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<opml version="2.0">
  <head>
    <title>078-03 Liver, biliary tree, pancreas, spleen, retroperitoneum, vessels, and lymphatics</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Upper abdominal organs, vessels, and lymphatics">
      <outline text="Liver form and attachments">
        <outline text="Mainly beneath right diaphragm, extends left"/>
        <outline text="Anatomical lobes split by falciform ligament"/>
        <outline text="Functional plane near middle hepatic vein">
          <outline text="Gallbladder fossa to inferior vena cava"/>
        </outline>
        <outline text="Couinaud segments are independent portal territories">
          <outline text="Portal pedicle central, hepatic veins between"/>
          <outline text="Caudate drains directly to cava"/>
        </outline>
        <outline text="Bare area, porta, gallbladder bed uncovered"/>
        <outline text="Hepatic veins and cava fix liver posteriorly"/>
        <outline text="Hepatoduodenal ligament arrangement">
          <outline text="Bile duct right anterior, artery left anterior"/>
          <outline text="Portal vein posterior, variants frequent"/>
        </outline>
      </outline>
      <outline text="Hepatic inflow and outflow">
        <outline text="Portal vein forms behind pancreatic neck">
          <outline text="Superior mesenteric and splenic veins join"/>
        </outline>
        <outline text="Proper hepatic artery from common hepatic"/>
        <outline text="Hepatic veins drain directly to cava"/>
        <outline text="Portal-systemic anastomoses">
          <outline text="Oesophagus, rectum, paraumbilical, retroperitoneal"/>
          <outline text="Portal hypertension enlarges collaterals"/>
          <outline text="Caput medusae not specific to portal disease"/>
        </outline>
        <outline text="Triad compression reduces inflow bleeding">
          <outline text="Hepatic-vein and caval bleeding persists"/>
        </outline>
      </outline>
      <outline text="Gallbladder and bile ducts">
        <outline text="Fundus, body, infundibulum, neck"/>
        <outline text="Fundus near right ninth costal cartilage"/>
        <outline text="Hepatic ducts form common hepatic duct"/>
        <outline text="Common bile duct behind first duodenum">
          <outline text="Joins pancreatic duct at hepatopancreatic ampulla"/>
        </outline>
        <outline text="Cystic artery in hepatocystic triangle">
          <outline text="Variants common, identify before division"/>
        </outline>
        <outline text="Stone site determines consequence">
          <outline text="Cystic duct: gallbladder inflammation"/>
          <outline text="Common bile duct: jaundice, cholangitis"/>
          <outline text="Ampulla: pancreatic drainage affected"/>
        </outline>
        <outline text="Diaphragmatic irritation refers to shoulder"/>
      </outline>
      <outline text="Pancreas">
        <outline text="Head in duodenal curve"/>
        <outline text="Uncinate process behind superior mesenteric vessels"/>
        <outline text="Tail in splenorenal ligament">
          <outline text="Vulnerable during splenic surgery"/>
        </outline>
        <outline text="Main duct joins bile duct"/>
        <outline text="Pancreas divisum alters pancreatitis risk"/>
        <outline text="Arcades to head, splenic branches to body, tail"/>
        <outline text="Pancreatitis spreads through retroperitoneal planes">
          <outline text="Lesser sac, mesentery, paracolic spaces"/>
        </outline>
      </outline>
      <outline text="Spleen">
        <outline text="Under left ribs nine to eleven"/>
        <outline text="Normal spleen not palpable"/>
        <outline text="Gastrosplenic ligament: short gastric vessels"/>
        <outline text="Splenorenal ligament: splenic vessels, pancreatic tail"/>
        <outline text="Segmental arteries with limited anastomosis"/>
        <outline text="Splenic vein behind pancreas joins mesenteric vein">
          <outline text="Isolated thrombosis gives gastric varices"/>
        </outline>
        <outline text="Rupture: bleeding and left-shoulder pain"/>
        <outline text="Accessory spleens matter after splenectomy"/>
      </outline>
      <outline text="Retroperitoneum and great vessels">
        <outline text="Between posterior peritoneum and transversalis fascia"/>
        <outline text="Aorta enters at T12, divides near L4">
          <outline text="Coeliac, superior, inferior mesenteric unpaired"/>
        </outline>
        <outline text="Coeliac: left gastric, splenic, common hepatic"/>
        <outline text="Variant origins crucial before embolisation"/>
        <outline text="Cava forms near L5, crosses diaphragm at T8"/>
        <outline text="Left gonadal, suprarenal veins to left renal">
          <outline text="Left renal vein crosses under superior mesenteric"/>
        </outline>
        <outline text="Retroperitoneal disease compresses before visible"/>
      </outline>
      <outline text="Autonomic and lymphatic pathways">
        <outline text="Splanchnic nerves synapse in prevertebral ganglia">
          <outline text="Postganglionic fibres follow arteries"/>
        </outline>
        <outline text="Plexus blocks trade relief for hypotension"/>
        <outline text="Pre-aortic nodes drain gut"/>
        <outline text="Lateral aortic nodes drain kidneys, gonads, wall"/>
        <outline text="Trunks feed cisterna chyli and thoracic duct"/>
      </outline>
      <outline text="Cross-sectional localisation">
        <outline text="Aorta left, cava right, kidneys posterolateral"/>
        <outline text="Portal confluence behind pancreatic neck"/>
        <outline text="Follow vessels to identify ambiguous organs"/>
        <outline text="Intraperitoneal fluid outlines viscera, fills recesses"/>
        <outline text="Retroperitoneal fluid tracks fascia and psoas"/>
        <outline text="Gas location marks perforation or infection"/>
        <outline text="Enhancement phase selects what is shown"/>
      </outline>
    </outline>
  </body>
</opml>
