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Gross II Unit 3 > Portal Venous System/Liver > Flashcards

Portal Venous System/Liver Flashcards

1
Q

The portal venous system drains what structures?

A

GI tract, spleen, pancreas, and gallbladder

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2
Q

All nutrients except what kind pass through the portal system to the liver?

A

Fats

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3
Q

What picks up the fats that bypass the liver?

A

Lymphatics of the small intestine (lacteals)

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4
Q

What is the pathway of the portal venous system?

A

Abdominal organs (GI tract, spleen, pancreas, gallbladder) –> Tributaries of the portal vein –> Portal vein which divides into right and left branches –> liver sinusoids –> Inferior vena cava via the hepatic veins

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5
Q

What is unique about the portal vein?

A

It has right and left branches, while veins usually have tributaries

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6
Q

What does the caval venous system drain?

A

Everything the portal system does not

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7
Q

What is the blood flow of the caval venous system?

A

Body wall and organs –> tributaries of the superior and inferior vena cava –> superior and inferior vena cava

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8
Q

What forms the portal vein?

A

Formed behind the head of the pancreas by the union of the splenic and superior mesenteric vein

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9
Q

What are the tributaries of the portal vein?

A

Splenic vein, superior mesenteric vein, left gastric vein, paraumbilical veins

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10
Q

What are the tributaries of the splenic vein?

A

Short gastric veins, left gastro-omental vein, pancreatic veins, inferior mesenteric vein

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11
Q

What are the tributaries of the inferior mesenteric vein?

A

Left colic vein, sigmoid veins, superior rectal vein

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12
Q

What forms the inferior mesenteric vein?

A

Sigmoid vein and superior rectal vein

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13
Q

What are the tributaries of the superior mesenteric vein?

A

Jejunal and ileal veins, ileocolic vein, right colic vein, middle colic vein, right gastro-omental vein, pancreaticoduodenal veins

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14
Q

What vein of the portal system accompanies the ligaments teres to the umbilicus?

A

Paraumbilical veins

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15
Q

What is cirrhosis of the liver?

A

A condition characterized by the destruction of hepatic cells and their replacement by fibrous tissue and fat

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16
Q

What is unique about the paraumbilical veins?

A

Only tributary of the portal vein that doesn’t accompany artery of the same name

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17
Q

How does portal hypertension occur with cirrhosis of the liver?

A

The liver becomes nodular and hard, therefore constricting the portal vein at the porta hepatis

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18
Q

What are the causes of cirrhosis of the liver?

A

Alcoholism, hepatitis, chronic obstruction of the bile duct, or congestive heart failure

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19
Q

What is portal hypertension?

A

Abnormal elevation of pressure within the portal system, often due to cirrhosis of the liver

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20
Q

What vein is compromised in portal hypertension?

A

Portal vein

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21
Q

What happens to blood flow during portal hypertension?

A

Due to the portal system’s lack of valves, the blood flow is reversed and bypasses the liver leading to back-ups in the caval system where portal-caval anastomoses occur

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22
Q

What happens to these portal-caval anastomoses during back-ups due to portal hypertension?

A

Veins can become varicose and may rupture

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23
Q

What are varicose veins like?

A

Dilated, tortuous, and thin-walled

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24
Q

What are the three sites of portal-caval anastomoses?

A

Distal esophagus, around the umbilicus, rectum/anal canal

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25
Q

What veins make up the portal-caval anastomosis of the distal esophagus?

A

Caval = esophageal, Portal = left gastric

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26
Q

What veins make up the portal-caval anastomosis around he umbilicus?

A

Caval = superficial veins of the anterior abdominal wall, Portal = paraumbilical

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27
Q

What veins make up the portal-caval anastomosis of the rectum and anal canal?

A

Caval = middle and inferior rectal, Portal = superior rectal

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28
Q

What is the obstructive sign of portal hypertension at the distal esophagus’s portal-caval anastomosis?

A

Esophageal varices

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29
Q

What is the obstructive sign of portal hypertension at the portal-caval anastomosis around the umbilicus?

A

Caput medusae

30
Q

What is the obstructive sign of portal hypertension at the rectum/anal canal’s portal-caval anastomosis?

A

Hemorrhoids

31
Q

What is the worst case scenario for esophageal varices?

