Stomach, Liver, and Spleen

What are the unpaired visceral branches of the abdominal aorta?
celiac trunk, superior mesenteric artery, inferior mesenteric artery.
What are the paired visceral branches of the abdominal aorta?
middle suprarenal artery., renal artery., ovarian/testicular artery.
What are the paired visceral branches of the abdominal aorta contained in the parietal peritoneum?
Inferior phrenic artery, Lumbar artery (4 pairs)
What are the unpaired visceral branches of the abdominal aorta contained in the parietal peritoneum?
Median Sacral Artery
Where does the Celiac Trunk originate?
Abdominal aorta at the level of T12
What are the three immediate branches of the Celiac Trunk?
left gastric artery, splenic artery, common hepatic artery.
The three branches of the Celiac trunk further branch and supply what organs?
Stomach, liver, gallbladder, spleen, and pancreas
Where does the Celiac Trunk terminate?
What does the Celiac Trunk divide into at L4?
Left and Right Common Iliac Arteries.
What arteries constitute the stomachs arterial supply and arise from the celiac trunk?
Left and right gastric arteries (branches of the celiac and heptatic artery)
The left and right gastroepiploic arteries (branches of the splenic artery and the gastroduodenal artery).
The short gastric arteries (branches of the splenic artery)
What vessels run along the lesser curvature of the stomach?
Right and Left gastric arteries
What vessels run along the greater curvature of the stomach?
Right and Left gastroepoploic arteries.
Why is the liver said to be functionally independent?
Right and left lobes have their own arterial, portal supply, along with separate venous drainage
What divides the liver in to the right and left liver?
Falciform ligament.
What does the round ligament represent in utero?
The represents the remnant of the left fetal umbilical vein
How is the round and falciform ligament related?
they are connected.
What are the four lobes of the liver?
Right lobe, left lobe, quadrate lobe, caudate lobe.
What component does the quadrate and caudate lobe belong to?
Left lobe.
What are the contents of the porta hepatis (portal triad)?
portal vein, hepatic artery, bile duct.
What is notable about the French system of the liver?
hepatic segments are based on the branching of the portal vein. One way to identify the liver segments is by starting at the caudate lobe in counting in a counter-clock-wise direction (8 lobes)
What is the name of the space between the diaphragm and the liver?
Sub-phrenic space
What is the coronary ligament?
A peritoneal reflection on the superior part of the liver that "crowns" the liver and attaches to the diaphragm
What is the bare area of the liver?
area which is not covered by peritoneum, so the liver is in direct contact with the diaphragm
What is the porta hepatis and where is it located (not contents)?
It is a transverse fissure on the visceral surface of the liver
How is the liver attached to the stomach and duodenum?
By the lesser omentum
What are the parts of the lesser omentum
Which has 2 parts the hepatogastric ligament and the hepatoduodenal ligament
What percentage of bloodflow is provided to the liver from the hepatic artery?
What percentage of bloodflow is provided to the liver from the hepatic artery?
What percentage of oxygen to the liver is provided by the hepatic artery and portal vein?
Can you describe the path of arterial blood flow from the aorta to the liver?
The common hepatic artery arises from the celiac trunk and becomes the proper hepatic artery (around where the gastroduodenal artery can starts its journey).
The hepatic artery proper divides into the right and left branches shortly before entering the porta hepatis
What is the general function of the portal vein?
It collects blood from the G.I. tract, gallbladder, pancreases, and spleen and brings it to the liver
What 2 veins unite to form the portal vein?
Superior mesenteric and splenic vein
What does the inferior mesenteric vein join?
It joins the splenic vein before the latter unites with the superior mesenteric
What is the venous drainage of the liver?
The hepatic veins drain directly into the inferior vena cava just inferior to the diaphragm!
Slide 32
Gall bladder
State the artery that supplies the gallbladder and what it branches off from?
The cystic artery which is usually a branch of the right hepatic artery, however there is lots of variability
What are the folds in the mucous membrane of the cystic duct called?
The spiral valves of "Heister" (impacted gallstones often lodge in the area)
Flow of bile?
Slide 34
Name the 2 muscular sphincters in the distal biliary tract?
The choledochal sphincter (located at the distal end of the bile duct) and the hepatopancreatic sphincters (located at the hepatopancreatic ampulla)
Describe the spleen.
largest lymphoid organ of body located in left hypochondriac region, between stomach and diaphragm. entirely sheltered by lower ribs
How big is the normal adult spleen?
The size of your fist
Which artery contribute to the spleens major blood supply?
The splenic artery (celiac trunk)
What is an accessory spleen?
Heterotopic splenic tissue found near the hilum (seen in about 20% of the population)
What are the two ligaments on the tails of the spleen?
What structure runs in the Gastero-lienal ligament?
short gastric and gastroepiploic artery.
What structure runs in the Spleno-renal ligament?
splenic artery, vein, tail of the pancreases
Describe the spleens venous drainage?
Venous drainage of the spleen is by the splenic vein which joins with the superior mesenteric vein posterior to the Pancrease to form the portal vein
Which 5 abdominal structures are normally in contact with the spleen?
Stomach, left kidney, pancreas, colon, diaphragm
What are the two ligaments that the lesser omentum is composed?
Hepato-duodenal liganment and hepato-gastric ligament.
What curvature is the lesser omentum attached to?
Lesser curvature
By what is the notch located in the lower part of the lesser omentum known?
Incisura Angularis
What are the two orifices of the stomach?
Cardial and pyloric.
Which of the two stomach orifices has a true anatomic sphincter?
Pyloric orifice
What are the four parts of the stomach?
Fundus, body, pyloric antrum, pyloric canal.
What are the Gastric Folds
Rugae that flatten when the stomach is distended.
What are the three forms of muscle of the stomach?
Oblique, circular, logitudinal.
What is the serosa?
The visceral peritoneum that will be covering the stomach.