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1 GI and liver > anatomy of the liver and gallbladder > Flashcards

anatomy of the liver and gallbladder Flashcards

1
Q

where is the liver?

A

right hypochondrium &epigastricareas

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2
Q

what are its 2 external surfaces?

A
  1. diaphragmatic (anterior superior)

2. visceral (posteroinferioro)

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3
Q

is the liver intra or retroperitoneal?

A

infraperitoneal

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4
Q

is the liver covered in peritoneum?

A

yes except for the ‘bare area’ on posterior surface which has direct contact with diaphragm

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5
Q

what are ligaments of the liver made of?

A

double layer of peritoneum

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6
Q

which ligament attaches the anterior surface of the liver to the anterior abdominal wall?

A

the falciform ligament

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7
Q

describe the shape of the falciform ligament?

A

sickle shaped

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8
Q

what ligament is contained within the free edge of the falciform ligament?

A

the ligamentum teres (a remnant of the umbilical vein)

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9
Q

which ligament attaches the superior surface of the liver to theinferior surface of thediaphragm ? and demarcates the bare area of the liver?

A

coronary ligament

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10
Q

what is the coronary ligament made of?

A
  • has an anterior and posterior fold
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11
Q

how are the left and right triangular ligaments formed?

A

by the union of the anterior and posterior folds of the coronary ligament

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12
Q

what attachments do the left and right triangular ligaments make?

A

Right attaches right liver lobe to Diaghragm, left attaches left lobe to diaphragm

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13
Q

what structure connects the liver to the lesser curvature of the stomach and 1st part of duodenum?

A

the lesser omentum

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14
Q

what 2 ligaments are contained within the lesser omentum?

A

the hepatoduodenal

the hepatogastric

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15
Q

which ligament surrounds the portal triad?

A

the hepatoduodenal (within lesser omentum)

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16
Q

where is the liver divided anatomically into the 2 main lobes?

A

by the falciform ligament

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17
Q

where is the liver divided functionally into 2 lobes?

functionally - meaning if you removed one half, the other won’t be affected

A

down gallbladder and IVC

  • this means both sides have their own single portal branch, a single hepatic artery branch and a single hepatic duct tributary.
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18
Q

how many independent functional segments are there in the liver?

A

8

19
Q

what are the 4 lobes of the liver?

A

right
left
caudate
quadrate

20
Q

where do the 2 accessory lobes arise from?

A

caudate and quadrate arise from right main lobe on visceral surface

21
Q

where exactly is the caudate lobe?

A
  1. on upper visceral surface
  2. It lies between the inferior vena cava and a fossa produced by the ligamentum venosum (a remnant of the fetal ductus venosus).
22
Q

where exactly is the quadrate lobe?

A
  1. on the lower aspect of the visceral surface.

2. It lies between the gallbladder and a fossa produced by the ligamentum teres

23
Q

what is the porta hepatis?

A

where all the neurovascular structures (except hepatic veins) enter/exit the liver

it is a deep transverse fissure that separates the quadrate and caudate lobes (on inferior surface)

24
Q

what are the hepatic arteries branches from?

A

aorta -> coeliac axis -> the common hepatic -> hepatic arteries

25
Q

where does the portal vein drain into?

A

drains the whole bowel

drains into the liver

26
Q

briefly outline the pathway of bile from liver to gallbladder

A

secreted by liver -> collecting ducts -> hepatic ducts -> common hepatic duct -> cystic duct -> stored in gallbladder

27
Q

briefly outline the pathway of bile from gallbladder to duodenum

A

released from gallbladder -> cystic duct -> common bile duct -> ampulla of vater (once pancreatic duct joins) -> into the duodenum via major duodenal papilla

28
Q

why is the blood supply to the liver unique?

A

its a dual blood supply from proper hepatic artery (25%) and hepatic portal vein (75%)

29
Q

describe the role of the portal vein

A

supplies majority of blood to liver by draining the bowels

blood is partially deoxygenated but high in nutrients

30
Q

describe the venous drainage of the liver

A

via the hepatic veins into IVC

31
Q

describe the sympathetic innervation of the liver

A

the celiac plexus (part of hepatic plexus)

32
Q

describe the parasympathetic innervation of the liver

A

vagus nerve (part of hepatic plexus)

33
Q

what is glissons capsule?

A

the fibrous covering of the liver

34
Q

what is the innervation of the glissons capsule?

A

lower intercostal nerves - well localised pain

35
Q

what are the structural units of the liver?

A

lobules or acini (same concept but different way of displaying)

36
Q

what are each of the lobules of the liver made of?

A
  • hexagonal plates of hepatocytes
  • portal triads at each of the vertices
  • a central vein
37
Q

where does the central vein of a lobule drain?

A

central vein -> interlobular vein -> hepatic vein -> IVC

38
Q

what are the 3 main structures in a portal triad?

A
  1. arteriole ( branch off hepatic artery)
  2. venule (branch off portal; vein)
  3. bile duct
39
Q

what 2 other structures run alongside the portal triads??

A

lymphatic vessels andvagus parasympathetic fibres

40
Q

how is blood transported from portal triads (hepatic artery and portal vein) on the vertices into the central vein?

A

via sinusoids

  • low pressure vascular channels
  • mix the blood from hepatic arteries and portal veins
41
Q

describe the structure of ancinus

A
  • an acinus encompasses the liver tissue that is served by a single terminal branch of the hepatic artery.
  • diamond-shaped in cross section, with a hepatic arteriole crossing the center and with central veins at the two opposite corners.
42
Q

make 3 direct comparisons between a lobule and acinus

  • shape
  • location of central vein
  • location of portal triad branches
A

hexagonal/diamond

1 in centre/2 on face corners

on all 6 corners/on the 2 short corners

43
Q

histology of sinusoids: how are they separated from hepatocytes?

A

by the space of disse

44
Q

histology of sinusoids: what specialised cells do they consist of?

A

endothelial and kupffer cells

1 GI and liver (6 decks)

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