4.8 Liver, gallbladder, pancreas

path of venous blood from GI tract to end?

GI tract > thru PORTAL VEIN> into liver> thru HEPATIC VEINS> into IVC

the 4 anatomical lobes of the liver?

Left, Right, Quadrate, & Caudate

The hepatic veins-relationship to porta hepatis?

NOT associated with porta hepatis

The right, middle, & left hepatic veins are found where?

Right vein within the right functional lobe; middle hepatic vein between the right & left functional lobes; left hepatic vein within the left functional lobe

what artery supplies blood to the liver?

The common hepatic artery

shape of diaphragmatic vs visceral surfaces of liver?

The diaphragmatic surface of the liver is convex, whereas the visceral surface of the liver is concave.

the hepatopancreatic ampulla is formed by what?

The infraduodenal portion of the common bile duct joining the major pancreatic duct

The duodenum is in contact with what surface of gallbladder?

The posterior surface of the gallbladder

The common hepatic artery is a branch of what?

a branch off of the celiac artery,

On the diaphragmatic (anterior) surface of the liver, a line between what separates the right & left functional lobes?

a line from the fundus of gallbladder to the IVC

On the visceral surface of the liver, a line between what separates the right & left functional lobes?

a line through the gallbladder bed to the IVC fossa

can divide the liver into four anatomical lobes by drawing lines where? resulting shape?

a line thru the gallbladder & IVC; thru the fissures for ligamentum teres hepatis and ligamentum venosum; a transverse line at level of the porta hepatis >>"H" shape

the round ligament of the liver (ligamentum teres hepatis)-is what? found where?

a remnant of the umbilical vein in the embryo; found in the free margin of the falciform ligament.

the inferior vena cava passes where relative to liver?

along the middle of it's visceral surface

The quadrate lobe is where relative to the gallbladder & ligamentum teres hepatis?

anterior and between the gallbladder and ligamentum teres hepatis.

The fundus of the gallbladder protrudes where relative to liver?

anteriorly from the inferior border of the liver.

The superior mesenteric vein rises runs where relative to pancreas? joins what?

anteriorly to the uncinate process ; joins the splenic vein.

the diaphragmatic and visceral surfaces meet where on liver?

at the sharp inferior border of the anterior surface of the liver

The pancreas function

both an exocrine and an endocrine gland. I

The infraduodenal portion of common bile duct is joined by what? to form what?

by the major pancreatic duct to form the hepatopancreatic ampulla.

The right lobe of the liver has what impressions (3)?

duodenal, renal, and colic impressions

Once at the hepatic duct, the bile can continue down what 2 possible paths?

either continue to the duodenum via the common bile duct, or it can back up into the valvular cystic duct and into the gallbladder.

the hepatopancreatic ampulla empties into where/via what?

empties into the duodenum via the Sphincter of Oddi.

The lymphatic drainage of the pancreas follows what?into what nodes?

follows the arterial supply to the celiac and superior mesenteric nodes.

The coronary ligament is formed by what? connecting what?

formed via reflections of the visceral peritoneal; connects the diaphragm and the liver.

the gastroduodenal artery branches from where? runs in what direction?

from the common hepatic artery and runs inferiorly.

The hepatic veins drain blood from where to what?

from the liver to the inferior vena cava. the three major hepatic veins: the right, middle, and left.

Bile travels from what parts of liver/via what ducts?

from the right and left lobes of the liver via right and left hepatic ducts.

The pancreas is located where?

in the posterior abdominal wall

The spleen is found in what quadrant?

in the upper left quadrant of the abdominal cavity. The spleen is found adjacent to what recess?: the costodiaphragmatic recess

Gallstones can cause pain in what quadrant?

in the upper right quadrant.

liver is located where? functions?

in the upper right quadrant; responsible for glycogen storage, bile production to aid in digestion and detoxification.

The gallbladder is located in what quadrant/where relative to liver? function?

in upper right quadrant along the visceral surface of the liver ; functions to store and concentrate bile.

The liver (and gallbladder) lymph drainage thru the diaphgram drains into what nodes?

into the posterior mediastinal nodes

The inferior mesenteric vein drains into what?

into the splenic vein

The bare area of the liver is what/what? surrounded by what?

is area on the posterior surface of the liver that is not covered by visceral peritoneum; surrounded by the superior and inferior leaves of coronary lig

The caudate lobe is where relative to the porta hepatis? to the lesser omentum ?

is posterior to porta hepatis, and is posterior to the lesser omentum

The common bile duct is where relative to the duodenum/head of the pancreas?

is posterior to the 1st part of duod & head of pancreas

The right lobe is where relative to the gallbladder?

lateral to the gallbladder.

The left lobe is where relative to the fissure for ligamentum teres hepatis?

medial to the fissure for ligamentum teres hepatis.

The gastroduodenal artery is a branch of what?

of the common hepatic artery.

the renal impression of liver reflects the position of what kidney?

of the right kidney/adrenal gland

The dorsal pancreatic artery is a branch of what?

of the splenic artery.

the gastric impression is found where on liver? formed by what (2)?

on the left lobe of the liver; formed by the esophagus and stomach.

the gallbladder emerges onto what surface of liver?

onto visceral surface

the blood coming back from the GI tract passes where before returing to IVC? why?

passes in the liver ; it acts as a sort of filter, detoxifying the blood on its way back from the organs of the GI tract.

the hepatic flexure of the colon is found where relative to gallbladder?

posterior and inferior to the body of the gallbladder.

The splenic vein runs where relative to pancreas?

posteriorly along the body of the pancreas.

The common bile duct runs in what direction/to where (2)?

posteriorly to the duodenum and head of the pancreas.

