Hepatobiliary System Flashcards
Where is the liver suspended from?
IVC and diaphragm
bare area of liver
Adventitia.
Posterior, mostly R lobe.
Outlined by coronary ligament (reflected peritoneum).
NO PERITONEUM.
coronary ligament of liver
Serosa/viseral peritoneum.
Transitional from adventitia to mesothelium.
Surrounds bare area.
Reflected peritoneum.
mesentary
Double layer of peritoneum btwn body wall and organ.
Meso- prefix used.
Usually the posterior wall.
ligament
Double layer of peritoneum beetween organs or between an organ and the abdominal wall
omentum
Double layer of peritoneum between STOMACH and another organ
ventral mesentary
Liver develops within ventral mesentery.
Forms adult lesser omentum and falciform ligament
ligaments of lesser omentum
Hepatogastric ligament.
Hepatoduodenal ligament.
lesser sac
Opening: epiploic foramen (of Winslow).
Formed by lesser omentum.
Btwn stomach and liver.
portal triad
Portal vein.
Hepatic artery.
Common bile duct.
Within hepatoduodenal ligament.
hepatorenal recess
Potential site for collection of fluid.
Bounded by right kidney and liver.
Drains along right colic gutter into pelvis.
AKA Pouch of Morison
falciform ligament
From ventral mesentary.
Between ventral wall and the liver.
Lower free border = ligamentum teres
Separates R and L lobes of liver
ligamentum teres
Obliterated umbilical vein (carried blood from mother to fetus).
On lower free end of falciform ligament.
lobes of liver
Right.
Left.
Caudate.
Quadrate.
R and L separated ventrally by falciform ligament/ligamentum teres.
Posteriorly, L is separated from all others by umbilical fissure (ligamentum venosum, ligamentum teres hepatis)
umbilical fissure
Separates L lobe from Caudate, Quadrate lobes.
Consists of ligamentum venosum, ligamentum teres
blood supply to liver
75% venous flow via portal vein.
25% arterial flow via hepatic artery proper (divides into R/L hepatic aa) (from celiac trunk, common hepatic a)
L hepatic artery supplies
Left lobe.
Quadrate lobe.
1/2 caudate lobe.
R hepatic artery supplies
Right lobe.
1/2 Caudate lobe.
Gallbladder
functional lobes of liver
Separated by hepatic arteries, portal veins, bile ducts, hepatic veins.
8 segments
cause of hepatic cirrhosis
Alcohol abuse.
Hepatitis infection.
Autoimmune disease.
Industrial solvents.
presentation of cirrhosis
Hobnail appearance.
Splenomegaly (bc portal hypertension.
Ascites.
which hepatic cells play critical role in generating cirrhotic scar tissue?
Ito/stellate cells.
with portal hypertension (reduced portal blood flow), blood can be shunted _________
To systemic circulation, via: Esophageal v. Retroperitoneal v. Rectal v. Paraumbilical v.
esophageal varices
enlarged veins in esophagus.
Due to portal hypertension, blood needs to be shunted here away from liver.
More flow than it can handle.
Rupture can be fatal.
intestinal varices
Enlarged retroperitoneal veins.
Due to portal hypertension, blood needs to be shunted here away from liver.
More flow than it can handle.
anorectal varices
Enlarged rectal veins.
Due to portal hypertension, blood needs to be shunted here away from liver.
More flow than it can handle.
caput medusa
Dilation of periumbilical veins.
Due to portal hypertension, blood needs to be shunted here away from liver.
Characteristic of cirrhotic liver.
porto-systemic shunt
Treatment for cirrhotic liver failure.
Bypass function of the liver to get the blood back into systemic circulation without using anastomotic shunts that lead to varices.
bile duct system
Bile canaliculi –> terminal bile ductules –> hepatic ducts –> R/L hepatic duct –> common hepatic duct –> cystic duct
sympathetic input to hepatobiliary system
Greater splanchnic n, (T5-T9).
Synapse on celiac ganglion.
Periarterial plexus follows blood vessels to target.
parasympathetic input to hepatobiliary system
Vagus nerve (CN X).
stimulate bile production, glycogen synthesis (BUT hormones control most functions)
what surrounds the bare area of the liver?
Coronary ligament.
L triangular ligament.
R triangular ligament.
