Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

104 Theme 2 - Liver and Metabolism > Anatomy of the liver > Flashcards

Anatomy of the liver Flashcards

1
Q

What is the largest gland in the body?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the macroscopic features of the liver?

A

Wedge shaped reddish brown organ

Highly vascularised

Pliable to touch; easily lacerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the liver located?

A
  • Below diaphragm
  • Right of the stomach
  • Above the colon

Overlies gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the main functions of the liver?

A

detoxification

protein synthesis

production of bile – aids lipid digestion

glycogen storage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which quadrant (of 9) is the liver in?

A

Located below diaphragm: mostly the right hypochondrium & epigastrium, but extends into left hypochondrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The liver is below the ribs

True or false?

A

False

The liver is covered by the ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Label the diagram

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Label the anterior view of the liver

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Label the posterior view of the liver

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the diaphragm affect the gross anatomy of the liver?

A

Diaphagmatic upper surface blunt, dome shaped/ sharp inferior border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the lobes of the liver?

A

Ant. view – divided into two main lobes: left and right

• Post. view – two other lobes: quadrate and caudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which part of the liver is covered by peritoneum?

A

Surface covered by peritoneum except bare area, where it touches the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What seperates the lobes?

A

Falciform (ant) and lesser omentum (post) ligaments separate right and left lobes

• Porta hepatis divides the quadrate and caudate lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the peritoneal folds?

A

•Falciform ligament

links anterior abdominal wall to liver

ligamentum teres (aka round ligament*) at lower end

  • Coronary ligaments - links diaphragm to liver
  • Lesser omentum - links liver to stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the round ligament?

A

Obliterated left umbilical vein

extends to umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complete the diagram on periotoneal folds

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the lesser omentum?

A

•From the lesser curvature stomach to porta hepatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which omentum has a free edge?

A

Lesser omentum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the lesser omentum made of?

A

Ventral mesentry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the lesser omentum enclose?

A

hepatic artery

portal vein

bile duct

lymph vessels

• Close to the stomach it also encloses the gastric arteries and veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where does the blood supply to the gut originate from?

A

• All midline branches of the abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the blood supply to the gut?

A

Foregut – coeliac artery / trunk

Midgut – superior mesenteric artery

Hindgut – inferior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Label the blood supply to the gut

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the blood supply to the liver?

A
  • Hepatic artery, a branch from the coeliac trunk brings oxygenated blood from the heart
  • Portal vein, formed by the coming together of the sup mesenteric + splenic veins, brings deoxygenated blood from the gut, carrying nutrients, drugs, toxins etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the 3 main branches of the coeliac artery/trunk/axis and what does it also supply?

A

left gastric (to stomach)

splenic (to spleen)

hepatic (to liver)

duodenum

pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where does the coeliac artery exit the aorta?

A

• Exits aorta at T12/L1 Level

27
Q

Complete the diagram of arteries

A
28
Q

Label the diagram on hepatic arteries

A
29
Q

Hepatic artery variations are seen in _______% of people

A

40-45%

30
Q

What are the common hepatic artery variations?

A

•Most common cases*:

right hepatic artery replaced to the SMA

left hepatic artery replaced to the left gastric artery

trifurcation of the common hepatic artery

  • right hepatic artery
  • left hepatic artery
  • gastroduodenal artery (GDA)
31
Q

When is a patient tested for hepatic artery variation?

A

• Critical test done prior to any surgery to the liver

32
Q

Where is the porta hepatis?

A

At hilum of liver – visceral surface

33
Q

What is the porta hepatis?

A
  • Deep fissure – 5 cm
  • Entry / exit point for

hepatic portal vein

hepatic artery proper

common hepatic duct

nerves and lymphatics

34
Q

What happens to the porta hepatis once it enters the liver?

A
35
Q

Why is the liver divided into lobes and segments?

A
  • Metabolism – portal system
  • Production and secretion of bile

and to perform these roles the liver is divided into lobes and segments

36
Q

What are liver segements?

A

•Liver lobes are subdivided into segments (termed Couinaud) according to how the hepatic artery and portal vein subdivide

37
Q

What does a liver segement contain?

