Anatomy of the liver

Question 1

Where is the location of the liver?

Answer 1

The liver is located in the upper right quadrant (URQ) of the abdomen.

Question 2

What are the surface markings of the liver?

Answer 2

The surface markings of the liver are the right ribs 7-11 in the mid-axillary line (MAL).

Question 3

In which regions of the abdomen can the liver be found?

Answer 3

The liver is present in the right hypochondrium, epigastrium, and left hypochondrium regions of the abdomen.

Question 4

What is the superior relationship of the liver?

Answer 4

The liver is in contact with the diaphragm in its superior aspect.

Question 5

What are the lateral relationships of the liver?

Answer 5

The liver is in contact with both the diaphragm and the thoracic wall laterally.

Question 6

What is the medial relationship of the liver?

Answer 6

The liver is adjacent to the stomach medially.

Question 7

What are the posterior relationships of the liver?

Answer 7

The liver is in proximity to the inferior vena cava (IVC), abdominal aorta, and the right kidney posteriorly.

Question 8

What is the inferior relationship of the liver?

Answer 8

The liver is located above the duodenum in its inferior aspect.

Question 9

What is the subphrenic recess?

Answer 9

The subphrenic recess is a superior extension of the greater sac located beneath the diaphragm.

Question 10

What is the hepatorenal recess?

Answer 10

The hepatorenal recess is a posterosuperior extension of the subhepatic space, which is situated between the liver and the right kidney.

Question 11

What is the subhepatic recess?

Answer 11

The subhepatic recess is the supracolic compartment of the greater sac located below the liver.

Question 12

What is the diaphragmatic surface of the liver characterized by?

Answer 12

The diaphragmatic surface of the liver is smooth and domed in shape.

Question 13

What is the visceral surface of the liver characterized by?

Answer 13

The visceral surface of the liver exhibits fissures and visceral impressions. Please note that these features may be more apparent in formalin-fixed specimens.

Question 14

What are the fissures of the liver and their associated structures?

Answer 14

The fissures of the liver include the right sagittal fissure (which contains the groove for the inferior vena cava and the gallbladder fossa), the left (umbilical) sagittal fissure (which contains the ligamentum teres hepatis and the ligamentum venosum), and the porta hepatis (transverse fissure) where structures enter and exit the liver.

Question 15

What are the lobes of the liver?

Answer 15

The liver is composed of four lobes: the right lobe, left lobe, quadrate lobe, and caudate lobe.

Question 16

What are the accessory lobes of the liver?

Answer 16

Accessory lobes are functionally part of the left lobe but anatomically part of the right lobe.

Question 17

What is the bare area of the liver?

Answer 17

The bare area refers to the portion of the diaphragmatic surface of the liver that is not covered by visceral peritoneum. It contains a groove for the inferior vena cava.

Question 18

What structures make up the portal triad?

Answer 18

The portal triad consists of the hepatic artery proper, the portal vein, and the common bile duct.

Question 19

What is the apex of the liver?

Answer 19

The apex of the liver refers to the left extremity of the organ.

Question 20

Name some peritoneal folds and ligaments associated with the liver.

Answer 20

The peritoneal folds and ligaments include the falciform ligament and ligamentum teres hepatis, coronary ligaments, triangular ligaments, and lesser omentum.

Question 21

What is the function of the falciform ligament?

Answer 21

The falciform ligament is a fold of the peritoneum that attaches the liver to the front abdominal wall. It provides structural support, divides the abdominal cavity, and contains blood vessels important for liver function.

Question 22

What are the components of the coronary ligaments?

Answer 22

The coronary ligaments consist of an anterior and posterior lamina, connecting the inferior diaphragmatic surface to the diaphragmatic surface of the liver.

Question 23

What are the triangular ligaments of the liver?

Answer 23

The liver has two triangular ligaments, one on the right and one on the left side, connecting the inferior diaphragmatic surface to the diaphragmatic surface of the liver.

Question 24

What are the two parts of the lesser omentum?

Answer 24

The lesser omentum consists of two parts: the hepatogastric ligament, which connects the liver to the stomach, and the hepatoduodenal ligament, which connects the liver to the duodenum.

Question 25

What is the main arterial blood supply to the liver?

Answer 25

The main arterial blood supply to the liver is through the Hepatic artery proper, which accounts for approximately 20-25% of the total blood supply.

