Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Latest Portal Vein Lecture PPT
PORTAL VEIN
PORTAL VEIN
Hepatic Portal Vein
? Origin & end in capillaries /
venous
sinusoids
? Size: 8cm X 1 cm
? Drains
? Abdominal part of alimentary
tract (except lower part of anal
canal)
? Spleen & Pancreas
? Conveys absorbed products of
digested food to liver
? Devoid of valves
? Reservoir of blood : 1200 ml /
min
Formation
? Union of Sup mesenteric & Splenic vein
? Between neck of Pancreas & IVC at level L2
Course: Extrahepatic part
Passes upwards & Rt,
behind neck of pancreas &
1st part of duodenum
? Enters rt free margin of
lesser omentum in front of
epiploic foramen with Bile
Dut & Hepatic artery.
? Reaches porta hepatis &
divides into rt & Lt
branches.
Course: Intrahepatic part
? Branches of
portal vein
? Segmental brs
? Brs in Portal
canal
? Hepatic
sinusoids
? Central veins
? Sublobular veins
? Hepatic veins
IVC
TRIBUTARIES
Rt Branch
-Shorter, wider
- Receives cystic
vein
Lt branch
-Narrower, longer
- Runs in Porta
hepatis
from Rt to Lt
- Brs to Caudate &
Quadrate
lobe
-Receives
Paraumbilical
veins
TRIBUTARIES
? Formative
? Sup Mesenteric vein
? Splenic vein
? Received by Trunk
? Rt & lt Gastric veins
? Superior PD vein
? Received by branches
? Cystic vein
? Paraumbilical veins
? Occasional
? Inf mesenteric vein
? Rt gastroepiploic vein
? Pre-pyloric vein.
PARTS
Parts
? Infraduodenal
? Retroduodenal
? Supraduodenal
RELATIONS
? Infra duodenal
? Ant: Neck of
Pancreas
? Post: IVC
? Retro duodenal
? Ant: Duodenum
(1st Part), Bile duct,
GD artery
? Post: IVC
? Supra duodenal : In
rt free margin of
lesser omentum
? Ant : hepatic artery
& bile duct
? Post: IVC
PORTO-CAVAL ANASTOMOSIS
Liver like lungs has dual blood
supply. The hepatic portal vein
brings 75-80% blood to liver.
Portal vein contains 40% oxygen
than blood returning to the heart
from systemic circuit.
The hepatic portal vein contains
virtually all nutrients absorbed
from the alimentary tract to the
liver with the exception of lipids
which is absorbed through the
hepatic artery.
PORTAL HYPERTENSION
? > 12 mm of Hg
? Causes :
? Pre hepatic : Thrombosis of portal
vein
? Hepatic: Cirrhosis
? Post hepatic: Budd-Chiari Syndrome
? Effects: Splenomegaly, Ascites,
Collateral circulation through sites of
Portasystemic anastomosis
EXPOSURE OF KIDNEY FROM
BEHIND
Loin: It is the region on the back of the trunk, bounded
above by the 12th rib, below by the iliac crest, medially
by the posterior median line, and laterally by flank.
SURFACE MARKING OF KIDNEY FROM BACK
It is done within parallelogram of Morris which is drawn in
the following way:
1. First two horizontal lines are drawn one at the level of
spine of T11 and other at the level of spine of L3.
2. Then two vertical lines are drawn, one 2.5 cm away and
other 9 cm away from the posteromedian plane.
3. The centre of hilum of the each kidney lies approximately
at the lower border of L1.
Layers to be reflected to reach the Kidney
1. Skin.
2. Superficial fascia.
3. Posterior layer of the
thoraco-lumbar fascia
with
attached latissimus dorsi
and serratus posterior
inferior muscles.
4. Erector spinae
(sacrospinalis) muscles.
5. Middle layer of the
thoraco-lumbar fascia.
6. Quadratus lumborum
muscle.
7. Anterior layer of the
thoraco-lumbar fascia.
This post was last modified on 30 November 2021