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2nd Year Med > Anatomy - Liver > Flashcards

Anatomy - Liver Flashcards

1
Q

where is the liver situated and what protects it?

A

mainly RUQ, R. hypochondrium and Epigastric region
extends into LUQ and L. hypochondrium

protected by ribs 5-9

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2
Q

how much does the liver move during ventilation?

A

moves in craniocaudal direction
normal breathing - 2.5cm
heavy breathing - 5.5cm

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3
Q

what borders the liver anteriorly?

A

diaphragm
hepatic flexure of colon
stomach
duodenum
gallbladder

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4
Q

what borders the liver posteriorly?

A

oesophagus
IVC
aorta
vertebral column
right suprarenal gland
right kidney

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5
Q

describe the peritoneal coverage of the liver?

A

intraperitoneal organ but with a bare area

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6
Q

describe the thickening of the peritoneum in the liver?

A

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

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7
Q

describe the gross anatomy of the liver

A

2% of aduly body weight
reddish-brown (healthy)
2 surfaces - diaphragmatic and visceral

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8
Q

name the 2 recesses around the liver

A

hepatorenal (between kidney and liver)
subphrenic (between liver and diaphragm)

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9
Q

what are the 2 embryological remnants of the liver?

A

ligamentum venosum and round ligament

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10
Q

what are the 2 fissures of the liver?

A

left/right sagittal

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11
Q

explain the porta hepatis (transverse fissure)

A

contains portal triad (hepatic artery proper, portal vein, bile duct)
sits on free border of lesser omentum

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12
Q

explain the functional lobes of the liver

A

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

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13
Q

explain the functional segments of the liver

A

8 functional segments
each segments has secondary/tertiary branch of HPV and HAP and has its own biliary/venous drainage
names 1-8 clockwise

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14
Q

describe the hepatic artery proper

A

branch of common hepatic artery from celiac trunk
branches into L/R hepatic arteries

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15
Q

describe the nerve supply of the liver

A

hepatic plexus
follows blood vessels
symp - celiac/superior mesenteric plexuses
parasymp - vagal trunks

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16
Q

explain referred pain

A

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

17
Q

explain the venous drainage of the liver

A

3 major hepatic veins, drain into IVC
slightly supports position of liver

18
Q

describe the portal venous system

A

portal vein - convergence of superior mesenteric and splenic veins, posterior to pancreas

19
Q

explain portal hypertension

A

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)

20
Q

explain the gross anatomy of the gallbladder

A

sits in fossa on visceral surface of liver (9th costal cartilage)
pear shaped sac
holds 50ml bile (contracts to eject bile)

21
Q

describe the cystic duct of gallbladder

A

drains gallbladder
has spiral , allows it to stay open
gallbladder mucosa is obliquely ridged at medial end (continuous with cystic duct mucosal folds)

22
Q

explain how the gallbladder connects to the biliary tree

A

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

23
Q

explain the course of the common bile duct

A

joins pancreatic duct at hepatopancreatic ampulla
enters 2nd (descending) part of duodenum
(sphincters around each duct and the ampulla)

24
Q

describe the anatomical positioning of the common bile duct

A

courses posterior to superior duodenum
sits in groove posterior to pancreas head

25
Q

describe the blood supple of the gallbladder

A

cystic artery (stems from right hepatic artery 80% of time)
hepatic ducts supplied by respective arteries

26
Q

explain the blood supply/drainage of the bile duct and gallbladder

A

bile duct - posterior superior pancreaticodoudenal artery

gallbladder - fundus/body drain into liver
cysticveins drain neck/biliary ducts to liver or HPV

27
Q

explain the nerve supply of the gallbladder

A

parasymp - anterior vagal trunk (contraction, sphincter relaxation)
symp - symp chain (postganglionic cell bodies in celiac ganglia, inhibit contraction)
cholecystokinin from enteroendocrine cells of SI more important

28
Q

explain gallstones

A

mostly in hepatopancreatic ampulla
stones in cystic duct pass back to gallbladder
causes inflammation and jaundice
pancreatic cancer can cause obstruction

2nd Year Med (18 decks)

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