Accessory Organs of the Digestive System Flashcards
The largest visceral organ and the largest gland in the human body
Liver
Important roles of Liver
- production and secretion of bile (used in emulsification of fats)
- detoxification (by filtering the blood to remove bacteria and foreign particles that have gained entrance from the intestine)
- storage of carbohydrate as glycogen (to be broke later to glucose)
- production of storage of lipids as triglycerides
- plasma protein synthesis (albumin and globulin)
- production of blood coagulants (fibrinogen and prothrombin)
- anticoagulants (heparin), and bile pigments (bilirubin and biliverdin) from the breakdown of hemoglobin (when RBC are being degraded)
- reservoir for blood and platelets
- storage of certain vitamins, iron, and copper
What is liver important for in the fetus?
manufacture of red blood cells
Liver is surrounded by the peritoneum and is attached to the diaphragm by?
coronary and falciform ligaments
right and left triangular ligaments
What is the point of reference for anatomical lobes?
falciform ligament
What are in the right and left lobes of anatomical division of liver?
Left Lobe: II (Lateral superior lobe), III ( Lateral inferior lobe)
Right Lobe: IVa (Medial superior lobe), IVb (Medial inferior lobe), V (Anterior inferior lobe), VI (Posterior inferior lobe), VII (Posterior superior lobe), VIII (Anterior superior lobe)
What is the other term for medial superior lobe?
Caudate lobe
What is the other term for medial inferior lobe?
Quadrate lobe
Important for determining landmark for surgeries (e.g. hepatectomy-removal of liver, liver transplant)
Functional division of liver
What is the point of reference for the functional division of liver?
rex cantlie line (imaginary line drawn between gallbladder and IVC)
What are the right and left lobes in the Functional division of liver?
Left: II (lateral superior lobe), III (lateral inferior lobe), IV a (medial superior lobe), IV b (medial inferior lobe)
Right: V (anterior inferior lobe), VI (posterior inferior lobe), VII (posterior superior lobe), VIII (anterior superior lobe)
Depressions / landmarks where specific organs are lodged into the liver
Impressions
What are the impressions on the liver?
Gastric impression: stomach; Esophageal impression: esophagus; Suprarenal impression: renal adrenal gland; Renal impression: right kidney; Colic impression: colon
What does the liver have on the diaphragmatic surface, which is limited by layers of the coronary ligament but is devoid of peritoneum?
Bare area
Where does liver receive oxygenated blood and deoxygenated, nutrient-rich, sometimes toxic blood?
hepatic artery
portal vein
What drains the liver?
hepatic veins into the IVC
Liver contains the portal triad in the portal hepatis. What is its arrangement anterior to posterior?
○ Bile duct
○ Hepatic artery
○ Portal vein
How is liver divided based on hepatic drainage and blood supply?
right and left lobes by functional units or hepatic segments
What vein divides the liver via couinaud classification or functional division?
Middle hepatic vein
Divided into anterior and posterior segments, each of which is subdivided into superior and inferior areas or segments
Right Lobe
Divided into medial and lateral segments, each of which is subdivided into superior and inferior areas (segments)
Left Lobe
Includes the medial superior (caudate lobe), medial inferior (quadrate lobe), lateral superior, and lateral inferior segments.
Left Lobe
Where does quadrate lobe receive blood and drain bile?
receives blood from the left hepatic artery
drains bile into the left hepatic duct
Where does caudate lobe receive blood and drain bile?
receives blood from the right and left hepatic arteries
drains bile into both right and left hepatic ducts
Fissure located between the lateral portion of the left lobe and the quadrate lobe
round ligament (ligamentum teres hepatis / umbilical vein)
Fissure located between the caudate lobe and the lateral portion of the left lobe
ligamentum venosum
Fossa located between the quadrate lobe and the major part of the right lobe
Fossa for Gallbladder
Fissure located between the caudate lobe and the major part of the right lobe
Fissure for the IVC
This transverse fissure on the visceral surface of the liver between the quadrate and caudate lobes lodges the hepatic ducts, hepatic arteries, branches of the portal vein, hepatic nerves, and lymphatic vessels.
Porta hepatis
What does the coronary ligament form?
Right and left triangular ligament
The upper & lower layers of coronary ligament & right triangular ligament bound a large area on the post surface of the liver which has no peritoneal covering.
Bare area
Bile Passage way
- From the liver (production)
- To right hepatic duct, left hepatic duct, forming the common hepatic duct (which will join the cystic bile duct to form common bile duct) (some bile go to gallbladder)
- Empty to 2nd part of duodenum
Bile Passage way
- From the liver (production)
- To (a) right hepatic duct, (b) left hepatic duct, forming the (c ) common hepatic duct (which will join the cystic bile duct to form common bile duct) (some bile go to gallbladder)
- empty to 2nd part of duodenum
A condition where the liver cells are progressively destroyed and replaced by fatty and fibrous tissue that surrounds the intrahepatic blood vessels and biliary radicals, impeding the circulation of blood through the liver.
Liver cirrhosis
Accumulation of fluid in the peritoneal cavity
Ascites
Dilated veins around the umbilicus
Caput medusa
Periportal zone, affected by viral hepatitis
Zone 1
Intermediate zone, associated with yellow fever
Zone II
Pericentral vein (centrilobular zone), affected 1st by ischemia and the site of alcoholic hepatitis
Zone III
Located at the junction of the right ninth costal cartilage and lateral border of the rectus abdominis, which is the site of maximum tenderness in acute inflammation of the gallbladder.
Gallbladder
Is a pear-shaped sac lying on the inferior surface of the liver in a fossa between the right and quadrate lobes
Gallbladder
What is the capacity of gallbladder?
approximately 30 to 50 mL
Where is gallbladder in contact with?
duodenum and transverse colon