A

They can hemorrhage with severe, often fatal, bleeding

32
Q

Are hemorrhoids diagnostic of portal hypertension when present alone?

A

NO.

33
Q

What is the largest visceral organ and the largest gland in the body?

A

Liver

34
Q

What are the functions of the liver?

A

Bile secretion; metabolism of macronutrients; storage of glycogen, vitamins, and iron; detoxification

35
Q

What is the function of bile?

A

Fat emulsification

36
Q

What surface of the liver is superior and convex?

A

Diaphragmatic surface

37
Q

What surface of the liver is inferior and concave

A

Visceral surface

38
Q

What separates the diaphragmatic and visceral surfaces of the liver?

A

A sharp, inferior border

39
Q

What does the porta hepatis contain?

A

Common hepatic duct (right), hepatic artery proper (left), portal vein (behind)

40
Q

What significant structure does NOT pass through the porta hepatis?

A

Inferior vena cava

41
Q

What lobe of the liver contains the gall bladder in a fossa on its visceral surface with the inferior vena cava lying posterior to it?

A

Right lobe

42
Q

What lobe of the liver lies between the right and left lobes and anterior to the porta hepatis with the gall bladder to its right?

A

Quadrate lobe

43
Q

What lobe of the liver lies between the right and left lobes and posterior to the porta hepatis?

A

Caudate lobe

44
Q

What lobe of the liver lies to the left of the falciform ligament and is small than the right lobe?

A

Left lobe of the liver

45
Q

What is jaundice?

A

Yellow discoloration of the skin, sclera, and mucous membranes due to the release of bilirubin into circulation

46
Q

What is often the cause of jaundice?

A

Liver damage

47
Q

Where would the functional division of the liver be made?

A

To the right of the falciform ligament

48
Q

What hepatic segments lie in the left function half of the liver?

A

I-IV

49
Q

What hepatic segments lie in the right functional half of the liver?

A

V-VIII

50
Q

What is the area of the liver that is uncovered by visceral peritoneum?

A

Bare area

51
Q

Where is the bare area of the liver located?

A

Posterior aspect of the diaphragmatic surface

52
Q

What sits on the bare area of the liver?

A

Diaphragm

53
Q

What important venous structure lies within the bare area?

A

Inferior vena cava

54
Q

What ligament connects the liver to the diaphragm and anterior abdominal wall?

A

Falciform ligament

55
Q

What ligament is the splitting of the falciform ligament as it passes posteriorly along the diaphragmatic surface of the liver?

A

Coronary ligament

56
Q

What are the borders of the bare area?

A

Superior and inferior layers of the coronary ligament

57
Q

What ligaments are formed at the junction of the superior and inferior layers of the coronary ligament on each side?

A

Right and left triangular ligaments

58
Q

What ligament forms the free edge of the falciform ligament?

A

Ligamentum teres

59
Q

The ligamentum teres is a remnant of what structure?

A

The obliterated umbilical vein

60
Q

What ligament is located between the left and caudate lobes?

A

Ligamentum venosum

61
Q

The ligamentum venosum is a remnant of what structure?

A

The ductus venosus

62
Q

What ligament covers the inferior vena cava within the bare area of the liver?

A

Ligament of the inferior vena cava

63
Q

The fissures of the liver form what shape on its visceral surface?

A

An H

64
Q

What fissure is located between the left lobe and quadrate lobe?

A

Fissure for the ligamentum teres

65
Q

What issue is located between the left lobe and caudate lobe?

A

Fissure for the ligamentum venosum

66
Q

What fossa is located between the right lobe and the quadrate lobe?

A

Fossa for the gallbladder

67
Q

What fissure is located between the right lobe and the caudate lobe?

A

Fissure for the inferior vena cava

68
Q

What forms the crossbar of the H-shape of fissures on the liver?

A

Porta hepatis

69
Q

What makes up the liver’s dual blood supply?

A

Portal vein and hepatic artery

70
Q

What is the innervation of the liver?

A

Autonomic and pain fibers are from the hepatic plexus which is an extension of the celiac plexus

71
Q

The portal vein makes up what percentage of the liver’s blood supply?

A

75-80%

72
Q

The hepatic artery makes up what percent of the liver’s blood supply?

A

20-25%

Gross II Unit 3 (8 decks)

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