A
  • Branches of hepatic artery and portal vein carry blood into sinusoids
  • Tributaries of the bile ducts accompany the two above, but carrying bile in the opposite direction. All three structures are called portal triad
38
Q

Why is knowledge of liver segements important?

A

Knowledge as to how segments are vascularized is also crucial knowledge for liver transplants or surgery

39
Q
A
40
Q

What does a liver lobe contain?

A
  • Each lobe of liver contains several lobules (functional units of the liver)
  • Each hexagon (lobule) has a portal triad at each corner
41
Q

What are lobules?

A

• Hexagon shaped and contain hepatocytes

(~60% of the liver cell population)

42
Q

Complete the diagram of the lobule

A
43
Q

Hepatocytes are responsible for what metabolic functions?

A

•Synthesis and release plasma proteins into blood, e.g.

albumin

clotting factors

  • Deaminates amino acids, creating ammonia (this is then converted into urea in order to be safe)
  • Converting bilirubin to bile pigment
  • Production of bile salts, to emulsify fats
44
Q

How does venous drainage of the liver work?

A
  • The ‘mixed’ blood from the two sources (portal and hepatic) in the sinusoids passes through the hepatocytes and from there into the central vein
  • Several central veins then drain into the interlobular (sublobular) vein
  • Interlobular/sublobular veins then drain into hepatic veins
  • Finally, hepatic veins drain into the inferior vena cava
45
Q

Where is the central vein?

A

• The central vein is found at the center of a hepatic lobule

46
Q

Complete the diagram of venous drainage of the lobule

A
47
Q

Complete the diagram on venous drainage

A
48
Q

What is the difference between the portal venous system and the systemic venous system?

A
  • The portal venous system is described as blood draining the GI tract towards the liver
  • This is distinct from the systemic venous system, which drains the rest of the body, E.g. muscles or skin, towards the heart
49
Q

Where does portal vein blood come from?

A
50
Q

What is the significance of portal circulation for drugs?

A

•Toxins, drugs etc. that are absorbed from the GI have to pass through the liver before reaching the heart

51
Q

What is portocaval anastomosis?

A
  • Communications between some branches of the portal and systemic systems is crucial for survival
  • These are known as portocaval anastomosis
52
Q

When is portocaval anasomosis important?

A
  • This anastomosis is particularly important if the portal vein becomes blocked or passage via liver meets resistance – portal hypertension
  • Blood is therefore allowing to travel collateral to the liver on its return to the heart, without which subject would die
53
Q

Name 4 Examples of portal systemic anastomosis

A
54
Q

What is portal hypertension?

A
  • Is a fairly common clinical condition
  • Any obstruction to the portal vein
55
Q

What are common presentation signs of portal hypertension?

A

Varicoses

Caput medusa ; oesophageal varices

56
Q

What is a Portacaval shunt?

A
  • A shunt was traditionally employed to ameliorate hypertension
  • It effectively diverted blood from portal vein to the IVC
57
Q

What treatment replaced portacaval shunts?

A

• However this has largely been abandoned since the advent of TIPS (transjugular intrahepatic portosystemic shunting)

58
Q

What is the livers role in bile production?

A
  • Bile is secreted by hepatocytes into (bile) canaliculi, at a rate of around 40 ml/ hr
  • Bile canaliculi join to form two main hepatic ducts – Left and Right – that drain the respective lobes
  • Emerge from porta – unite to form common hepatic duct
59
Q

How does bile enter the duodenum?

A

• Although bile flows continuously towards the duodenum it is prevented entry by a closed sphincter of Oddi, located at the end of the biliary tree

60
Q

How is lymph drained from the liver?

A
  • Liver produces vast amount of lymph, that drain into the coeliac nodes located in the vicinity of porta hepatis
  • Coeliac nodes in turn drain to cisterna chyli
61
Q

What does this ultrasound show?

A

Liver trauma

62
Q

How does liver trauma occur?

A
  • Closely related to lower ribs
  • Fracture ribs / penetrating wounds
63
Q

Why is liver trauma so dangerous?

A

• High vascularisation => severe haemorrhage

64
Q

Why would a doctor remove portions of a liver?

A

• Remove portions due to segmental nature liver and vessels / ducts supplying it

liver biopsies

metastatic spread

cirrhosis

104 Theme 2 - Liver and Metabolism (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions