Quiz
GI BLOCK: Week 2 - Liver
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Questions in this quiz (39)
1Label this diagram of the visceral (inferior) surface of the liver.
- Acaudate lobe
- Bleft lobe
- Cright lobe
- Dquadrate lobe
- Ehepatic ducts
- Ffissure for ligamentum teres
- Gfissure for ligamentum venosum
- Hportal vein
- Icommon bile duct
- Jcystic duct
- Kporta hepatis
- Lfundus
- Mbody
- Nneck
- Ogallbladder
- Phepatic artery proper
2Label this diagram of the posterior surface of the liver.
- Ainferior vena cava
- Bcaudate lobe
- Cfalciform ligament
- Dleft triangular ligament
- Egastric
- Foesophageal
- Gright lobe
- Hsuprarenal
- Ibare area
- Janterior coronary ligament
- Kposterior coronary ligament
- Lright triangular ligament
- Mrenal
- Nright lobe
- Oneck
- Pbody
- Qfundus
- Rcolic
- Sporta hepatis
- Tquadrate lobe
3Label the blood supply of the liver.
- Aleft hepatic artery
- Bright hepatic artery
- Chepatic artery proper
- Dleft gastric artery
- Ecystic artery
- Fgastroduodenal artery
- Gright gastric artery
- Habdominal aorta
4How much does a normal liver weigh?
- A1500g
- B2000g
- C1000g
- D2500g
- E3000g
5Which recesses are associated with the liver?
- ASubphrenic recess
- BHepatorenal recess
- CHepatogastric recess
- DSuprarenal recess
- EHepatoduodenal recess
- FFalciform recess
6What are the 6 ligaments associated with the liver?
1. [blank_start]Falciform ligament[blank_end]
2. [blank_start]Visceral peritoneum[blank_end]
3. [blank_start]Hepatogastric ligament[blank_end]
4. [blank_start]Hepatoduodenal ligament[blank_end]
5. [blank_start]Right/left triangular ligaments[blank_end] (x2)
6. [blank_start]Anterior/posterior coronary ligaments[blank_end] (x2)- AFalciform ligament
- BVisceral peritoneum
- CHepatogastric ligament
- DHepatoduodenal ligament
- ERight/left triangular ligaments
- FAnterior/posterior coronary ligaments
7Which is true about the falciform liver?
- AAttaches liver to the anterior abdominal wall (to the level of the umbilicus)
- BAttaches liver to the posterior abdominal wall (to the level of the large intestines)
- CAttaches liver to the anterior abdominal wall (to the level immediately surrounding the liver)
- DAttaches liver to the right lateral abdominal wall
- EAttaches the visceral peritoneum to the liver and surrounding structures to prevent detachment
8Which of the following is functionally completely distinct from the left and right lobes of the liver?
- AQuadrate lobe
- BCaudate lobe
9What percentage of total blood flow into the liver is from the hepatic artery proper?
- A30-40%
- B20-30%
- C50-60%
- D60-70%
- E70-80%
10Where does the cystic artery branch from?
- ARight hepatic artery
- BLeft hepatic artery
- CHepatic artery proper
- DCommon hepatic artery
- EGastroduodenal artery
11Label this diagram of the portal vein system.
- Aleft gastric vein
- Bsplenic vein
- Cinferior mesenteric vein
- Djejunal and ileal veins
- Esuperior mesenteric vein
- Fmiddle colic vein
- Gright colic vein
- Hileocolic vein
- Iportal vein
12What are the 3 main branches of the portal vein?
1. [blank_start]Splenic vein[blank_end]
2. [blank_start]Superior mesenteric vein[blank_end]
3. [blank_start]Inferior mesenteric vein[blank_end]- ASplenic vein
- BSuperior mesenteric vein
- CInferior mesenteric vein
13Which of the following drain directly into the portal vein? (As opposed to draining into the superior mesenteric v. etc.)
- ARight/left gastric veins
- BCystic veins
- CPara-umbilical veins
- DPosterior superior pancreaticoduodenal vein
- ELeft colic veins
- FAnterior/posterior inferior pancreaticoduodenal veins
- GRight gastro-omental vein
- HPancreatic vein
14What is the normal blood pressure in the portal vein?
- A5-10 mmHg
- B10-15 mmHg
- C15-20 mmHg
- D20-25 mmHg
- E25-30 mmHg
15How long is the portal vein?
- A8cm
- B4cm
- C12cm
- D16cm
- E20cm
16What percentage of total blood flow into the liver comes from the portal vein?
- A60-70%
- B50-60%
- C40-50%
- D30-40%
- E20-30%
17What is special about the connecting sinusoids of the liver?
- AFenestrated endothelium
- BLowest pressure venous system in the body
- CFlow in opposite direction to the arteries
- DContain membrane channels
- ETortuous
18What is the lymphatic drainage of the liver?
- AHepatic nodes
- BCoeliac nodes
- CThoracic duct
- DSuperior mesenteric nodes
- EInferior mesenteric nodes
- FPara-aortic duct
19What is the ligamentum teres?
