Anatomy Of The Liver Flashcards
Functions of the liver?
Synthesis of bile
Glycogen storage
Clotting factor production
Where is the liver?
In the peritoneum
Upper right quadrant of abdomen
What structures are around the liver?
Anteriorly - anterior abdominal wall and ribcage
Superiorly - diaphragm
Posteriorly - oesophagus, stomach, gallbladder, duodenum (foregut derivatives)
Features of the diaphragmatic surface of the liver
Anteriosuperior surface
Smooth and convex
Part of this is the bare area (not covered by peritoneum)
Features of the visceral surface
Posterioinferior
Moulded by shape of surrounding organs so is irregular and flat
What does the visceral surface come into contact with?
Oesophagus Right kidney and adrenal gland Right colic flexure Duodenum Gallbladder Stomach
What does the free edge of the falciform ligament contain?
Ligamentum teres (from umbilical vein)
What are the ligaments of the liver?
Falciform
Coronary ligaments (left and right)
Lesser omentum
What do the coronary ligaments connect the liver to?
Diaphragm
What does the lesser omentum connect the liver to?
Hepatoduodenal ligament
- duodenum
Hepatogastric ligament
- stomach
What is the posterior surface of the liver attached to and by what?
Inferior vena cava
Hepatic veins and fibrous tissue
Clinical relevance of the hepatic recesses?
Infected fluids can collect here and form abscesses
Name the hepatic recesses
Left and right subphrenic spaces
Subhepatic space
Morrison’s pouch
Where are the subphrenic spaces?
Between the diaphragm and liver, either side of the falciform ligament
Where is the subhepatic space?
Between the inferior surface and transverse colon
Where is Morrison’s pouch?
Posteriosuperior aspect of right subhepatic space between visceral surface of liver and right kidney.
Place where fluid is likely to collect in a bed ridden patient.
What is the liver covered by?
A fibrous layer called Glisson’s capsule
What divides the liver into four lobes?
Ligaments and surface depressions
What is the right and left lobe of the liver divided by?
The falciform ligament
Where is the caudate lobe?
On the upper aspect of the visceral surface
Lies between the IVC and fossa produced by the ligamentum venosum
Where is the quadrate lobe?
Lower aspect of the viral surface
Lies between gall bladder and fossa produced by ligamentum teres
Where is the porta hepatis and what is it?
Between the caudate and quadrate
It is a deep fissure
Transmits all nerves, vessels and ducts to and from the liver
Arterial supply to the liver?
Foregut organ so from the coeliac trunk
Coeliac trunk - hepatic artery - hepatic artery proper
What is the dominant blood supply to the liver parenchyma?
Hepatic portal vein
Carriers deoxygenated blood from the small intestine to the liber parenchyma
Venous drainage of the liver?
Right, intermediate and left hepatic veins
Formed by union of collecting veins that drain the central veins of hepatic parenchyma
Drain into IVC just inferior to diaphragm
Nerve supply of the liver?
Parenchyma - hepatic plexus which contains
- sympathetic innervation from coeliac plexus
- parasympathetic innervation from vagus nerve
Follows course of hepatic artery and portal vein
What is Glisson’s capsule innervated by and what is it sensitive to?
Branches of the lower intercostal nerves
Distension of the capsule - causes sharp, localised pain
Lymphatic drainage of the liver?
Hepatic lymph nodes
Lie along hepatic vessels and ducts in the lesser omentum
Empty into coeliac lymph nodes
How can the liver be located from surface anatomy?
Lies deep to ribs 7-11
Inferior to nipples