The gastroduodenal artery runs where relative to duodenum? with what duct?

posteriorly to the duodenum with the common bile duct.

The spleen is protected by what ribs?

ribs 9-11.

the common hepatic artery passes along border of what organ?

runs along superior border of pancreas.

the splenic artery passes where to pancreas?

runs along the superior border of the pancreas.

The gastroduodenal artery passes where relative to duodenum? to give rise to what artery of pancreas?

runs posteriorly to the duodenum to give rise to the superior pancreaticoduodenal artery.

The cystic artery supplies what? usually branch of what artery/within what area?

supplies the gallbladder; usually branch of right hepatic artery within the cystic triangle of Calot.

The proper hepatic artery supplies what?

supplies the liver with blood.

The right and left hepatic ducts merge to form what?

the (common) hepatic duct.

the fundus of the gallbladder is in contact with what wall?

the anterior abdominal wall

What surface of the gallbladder is in contact with the liver?

the anterior surface of gallbladder in contact w/ visceral surface of liver.

The release of bile and digestive enzymes from their ducts is regulated by what 3 sphincters??

the bile duct sphincter, the pancreatic duct sphincter, the sphincter of the hepatopancreatic ampulla (Sphincter of Oddi)

The blood supply to the pancreas stems from two major arteries

the celiac artery and the superior mesenteric artery.

Left border of the cystic triangle of Calot?

the common hepatic duct

Right border of the cystic triangle of Calot?

the cystic duct

the exocrine pancreas secretes what? the endocrine pancreas secretes what?

the exocrine pancreas: digestive enzymes/The endocrine pancreas (Islets of Langerhans) secretes insulin and glucagon.

The gallbladder itself can be divided into three parts

the fundus, body, and neck.

Blood from the liver drains into what? eventually into what?

the hepatic veins and, eventually, in the inferior vena cava.

the lesser omentum is formed by what 2 ligaments?

the hepatogastric and hepatoduodenal ligaments

At the point where the major pancreatic & bile duct ducts fuse, the structure is called what?

the hepatopancreatic ampulla.

The superior mesenteric artery gives rise to what artery of pancreas?

the inferior pancreaticoduodenal artery.

The right triangular ligament is present at junction of what?

the junction of the superior and inferior leaves of the coronary ligament

Together, the hepatogastric and hepatoduodenal ligaments form what?

the lesser omentum.

ligaments & fissures present on visceral surface of liver?

the ligamentum teres hepatis (round ligament of liver) & the ligamentum venosum & their respective fissures

Superior border of the cystic triangle of Calot?

the liver

The cystic triangle of Calot has three borders (superior, left, right)

the liver (superiorly), the common hepatic duct (left), and the cystic duct (right).

The falciform ligament joins what to what?

the liver to the anterior abdominal wall.

The contents of the porta hepatis include (3)

the portal vein, hepatic artery, and hepatic ducts.

The anterior and posterior layers converge on liver to form what ligaments?

the right & left triangular ligaments

the right & left hepatic arteries supply what?

the right and left functional lobes of the liver, respectively.

what artery gives off a branch in the cystic triangle of Calot? this branch supplies what?

the right hepatic artery gives rise to the cystic artery> supplies gallbladder

The celiac artery gives rise to what artery supplying pancreas?

the splenic artery,

The pancreas has five distinct parts

the uncinate process, head, neck, body, and tail.

what layer is covering the liver? forms folds/ligaments connecting what?

the visceral peritoneum covers the liver; forms folds/ligaments connecting organs to one another.

The liver (and gallbladder) lymph drainage follows blood supply to what nodes/where? then to what?

to hepatic nodes in porta hepatis> then to celiac nodes

The liver (and gallbladder) drains their lymphatic drainage to what nodes (3)?

to the hepatic, celiac, and posterior mediastinal nodes.

the liver is connected to the lesser curvature of the stomach via what? to the 1st part of duodenum?

to the lc of stomach by the hepatogastric ligament; to 1st part duodenum via the thicker hepatoduodenal ligament.

The left triangular ligament is found where relative to falciform lig?

to the left of the falciform ligament.

The gallbladder is connected via a system of ducts to what 2 things?

to the liver and duodenum

The fundus of the gallbladder projects from where on liver?

under the sharp inferior border of the liver.

the portal vein passes where relative to pancreas?

upward posteriorly to the neck of the pancreas.

after branching from common hepatic a., the proper hepatic artery passes where? then divides into what?

upward to the porta hepatis to then divide into the right & left hepatic arteries

the digestive enzymes from exocrine pancreas are released into the duodenum via what?

via pancreatic ducts.

bile travels to the duodenum via what?

via the common bile duct

Bile exits the liver via what?

via the common hepatic duct.

Blood drains into the liver via what?

via the hepatic portal vein.

the blood coming back from GI tract passes into liver via what?

via the portal vein

bile travels to the gallbladder via what? requires action of what sphincter?

via the valvular cystic duct ; requires the sphincter of the hepatopancreatic ampulla (Sphincter of Oddi) to be CLOSED

the hepatopancreatic ampulla (Sphincter of Oddi)-function?

when closed, allows bile to travel to gallbladder; when open, allows bile to enter duodenum

the lesser and greater duodenal papillae are formed at location of what?

where the minor and major pancreatic ducts empty the products of the exocrine pancreas into the duodenum.

The superior/anterior leaf of the coronary ligament marks the location of what?

where the peritoneum covering the inferior diaphragmatic surface reflects to cover the superior surface of the right lobe of the liver.

The inferior/posterior leaf of the coronary ligament marks the location of what?

where the visceral peritoneum covering the inferior surface of the liver reflects onto the right kidney.