- ARemnant of the foetal umbilical vein
- BRemnant of the foetal umbilical arteries
- CPart of the falciform ligament which attaches the liver to the diaphragm
- DPart of the falciform ligament which attaches the liver to the umbilicus
- EPart of the falciform ligament which separates the two lobes of the liver
20Describe the 3 different ways of viewing the liver lobule.
- Aclassic lobule
- Bportal lobule
- Cliver acinus
21Label this diagram of the classic lobule in the liver.
- Ainterlobular bile duct
- Binterlobular vein
- Cinterlobular artery
- Dcentral vein
- Ehepatocyte
- Fhepatic sinusoid
22What is the function of stellate/ito cells in the liver?
- AFat storage
- BVitamin A storage
- CStructural support of hepatocytes
- DDigest debris, toxins, bacteria
- EBreak down RBCs
- FStructural support of fenestrated sinusoids
23Which of the following happen in zone 1 of the liver acinus?
- AOxidative metabolism
- BGluconeogenesis
- CUrea synthesis
- DBile/cholesterol formation
- EGlycolysis
- FLipogenesis/ketogenesis
- GDrug metabolism
- HGlutamine synthesis
24Which of the following happen in zone 3 of the liver acinus?
- AGlycolysis
- BLipogenesis/ketogenesis
- CDrug metabolism
- DGlutamine synthesis
- EOxidative metabolism
- FGluconeogenesis
- GUrea synthesis
- HBile/cholesterol formation
25Where are the 5 areas where the portal and systemic circulation meet?
1. [blank_start]Lower end of oesophagus[blank_end]
2. [blank_start]Umbilicus[blank_end]
3. [blank_start]Retroperitoneal areas[blank_end]
4. [blank_start]Bare area of liver[blank_end]
5. [blank_start]Upper end of anal canal[blank_end]- ALower end of oesophagus
- BUmbilicus
- CRetroperitoneal areas
- DBare area of liver
- EUpper end of anal canal
26What are the 5 stages of bilirubin metabolism? Hint: they are the places where each stage happens.
1. [blank_start]Reticulo-endothelial system[blank_end]
2. [blank_start]Plasma[blank_end]
3. [blank_start]Liver[blank_end]
4. [blank_start]Small intestine[blank_end]
5. [blank_start]Large intestine[blank_end]- AReticulo-endothelial system
- BPlasma
- CLiver
- DSmall intestine
- ELarge intestine
27What are the 3 main consequences of portal hypertension?
1. [blank_start]Splenomegaly[blank_end]
2. [blank_start]Oesophageal varices[blank_end]
3. [blank_start]Ascites[blank_end]- ASplenomegaly
- BOesophageal varices
- CAscites
28Outline some causes of portal hypertension.
- Aportal vein thrombosis
- Btrauma
- Cschistosomiasis
- Ddrugs
- Esarcoidosis
- Fcirrhosis
- Gpolycystic liver disease
- Hveno-occlusive disease
- Iright sided heart failure
29Describe the pathophysiology of portal hypertension.
1. Increased [blank_start]resistance[blank_end] to blood flow in the portal system
2. Increased [blank_start]resistance[blank_end] to blood flow through the sinusoids of the liver
3. [blank_start]Prehepatic obstruction[blank_end] causing increased resistance:
a. [blank_start]Obstructive thrombosis[blank_end] (portal vein narrowing)
b. [blank_start]Increased splenic blood flow[blank_end]
i. Due to: splenomegaly
ii. Causes [blank_start]increased blood volume[blank_end] in portal system
--- Therefore blood cannot pass through the liver [blank_start]quickly[blank_end] enough
--- Therefore there is a [blank_start]back-up of blood[blank_end] into the portal system
4. [blank_start]Intrahepatic obstruction[blank_end] causing increased resistance:
a. [blank_start]Cirrhosis[blank_end]
i. Liver structure is distorted and obstructs blood flow through the sinusoids
ii. This is due to [blank_start]fibrosis[blank_end] and [blank_start]nodule[blank_end] formation
iii. This causes increased resistance and a [blank_start]back-up of blood[blank_end] into the portal system
5. [blank_start]Post-hepatic obstruction[blank_end] causing increased resistance:
a. [blank_start]Hepatic vein outflow obstruction[blank_end]
b. [blank_start]Right heart failure[blank_end]
i. Causes back up of blood in the [blank_start]IVC[blank_end]
ii. This causes back log of blood in the [blank_start]hepatic vein[blank_end]
iii. This causes back log of blood in the [blank_start]liver[blank_end]
iv. This causes back log of blood in the [blank_start]portal system[blank_end]- Aresistance
- Bresistance
- CPrehepatic obstruction
- DObstructive thrombosis
- EIncreased splenic blood flow
- Fincreased blood volume
- Gquickly
- Hback-up of blood
- IIntrahepatic obstruction
- Jfibrosis
- Knodule
- Lback-up of blood
- MPost-hepatic obstruction
- NHepatic vein outflow obstruction
- OCirrhosis
- PRight heart failure
- QIVC
- Rhepatic vein
- Sliver
- Tportal system
30What are the 4 features of cirrhosis pathophysiology?
