Anatomy of Liver Flashcards
Liver surfaces (2)
1) Diaphragmatic
( Anterosuperior surface
Smooth and convex
Fits beneath curvature of diaphragm (direct contact) )
2) Visceral
(Posteroinferior surface
Covered with peritoneum (except for porta hepatitis + gall bladder fossa)
Irregular flat shape - moulded to surrounding organs)
“Bare area” of liver =
Posterior area of diaphragmatic surface not covered with peritoneum
What are liver ligaments?
Attach liver to surrounding structure
Formed from double layer of peritoneum
Falciform Ligament
Attaches to anterior surface of liver + anterior abdominal wall
Form natural anatomical division between left + right lobes
ligamentum teres?
Free edge of falciform ligament = (remnant of umbilical vein)
Coronary ligament
Superior surface of liver to inferior diaphragm surface
Demarcrates (set’s boundaries of) ‘bare area’ of liver
Anterior + posterior fold unite (form triangular ligaments)
R + L Triangular Ligaments
Left Triangular Ligament:
Formed by union of anterior + posterior layers of coronary ligament
Attaches left lobe to diaphragm
Right Triangular Ligament:
Anterior + posterior coronary ligament union
Adjacent to bare area
Attaches right lobe to diaphragm
Lesser Omentum
Attaches liver to lesser curvature of stomach + first part of duodenum
lesser momentum ligaments
Hepatoduodenal ligament - surrounds portal triad
Hepatogastric ligament
Subphrenic spaces
Between diaphragm + anterior + superior aspects of liver
Divided into left + right by falciform ligament
subhepatic spaces
Sub division of supracolic compartment (above transverse mesocolon)
Peritoneal space between inferior liver surface + transverse colon
Morison’s Pouch
Potential space between visceral surface of liver + right kidney
Deepest part of peritoneal cavity when supine (lying flat)
Glisson’s capsule?
Fibrous capsule covering the liver
Where + what are the 2 accessory lobes?
On the right lobes visceral surface
Caudate + Quadrate Lobes
Caudate Lobe?
Upper aspect of visceral surface
Between Inf. Vena Cave + fossa produced by ligamentum venosum (remnant of fetal ductus venosus)
Quadrate Lobe?
Lower aspect of visceral surface
Between gall bladder + fossa produced by ligamentum teres (remnant of fetal umbilical vein)
Porta Hepatis?
Deep transverse fissure seperating caudate + quadrate
Transmits all vessels, nerves + ducts entering/leaving liver (EXCEPT for hepatic veins)
Structural Unit of Liver
Hepatocytes in lobules
Lobules
Hexagonal shaped
Drained by a central vein
Periphery of hexagon = portal triad (3 structures: arteriole, venule, bile duct)
(+sinusoids + kpuffer cells)
Portal Triad
Arteriole = branch of hepatic artery entering the liver
Venule = branch of hepatic portal vein entering liver
Bile duct = branch of bile duct leaving the liver
Also contains: lymphatic vessels + vagus nerve (parasympathetic) fibres
Hepatic Plates
2 cells thick
Plates separated from each other by sinusoids (capillary spaces)
Cell type lining sinusoids (2)
1) Specialised fenestrated (perforated) vascular endothelial cells
Form lining with gaps to facilitate transfer of metabolite from blood to hepatocytes
2) Mononuclear + phagocytic Kupffer cells
Near gaps in endothelial cells
Recycle non-functioning red blood cells (used to make bile)
Arterial Supply
Dual blood supply
HEPATIC ARTERY PROPER
(25% of blood supply)
Supplies non-parenchymal structures with arterial blood
Derived from Coeliac Trunk
HEPATIC PORTAL VEIN (75% of blood supply) Supplies partially deoxygenated blood Nutrients absorbed from small intestine Dominant blood supply from parenchyma (allows liver to detoxify)
Venous Drainage
Central Veins in Hepatic Lobules form collecting veins
Combine to form multiple hepatic veins
Hepatic veins open into Inferior Vena Cava
Nerve supply (parasympathetic + sympathetic)
Parenchyma innovated by Hepatic Plexus
Sympathetic = Coeliac Plexus nerve fibres Parasympathetic = Vagus Nerve nerve fibres
Enter liver at porta hepatis + follow hepatic artery
Lymphatic Drainage (anterior aspect)
Drain into Hepatic Lymph Nodes (along hepatic vessels + ducts in lower omentum)
Empty into colic lymph (cisterna chyli)
Lymphatic Drainage (Posterior aspect)
Drain into phrenic + posterior mediastinal nodes
Join right lymphatic + thoracic ducts
