Anatomy - Liver Flashcards
where is the liver situated and what protects it?
mainly RUQ, R. hypochondrium and Epigastric region
extends into LUQ and L. hypochondrium
protected by ribs 5-9
how much does the liver move during ventilation?
moves in craniocaudal direction
normal breathing - 2.5cm
heavy breathing - 5.5cm
what borders the liver anteriorly?
diaphragm
hepatic flexure of colon
stomach
duodenum
gallbladder
what borders the liver posteriorly?
oesophagus
IVC
aorta
vertebral column
right suprarenal gland
right kidney
describe the peritoneal coverage of the liver?
intraperitoneal organ but with a bare area
describe the thickening of the peritoneum in the liver?
anterior/posterior coronary ligaments around crown of liver (forms triangular ligaments where these ligaments join, anteriorly = falciform ligament)
falciform ligament - attaches liver to anterior abdominal wall
describe the gross anatomy of the liver
2% of aduly body weight
reddish-brown (healthy)
2 surfaces - diaphragmatic and visceral
name the 2 recesses around the liver
hepatorenal (between kidney and liver)
subphrenic (between liver and diaphragm)
what are the 2 embryological remnants of the liver?
ligamentum venosum and round ligament
what are the 2 fissures of the liver?
left/right sagittal
explain the porta hepatis (transverse fissure)
contains portal triad (hepatic artery proper, portal vein, bile duct)
sits on free border of lesser omentum
explain the functional lobes of the liver
left/right functional lobe
each lobe receives a branch of hepatic portal vein/hepatic artery proper and is drained by a hepatic duct
separated by cantlie line
explain the functional segments of the liver
8 functional segments
each segments has secondary/tertiary branch of HPV and HAP and has its own biliary/venous drainage
names 1-8 clockwise
describe the hepatic artery proper
branch of common hepatic artery from celiac trunk
branches into L/R hepatic arteries
describe the nerve supply of the liver
hepatic plexus
follows blood vessels
symp - celiac/superior mesenteric plexuses
parasymp - vagal trunks
explain referred pain
pain felt in different area than anatomical location (pain in dermatome not organ)
liver - epigastric region (poor localised)
diaphragm - C3/4/5 dermatome on right side only
fibrous capsule - well localised/somatic
explain the venous drainage of the liver
3 major hepatic veins, drain into IVC
slightly supports position of liver
describe the portal venous system
portal vein - convergence of superior mesenteric and splenic veins, posterior to pancreas
explain portal hypertension
increased portal pressure system causing backlog of blood in portal veins
porto-systemic anastomoses enlarge due to increased pressure
treated with transjugular intrahepatic portal system shunt (TIPS)
explain the gross anatomy of the gallbladder
sits in fossa on visceral surface of liver (9th costal cartilage)
pear shaped sac
holds 50ml bile (contracts to eject bile)
describe the cystic duct of gallbladder
drains gallbladder
has spiral , allows it to stay open
gallbladder mucosa is obliquely ridged at medial end (continuous with cystic duct mucosal folds)
explain how the gallbladder connects to the biliary tree
ductules join to form segmental ducts
segmental ducts join to form L/R hepatic ducts (intra/extrahepatic)
hepatic ducts join to form common hepatic duct
common hepatic duct and cystic duct join to form common bile duct
explain the course of the common bile duct
joins pancreatic duct at hepatopancreatic ampulla
enters 2nd (descending) part of duodenum
(sphincters around each duct and the ampulla)
describe the anatomical positioning of the common bile duct
courses posterior to superior duodenum
sits in groove posterior to pancreas head
