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Anatomy - abdominal aorta > Anatomy of the liver > Flashcards

Anatomy of the liver Flashcards

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1
Q

Approx weight of liver

A

1.4-1.6kg weight

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2
Q

Location of liver

A

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

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3
Q

Main functions of the liver

A
  • Detoxification
  • Protein synthesis
  • Production of bile - accessory GI organ
  • Glycogen storage
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4
Q

Relations of the liver

A
  • Below diaphragm
  • Right wrt stomach
  • Above the colon
  • Overlies gallbladder
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5
Q

Position of liver in relation to ribs

A

The liver extends from the 5th rib to the bottom of the rib cage

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6
Q

Describe anterior view of liver

A

Right and left lobes separated by falciform ligament with ligamentum teres

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7
Q

Describe posterior view of liver

A
  • Caudate lobe superior to the quadrate lobe

- Gastric impression on the left lobe and renal impression on the right lobe

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8
Q

What is the porta hepatis

A

Is a deep 5cm fissure in the interior surface of the liver through which all of the neruovascular structures (except hepatic veins) and hepatic ducts enter or leave the liver

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9
Q

Location of the porta hepatis….

A

Porta hepatis is located beneath the left portion of the right lobe of the liver, nearer to its posterior surface than its anterior border

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10
Q

What does the porta hepatis divide

A

The quadrate and caudate lobes

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11
Q

What is the bare area?

A

Area on the upper part of the right lobe where it is not covered by peritoneum as it connects with diaphragm 5hhm

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12
Q

Which ligaments separate the right and left lobes?

A

Falciform (ant) and lesser omentum (post) ligaments

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13
Q

Falciform ligament

A
  • Links diaphragm to upper surface liver

- Ligamentum teres(aka round ligament) at lower end

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14
Q

Round ligament

A

Obliterated left umbilical vein extends to umbilicus

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15
Q

Coronary ligaments

A

Link diaphragm to liver

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16
Q

Lesser omentum

A

Links liver to stomach

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17
Q

What are the peritoneal folds?..

A
  • Falciform ligament
  • Lesser omentum
  • Round ligament
  • Coronary ligaments
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18
Q

What is the lesser omentum?

A
  • From lesser curvature stomach to porta hepatis
  • Has a free margin (ventral mesentery)
  • Close to the stomach
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19
Q

What does the lesser omentum enclose?

A

Hepatic artery, portal vein, bile duct, lymph vessels and gastric arteries and veins

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20
Q

Blood supply to gut

A

Foregut - coeliac artery/trunk
Midgut - SMA
Hindgut - IMA

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21
Q

Blood supply to liver

A

Coeliac artery - left gastric, splenic and hepatic

22
Q

Level of coeliac artery

A

T12/L1 level

23
Q

What does the coeliac artery also supply?

A

Duodenum and pancreas

24
Q

In what % of people are hepatic artery variations seen?

A

40-45%

25
Q

What are the most common cases of hepatic artery variations?

A
  • Right hepatic artery replaced to the SMA
  • Left hepatic artery replaced to the left gastric artery
  • Trifurcation of the common hepatic artery into right hepatic, left hepatic and gastroduodenal artery
26
Q

What are the normal branches of the hepatic artery?

A
  • Right gastric artery
  • Gastroduodenal artery
  • Hepatic artery proper
27
Q

What is porta hepatis the entry/exit point for?

A
  • Hepatic artery proper
  • Hepatic portal vein
  • Common hepatic duct
  • Nerves and lymphatics
28
Q

What are liver anatomic lobes subdivided into?

A

Couinaud segments

29
Q

What do the branches of hepatic artery and portal vein carry blood into?

A

Sinusoids

30
Q

What are sinusoids?

A

Small blood vessels

31
Q

What structures form the portal triad?

A

Bile duct branch, hepatic artery and portal vein

32
Q

What are liver lobules?

A

Hexagon shaped functional units of the liver which contain hepatocytes (60% liver cells)

33
Q

What do hepatocytes secrete?

A

Hepatocytes secrete bile

34
Q

Where are portal triads located in the liver?

A

At the corners

35
Q

Functions of hepatocytes

A
  • Synthesis and release of plasma proteins into blood (albumin)
  • Deaminates amino acids (release of urea into blood)
  • Bilirubin to bile pigment
  • Bile salts for emulsification of fats
36
Q

Where is the central vein found

A

center of a hepatic lobule

37
Q

Describe the drainage from central veins

A

Central veins drain into the sublobular vein which then drains into hepatic veins

38
Q

What drains into the central vein?

A

Mixed blood from the two sources (portal and hepatic) in the sinusoids passes through the hepatocytes and into the central vein

39
Q

What do the hepatic veins ultimately drain into?

A

IVC

40
Q

What are portal systemic anastomosis and why are they important?

A
  • Communications between some branches of the portal and systemic systems (portocaval anastomosis)
  • Very important if portal vein blocked or passage via liver meets resistance - portal hypertension
  • Allows collateral return of blood to heart
41
Q

Give 4 examples of portal systemic anastomosis

A
  • Abdominal part of oesophagus - left gastric tributaries* with oesophageal branches azygos
  • Anal canal - Superior rectal* anastomoses with middle and inferior rectal
  • Umbilicus - Paraumbilical veins* with epigastric veins
  • Veins of colon, duodenum, pancreas, liver* with renal, lumbar and phrenic
  • portal
42
Q

What is portal hypertension?

A

obstruction of portal vein which causes an increase in pressure(hypertension)

43
Q

Signs of portal hypertension

A

Varicoses and caput medusa

44
Q

What is the portacaval shunt?

A

Reduction of hypertension via diversion of blood from portal to systemic

Blood diverted from portal to IVC

45
Q

What percentage of blood does the portal vein convey to the liver?

A

70%

46
Q

Why has the portacaval shunt been abandoned?

A

Advent of TIPS(transjugular intrahepatic portosystemic shunting)

47
Q

Where is bile secreted into by the canaliculi?

A

Bile canaliculi

48
Q

How much bile is secreted per hour?

A

40 ml/hr

49
Q

What do the left and right hepatic ducts merge to form?

A

common hepatic duct

50
Q

Describe the biliary tree

A
  • Common hepatic duct joins with the cystic duct to form the common bile duct
  • Common bile duct joins with the pancreatic duct hepatopancreatic ampulla of vater
51
Q

Lymph drainage of the liver

A

Lymph nodes in porta hepatis passes to coeliac nodes which then drain to cisterna chyli

Anatomy - abdominal aorta (10 decks)

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