Case 8: Liver and Biliary System Flashcards
How much blood does the liver receive per minute?
1.5L
wHAT ARE THE 2 MAJOR SURFACES OF THE LIVER
Diaphragmatic and visceral surfaces
What are the 4 surfaces of the diaphragmatic surface of he liver?
Anterior, posterior, left and right
The inferior border of the liver is comprised `of the joining of which 2 surfaces?
Anterior and visceral surfaces
what is the superior relation of the anterior surface of the liver?
Diaphragm
What is able the superior surface of the liver?
Pleura, pericardium and lungs (plus diaphragm)
What are the anatomical landmarks of the right surface of the liver?
Ribs 7-11
What comprises each of the 3 compartments of the visceral surface of the liver?
Laterally = colic area and left lobe Middle = caudate and quadrate lobes
What separates the caudate and quadrate lobes from the right lobe?
Gall bladder plus IVC
What separates the caudate and quadrate lobes from the left lobe?
Ligamentum venosum and falciform ligament
What separates the caudate and quadrate lobes?
Porta hepatis
Where is the flalciform ligament of the liver located?
centre of the liver, left of the fungus of the gallbladder
What is the left triangular ligament?
An extension of the falciform ligament as it continues to the left
What is the upper border of the coronal ligament?
The extension of the falciform ligament as ti sweeps to the right
The couinard segments are the ____ segments of the lie
Functional segments
what determines each couinard segment?
The venous and biliary drainage
Are the caudate and quadrate lobes part of the left or right lobe of the liver?
Left
The quadrate lobe is locate between which 2 structures?
Falciform ligament and the gall bladder
The caudate lobe is located between which 2 structures?
IVC and ligmaentum venosum
What is the origin of the common hepatic artery?
Coeliac trunk
What are the branches o fit ecommon hepatic artery?
Gastroduodenal, RIght hepatic, left heptic
what are the bifurcation o the richt hepatic artery?
Anterior and posterior branches of the right hepatic artery
Where does the right hepatic artery run?
Posterior t the hepatic bile duct
What veins form the hepatic portal vein?
SMV ad Splenic veins
What 3 structures form the portal canal?
Portal vein, hepatic artery and tributaries to he bible ducts
Where does lymph from the liver drain?
To 3 or 4 nodes around the portal hepatis
What are the contents of the portal hepatic?
Hepatic bile duct, Hepatic artery ad portal vein
What is the arrangement of the hepatic lobule?
Central vein in the centre, with 6 portal triads at each point of a hexagon
Where does bile originate and where does it run?
Synthesised by the hepatocytes, it runs away from the central vein and towards the portal triad
Wha are the hepatic sinusoids
Grooves between the cords of hepatocytes, lined ty fenestrate endothelium
What is special about hepatic endothelium?
Contains kupffer cells and fenestrations
Outline the bile pathway through the liver
Made by hepatocytes }-> collected in the canaliculi }-> along the portal canals in the bile duct tributaries ]-> then to the right and left heatic ducts, emerging at porta hepatis }-> joining of right and left hepatic ducts form the common hepatic duct
What is the function of the gallbladder?
Stores and concentrates the bile secreted by the liver
What is the shape of the gallbladder?
globular and pear shaped with a fundus, body and neck
The ___ artery, which originates from the ____ ____ artery, supplies the gallbladder
The cystic artery, which originates from the right hepatic artery, supplies the gallbladder
The boundaries of Calot’s triangle are as follows:
Visceral surface of the liver, common hepatic duct and cystic duct
why is the cystic artery of clinical importance?
it must be ligated prior to cholecysctomy
Name the 3 parts of the common bile duct and their relations
Supraduodenal: lies on the free edge of the lesser omentum
Retroduodenal: posterior to the first part of the duodenum
Pancreatic: feeds into the duodenum and is joined by the pancreatic duct
What is the hepatopancreatic ampulla?
A swelling in the common bile duct just after it has joined the pancreatic duct
what is the sphincter of Oddi?
A ring of smooth muscle on the common bile just proximal to the hepatopancreatic ampulla. It is therefore located just before the common bile duct and the pancreatic duct join
What are the spiral valves of the cystic duct?
The muscular arrangement of the cystic duct to maintain patency and allow for bile motiliy
where is the gall bladder located?
Gall bladder fossa
What is thesurace anatomy of the gall bladder’s funds?
MCL, 9th costal cartilage