Question 26

From which artery does the Hepatic artery proper arise?

Answer 26

The Hepatic artery proper arises from the coeliac artery, which is located at the level of T12 and branches off from the abdominal aorta.

Question 27

What are the branches of the coeliac artery that contribute to the blood supply of the liver?

Answer 27

The coeliac artery gives rise to several branches that contribute to the blood supply of the liver, including the left gastric artery, splenic artery, common hepatic artery, gastroduodenal artery, right gastric artery, and the Hepatic artery proper itself.

Question 28

Are there any specific branches of the Hepatic artery proper that supply different areas of the liver?

Answer 28

Yes, the Hepatic artery proper further branches into the right hepatic artery and left hepatic artery, which supply the respective right and left lobes of the liver.

Question 29

What is the main venous blood supply to the liver?

Answer 29

The main venous blood supply to the liver is through the portal vein, which accounts for approximately 75-80% of the total blood supply.

Question 30

What are the tributaries that contribute to the portal vein?

Answer 30

The tributaries of the portal vein include the left gastric vein, splenic vein, inferior mesenteric vein, and superior mesenteric vein.

Question 31

: What are the hepatic veins responsible for venous drainage from the liver?

Answer 31

The venous drainage from the liver is accomplished by the right hepatic vein, intermediate/middle hepatic vein, and left hepatic vein, which drain directly into the inferior vena cava (IVC).

Question 32

What are the two types of lymphatic drainage from the liver?

Answer 32

: The lymphatic drainage of the liver includes superficial capsular drainage and deep connective tissue drainage.

Question 33

How does the anterior aspect of the liver drain lymphatically?

Answer 33

The anterior aspects of the liver drain to the hepatic nodes, then to the coeliac nodes, and ultimately to the cisterna chyli.

Question 34

How does the posterior aspect of the liver drain lymphatically?

Answer 34

The posterior aspects of the liver drain to the phrenic nodes, then to the posterior mediastinal nodes, and finally to either the right lymphatic duct or the thoracic duct.

Question 35

What are the components of the hepatic plexus innervating the liver?

Answer 35

The hepatic plexus provides innervation to the liver. It consists of sensory fibers from intercostal nerves T6-9, sympathetic fibers from the greater splanchnic nerves (T5-9) and lesser splanchnic nerves (T10-11), and parasympathetic fibers from the vagus nerve (CN X).

Question 36

What are the dermatomes associated with referred hepatic pain?

Answer 36

Referred hepatic pain is commonly experienced in dermatomes T6-9, which include the epigastrium and right hypochondrium. It can also refer to dermatomes C3-5, involving the shoulder and neck region.

Question 37

What are the three sites of porto-systemic anastomoses?

Answer 37

The three sites of porto-systemic anastomoses are the gastro-esophageal junction, peri-umbilical region, and the anal canal.

Question 38

What is the specific anastomosis that occurs at the gastro-esophageal junction?

Answer 38

At the gastro-esophageal junction, anastomosis occurs between the left gastric vein and tributaries of the azygos vein, resulting in the formation of esophageal varices.

Question 39

What is the anastomosis that occurs in the peri-umbilical region?

Answer 39

In the peri-umbilical region, anastomosis occurs between the para-umbilical veins and the superficial abdominal wall veins, giving rise to the characteristic “Caput Medusae” appearance.

Question 40

What is the anastomosis that occurs in the anal canal?

Answer 40

In the anal canal, anastomosis occurs between the superior rectal vein and the middle/inferior rectal veins, which can be clinically significant in the development of internal hemorrhoids.

Question 41

How many functional divisions are there in the liver?

Answer 41

he liver has four functional divisions.

Question 42

How many surgically resectable hepatic segments are there?

Answer 42

The liver has eight surgically resectable hepatic segments.

Question 43

What are the independent branches of the portal triad associated with the divisions and hepatic segments?

Answer 43

The divisions and hepatic segments of the liver are determined based on the independent branches of the portal triad.

Question 44

What is one of the functional roles of the liver?

Answer 44

One of the functional roles of the liver is glycogen storage. The liver stores glycogen, a form of glucose, for energy regulation and maintenance of blood sugar levels.

Question 45

What is another important function of the liver?

Answer 45

The liver is responsible for bile synthesis. It synthesizes bile, a substance that aids in the digestion and absorption of dietary fats.