Liver & gallbladder

Question 1

4 unpaired accessory digestive organs

Answer 1

Liver

Gallbladder

Spleen

Pancreas

Question 2

Is the liver intraperitoneal or retroperitoneal

What does the liver have low levels of

Answer 2

INTRAperitoneal

Connective tissue

Question 3

Where is the liver located

Answer 3

RUQ

Question 4

What is the liver a major producer of

Answer 4

Lymph

25-50% of lymph

Question 5

What is the largest gland in the body

Answer 5

Liver

Question 6

What does the liver synthesise

Answer 6

• Bile
• AAs
• Gluconeogenesis
• Cholesterol

Question 7

What does the liver break down

Answer 7

• TOXINS
• Hormones
• Drugs
• Ammonia

Question 8

What does the liver store

Answer 8

Glucose

Iron

Question 9

Name the 4 anatomical lobes of the liver

What are these functional lobes based on

Answer 9

1. Right lobe
2. Left lobe
3. Quadrate Lobe
4. Caudal lobe

Based on blood supply - independent segments can undergo surgical resection

Question 10

What is the porta hepatis

Where does the hepatic vein drain

Answer 10

“hilum” of liver where abdominal structures can enter or leave

Hepatic vein drains posteriorly to IVC - drains blood away from liver but does not pass through the porta hepatis

Question 11

Lobes of liver - different views

Answer 11

Question 12

Embryological diagram

Answer 12

Question 13

What is the ligamentum venosum

Answer 13

Remnant of ductus venosus

Question 14

What are the 3 components of the portal triad

Answer 14

1. Common bile duct
2. Hepatic artery proper
3. Hepatic portal vein

Question 15

Posterior surface of liver - arterial and venous supply

Answer 15

Question 16

Where does the common hepatic artery branch from

Answer 16

Celiac trunk

Question 17

When does the common hepatic artery become the hepatic artery proper

Answer 17

When the gastroduodenal artery branches off to travel inferiorly

Question 18

Where does the hepatic artery proper branch

Answer 18

At the PORTA HEPATIS to become the right and left hepatic arteries

Question 19

Where does the liver receive blood from

Answer 19

ARTERIAL

Hepatic arteries - 20-25%

VENOUS

Hepatic portal vein - 75-80%

Question 20

Where does the hepatic portal vein carry blood to and from

Answer 20

Carries all nutrients (carried in venous blood) from GIT directly to the liver

Question 21

What is special about the O2 content in the hepatic portal vein

Answer 21

Has a slightly higher O2 content than the venous blood in the systemic system

(Blood that has drained from the muscles in lower limb drains into IVC)

Question 22

When does the hepatic portal vein form

Answer 22

When the superior mesenteric and splenic veins unite

Question 23

Venous drainage of the liver

Answer 23

Hepatic vein drains blood away from liver and back to systemic system

Question 24

What do the central veins of the liver form

Answer 24

central veins of liver unite together and drain to form the left, right and middle hepatic veins respectively

Question 25

What helps to keep the liver in position

Answer 25

Relationship between hepatic veins and IVC helps to keep liver in position - in addition to ligaments of liver

Question 26

Summary of liver

Answer 26

Question 27

What does the gallbladder do

Answer 27

An organ that stores and concentrates bile

Question 28

1. What is bile 2. Where is it produced

Answer 28

1. Bile is a yellow-brown/green fluid that aids in emulsification of fat 2. Produced by liver - secreted by hepatocytes

Question 29

What is emulsification

Answer 29

Breakdown of large fat globules into smaller, uniformly distributed particles prior to being digested by specific enzymes

Question 30

What do the biliary ducts do

Answer 30

Convey bile from liver and deposit it into the GIT, specifically into 2nd part of duodenum

Question 31

What does the biliary system allow

Answer 31

BIle to be released intermittently and when needed

Question 32

Name the 3 parts of the gallbladder

Answer 32

1. Fundus 2. Body 3. Neck

Question 33

What is the body of the gallbladder in contact with

Answer 33

1st part of duodenum Visceral surface of the liver

Question 34

What is a special feature of the neck of the gallbladder

Answer 34

* Narrow * Mucosa begins to twirl into a spiral fold which acts like a valve in the cystic duct - sometimes called The Spiral Valves of Heister

Question 35

What happens if the sphincter of the bile duct is closed

Answer 35

Bile can back up along the common bile duct, travel along the cystic duct and be stored in the bladder (up to 50ml - concentrated through the absorption of water and salts)

Question 36

Where does the cystic artery branch from

Answer 36

Right hepatic artery (variable)

Question 37

Where does the cystic artery travel

Answer 37

In the cystohepatic triangle - triangle of Calot

Question 38

Venous drainage of gallbladder

Answer 38

Cystic veins drain blood away from the gallbladder

Question 39

What is the gallbladder in direct contact with

Answer 39

Visceral (inferior) surface of the liver and is firmly adhered

Question 40

Where do most small veins from the body of the gallbladder pass

Answer 40

Directly into hepatic sinusoids within liver

Question 41

Where do most veins around the neck of the gallbladder drain into

Answer 41

Hepatic portal vein

Question 42

Summary of Gallbladder

Answer 42