1. [blank_start]Ascites[blank_end]
2. [blank_start]Hepatic encephalopathy[blank_end]
3. [blank_start]Hepatocellular carcinoma[blank_end]
4. [blank_start]Portal hypertension[blank_end]- AAscites
- BHepatic encephalopathy
- CHepatocellular carcinoma
- DPortal hypertension
31Why does cirrhosis/portal hypertension cause ascites?
1. [blank_start]Increased hydrostatic pressure[blank_end] in abdomen (due to stagnation of blood in portal system)
2. [blank_start]Salt and water retention[blank_end] by kidneys
3. [blank_start]Impaired albumin synthesis[blank_end] by the liver (therefore [blank_start]decreased osmotic pressure[blank_end])- AIncreased hydrostatic pressure
- BSalt and water retention
- CImpaired albumin synthesis
- Ddecreased osmotic pressure
32What are the 3 main features to include in the definition of cirrhosis?
1. [blank_start]Diffuse[blank_end]
2. [blank_start]Fibrosis[blank_end]
3. [blank_start]Nodules[blank_end]- ADiffuse
- BFibrosis
- CNodules
33List the 6 main functions of the liver.
1. [blank_start]Metabolism[blank_end] (e.g. amino acids, carbohydrates, lipids)
2. [blank_start]Plasma protein and enzyme synthesis[blank_end]
3. [blank_start]Bile production[blank_end]
4. [blank_start]Detoxification[blank_end]
5. [blank_start]Storage[blank_end] (e.g. proteins, glycogen, vitamins, metals)
6. [blank_start]Immune functions[blank_end]- AMetabolism
- BPlasma protein and enzyme synthesis
- CBile production
- DDetoxification
- EStorage
- FImmune functions
34What are the 4 processes that are carried out by the liver that are involved in carbohydrate metabolism?
1. [blank_start]Glycolysis[blank_end]
2. [blank_start]Gluconeogenesis[blank_end]
3. [blank_start]Glycogenesis[blank_end]
4. [blank_start]Glycogenolysis[blank_end]- AGlycolysis
- BGluconeogenesis
- CGlycogenesis
- DGlycogenolysis
35What are the 6 processes carried out by the liver that are involved in lipid metabolism?
1. [blank_start]Fatty acid synthesis[blank_end]
2. [blank_start]Triglyceride synthesis[blank_end]
3. [blank_start]Beta oxidation[blank_end] of short chain fatty acids
4. [blank_start]Cholesterol synthesis[blank_end]
5. [blank_start]Phospholipid synthesis[blank_end]
6. [blank_start]Lipoprotein synthesis[blank_end]- AFatty acid synthesis
- BTriglyceride synthesis
- CBeta oxidation
- DCholesterol synthesis
- EPhospholipid synthesis
- FLipoprotein synthesis
36What are the effects of cirrhosis on the liver?
1. [blank_start]Portal hypertension[blank_end] (oesophageal varices, ascites, splenomegaly)
2. [blank_start]Liver failure[blank_end]
3. [blank_start]Hepatocellular carcinoma[blank_end]
4. [blank_start]Hepatic encephalopathy[blank_end]- APortal hypertension
- BLiver failure
- CHepatocellular carcinoma
- DHepatic encephalopathy
37What are the effects of liver failure?
1. [blank_start]Impaired synthesis[blank_end] (e.g. albumin, clotting factors)
2. [blank_start]Jaundice[blank_end]
3. [blank_start]Coagulation disorders[blank_end] (due to impaired prothrombin synthesis)
4. [blank_start]Altered metabolism[blank_end] (e.g. impaired urea synthesis)
5. [blank_start]Altered drug metabolism[blank_end]
6. [blank_start]Immune[blank_end], [blank_start]circulatory[blank_end] and [blank_start]endocrine[blank_end] disturbances- AImpaired synthesis
- BJaundice
- CCoagulation disorders
- DAltered metabolism
- EAltered drug metabolism
- FImmune
- Gcirculatory
- Hendocrine
38What is Calot's triangle?
- AArea where the left and right hepatic ducts converge to form the common hepatic duct
- BArea where the common hepatic duct and cystic duct converge to form the common bile duct
- CArea where the common bile duct and the main pancreatic duct converge to form the ampulla of Vater
- DArea where the hepatic artery proper splits into the left and right hepatic arteries
- EArea where the superior mesenteric vein and the splenic vein converge to form the portal vein
39What is the foramen of Winslow?
- AOmental foramen - opening between the greater sac and lesser sac
- BOpening between greater omentum and peritoneum
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- Undergraduate MBChB Year 2 Quiz on GI BLOCK: Week 2 - Liver, created by Melissa Denker on 17/05/2016.
- Author
- Melissa Denker
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