Anatomy lecture 21

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9spr
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70488
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Anatomy lecture 21
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2011-03-03 16:00:56
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the end of the digestive system lectures
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  1. Liver:
    • diaphragmatic (anterior) and visceral (posterior) surfaces
    • right, left, quadrate and caudate lobes
    • peritoneum
    • :falciform ligament: round ligament
    • coronary ligament: bare area
    • lesser omentum
  2. lecture notes
    • largest lobe is the right lobe
    • quadrate is anterior, caudate is posterior
    • coronary ligament- connects liver to diaphragm
    • round ligament/ligamentum teres,- the obliterated umbilacral cord
  3. porta hepatis (hilus):
    • portal (hepatic) triad:
    • hepatic artery (proper): branch of celiac artery----carries oxygenated blood to the liver tissues
    • (hepatic) portal vein: carries nutrient rich venous blood from the digestive tract
    • bile duct: carries bile from the liver
  4. lecture notes
    • portal hepatis- where major things enter or leave liver
    • 2/3 of the blood going to the liver is from the portal vein
    • hepatic veins empty into the inferior vena cava (can be embedded in the liver)
    • gall bladder attatched anteriorly
  5. histology of the liver
    • functional unit: liver lobule:
    • liver cells (hepatocytes) arranged in plates (cords) radiating outward from a central vein
    • at periphery of lobule are portal (hepatic) triads containing branches of portal vein, hepatic artery and bile duct
    • between plates are sinusoids
    • blood from the portal vein (containing products of digestion) enters the sinusoids and components leave the sinusoids (which have a fenestrated endothelium) to enter a perisinusoidal space in direct contact with hepatocytes which absorb products via microvilli
    • remaining blood in sinusoids enters central veins which connect to hepatic veins which connect to IVC
    • Kupffer cells in sinusoidal lining are phagocytic, removing bacterial and foreign material from blood
    • bile is secreted by hepatocytes into canaliculi which
    • connect to the bile duct system
  6. lecture notes
    • is divided into lobules
    • triads are found at the perferee of the lobules (artery, veins and duct)
    • hepadocytes (liver cells) are arranged in chords and at the center is a vein and on the out side are the triads
    • arteries and veins give blood to the sinusoids (leaky capillaries) which leak into the peri sinusoidal space which is then absorbed by the hepatic cells
    • in the wall of capillaries there a cooper cells which remove debris
  7. Biliary Ducts and Gall Bladder:
    • bile leaves the liver by the right and left hepatic ducts which join to form the common hepatic duct
    • from the common hepatic duct, bile can flow either to the (common) bile duct which enters the duodenum or the cystic duct which enters the gall bladder
    • cystic duct has mucosal spiral fold, which keeps lumen open allowing bile to pass either way
    • common bile duct joins the pancreatic duct to form the duodenal ampulla which opens to the duodenum at the duodenal papilla
    • hepatopancreatic sphincter (of Oddi)
  8. gall bladder
    • pear‑shaped muscular sac
    • fundus, body, neck
    • cystic duct
    • stores and concentrates bile not immediately required
    • for digestion
    • blood supply: cystic artery
  9. histology of the gal bladder
    • simple columnar epithelium with apical microvilli
    • no muscular mucosa and little submucosa
    • muscularis externa is scattered muscle fibers
    • outer adventitia
  10. Pancreas:
    • gross anatomy:
    • retroperitoneal
    • head lies in concavity of duodenum
    • elongated body passes to left, becoming the tail which reaches spleen
    • main pancreatic duct (of Wirsung) fuses with the bile duct at the hepatopancreatic ampulla which empties into duodenum
    • may be an accessory duct that opens separately to the duodenum
  11. blood supply and venous drainage of the pancreas:
    • celiac and superior mesenteric arteries supply the head
    • splenic artery supplies the body and tail
    • equivalent veins drain into the portal vein
  12. histology:
    • an exocrine gland (99%) and endocrine gland (1%)
    • exocrine part consists of acini which empty into small ducts that eventually connect to the main duct
    • endocrine part consist of islets scattered among the acini
    • the acinar cells secrete an enzyme‑rich pancreatic juice which also contains bicarbonate ions secreted by the epithelial cells of the smallest ducts

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