| What attaches the liver to the anterior body wall? |
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Definition
| The falciform ligament. This also separates the left and right lobes of the liver. |
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Term
| What are the triangular ligaments? |
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Definition
| Portions of the coronary ligaments, and these attach the liver to the diaphragm. |
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Term
| Which structures constitute the 'H' like appearance of the underside of the liver? |
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Definition
| Gall bladder, IVC, ligamentum teres, ligamentum venosa, and the Porta Hepatis (which consists of portal vein, hepatic artery proper, common hepatic duct). |
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Term
| What is the connection between the liver and the lesser curvature of the stomach called? What structures are located here? |
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Definition
| Lesser omentum. Hepatoduodenal and hepatogastric ligaments are here. |
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Term
| What three structures consist of the hepatoduodenal ligament? |
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Definition
| Portal vein, common bile duct, and the hepatic artery proper. |
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Term
| Why is portal hypertension a concern? |
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Definition
| The portal vein has a very low blood pressure, because the blood flowing to through it has passed through 2 capillary beds. Also, portal vein doesn't have any valves to prevent backflow, so if damage occurs (cirrhosis) to increase pressure, it'll create a back up of blood. |
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Term
| What are the three tributaries of the portal vein? |
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Definition
| SMV, IMV, and the splenic vein. |
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Term
| With portal hypertension, blood will look to flow back to the heart through 4 other anastomoses. What are they? |
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Definition
Esophageal varices: Near stomach area, the left gastric and azygous veins become enlarged.
Internal hemorrhoids: blood from superior rectal vein can leak into middle and inferior rectal vein.
Caput Medusa: Blood flows from paraumbilical veins to the superficial veins of anterior abdominal wall.
Retroperitoneal anastomoses: Aren't usually problematic. |
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Term
| Describe the path of bile, and the different ducts involved. |
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Definition
| Bile is made in all 8 functional lobes of the liver. It is taken up via L and R hepatic ducts, which join together to make the common hepatic duct. Common hepatic duct joins with cystic duct (coming from gall bladder) to give common bile duct, which joins with pancreatic duct, and it finally empties in duodenum. |
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Term
| Which two structures (in addition to the liver) is the gall bladder in contact with? |
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Definition
| Duodenum and the transverse colon. Gall bladders in these areas can lead to fistulas (shortcuts). |
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Term
| Does referred pain occur if there's an irritation in the visceral layer of these organs, or in the parietal layer? |
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Definition
| The visceral layer. If Pain migrates to parietal layer, then pain will become localized. |
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Term
| What part of pancreas isn't retroperitoneal? |
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Definition
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Term
| What is the anatomical relationship of the SMA and SMV to the pancreas? |
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Definition
| These vessels are located posteriorly to the body of the pancreas, but they pass anteriorly over the uncinate process of the pancreas. |
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Term
| Describe the pathway of the major pancreatic duct. |
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Definition
| It joins with the common bile duct, then empties into the ampulla of vatter/aka the sphincter of oddi. |
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Term
| What is the most common site for gall stones to get stuck? |
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Definition
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Term
| What's the blood supply to the pancreas look like? |
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Definition
| Pancreas is part of foregut, and it does get some blood from branches off the celiac trunk. BUT it mostly gets blood from SMA branches. In particular, from the Superior and inferior (anterior and posterior as well, so 4 total vessels) pancreaticoduodenal arteries. |
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Term
| Why is pancreatic cancer usually deadly? |
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Definition
| Symptoms show up late, surgery in the area is difficult because of the proximity of the celiac trunk and the SMA. Cancer cells can spread to the liver pretty easily too. If patient is lucky, tumor will be in the uncinate process of pancreas, and they'll present with symptoms of jaundice. |
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Term
| Which two ligaments anchor the spleen into place? |
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Definition
| The gastrosplenic ligament attaches it to the stomach, and the splenorenal ligament attaches it to the left kidney. |
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Term
| Blood supply to the spleen? |
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Definition
| Splenic artery and splenic vein basically. |
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Term
| Lymphatics to the spleen? |
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Definition
| NONE. trick question. It's the largest lymph organ but it lacks lymph vessels. |
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