Hulka Liver Flashcards
What are the 2 surfaces of the liver?
diaphragmatic
visceral
Describe the diaphragmatic surface of the liver.
This is the superior & posterior section of the liver. It includes the bare area of the liver. The IVC runs thru the bare area.
Describe the visceral surface of the liver.
This is the inferior portion of the liver.
H shaped fissures are found here that mark the porta hepatis
What is found in the port hepatis?
portal vein hepatic artery common bile duct lymphatic duct hepatic nerve plexus
T/F Each lobe of the liver has its own arterial, venous, & biliary system.
TRUE
T/F There are 3 lobes in the liver.
FALSE
There are only 2.
Right Lobe: to the right of the falciform ligament; Left lobe: to the left of the falciform ligament
BUT there are 2 smaller lobes that comprise the right lobe.
What are the 2 mini lobes that comprise the right lobe of the liver?
Quadrate Lobe
Caudate Lobe
**caudate is on top
What’s the deal w/ the falciform ligament?
develops from the umbilicus
it is attached to the anterior abdominal wall
becomes the coronary ligament in the bare area of the liver
divides the liver into L & R lobes
What is different about the falciform ligament before & after birth?
Before Birth: contains the umbilical vein
After Birth: umbilical vein becomes the ligamentum trees
What’s the deal w/ the coronary ligament?
it begins @ the superior aspect of the liver where the falciform ligament ends
surrounds the bare area of the liver
contains the left triangular ligament & right triangular ligament
What’s the deal w/ the hepatogastric ligament?
this begins @ the left triangular ligament & goes to the lesser curvature of the stomach
it is a part of the lesser omentum
What runs thru the hepatogastric ligament?
left & right gastric arteries & veins
gastric lymphatics
What’s the deal w/ the hepatoduodenal ligament?
begins @ the caudate lobe
terminates @ the C loop of the duodenum
a part of the lesser omentum
What runs thru the hepatoduodenal ligament?
peripancreatic lymphatics
Which 2 ligaments does the lesser omentum contain?
hepatogastric
hepatoduodenal
What runs thru/along the lesser omentum?
portal triad
Describe the dual blood supply of the liver.
Hepatic Artery (responsible for 30%) Portal Vein (responsible for 70%)
Where does the hepatic artery for the liver come from?
It comes from the common hepatic artery that was a branch off the celiac trunk.
The common hepatic branches into the gastroduodenal & right gastroepiploic branches
After it gives off these branches it is considered the proper hepatic artery
What does the proper hepatic artery branch into?
left & right hepatic arteries
Describe 2 weird variation of the liver arterial blood supply.
Replaced Left Hepatic:
10% of people will have their left hepatic arteries coming off of the left gastric artery
Replaced Right Hepatic:
1-2% of people will have their right hepatic arteries coming directly off of the SMA
Where does the portal vein run? What does it divide into? What empties into it?
It runs behind the bile duct & proper hepatic artery
It divides into R & L portal veins
**SMV, IMV, & Splenic Veins all empty into it.
Describe the venous drainage for the superior aspect of the liver.
there are 3 superior hepatic veins that drain the liver.
Right Vein–>Right Lobe (Quadrate?)
Middle Vein–>Caudate Lobe
Left Vein–>Left Lobe
Describe the venous drainage for the inferior aspect of the liver.
this is the posterior inferior portion of the liver
drains into the IVC
6-18 branches drain the different portion of the liver
T/F During a liver transplant the surgeon makes sure to leave the IVC w/ the donor.
False. They take the IVC w/ it to assure proper venous drainage.
Where does the lymph from the superior & anterior portions of the liver drain?
parasternal lymph nodes
Where does the lymph from the inferior portions of the liver drain?
hepatic lymph nodes (found in porta hepatis) & gastric lymph nodes (found in lesser omentum)
What do the right & left hepatic ducts form?
the common hepatic duct @ the superior portion of the porta hepatis
Once the cystic duct drains into the common hepatic duct–>what does it become?
the common bile duct
Once the pancreatic duct drains into the common bile duct what does it become known as?
ampulla of Vater, has the sphincter of Oddi
What are the symptoms of choledocolithiasis?
pain, jaundice, nausea, vomiting
How do you evaluate if you have choledocolithiasis?
endoscopic retrograde cholangiopancreatogram
What hormone stimulates the gallbladder to empty?
CCK
What is the arterial supply to the gallbladder?
cystic artery–>from the right hepatic artery
What is the venous drainage of the gallbladder?
it drains into the portal vein or liver directly
Describe the lymphatic drainage of the gallbladder.
the cystic lymph node drains into the hepatic lymph node, which drains into the celiac lymph nodes.
Where is the cystic lymph node located?
it is found @ the confluence of the cystic & common hepatic duct
If you have gallstones lodging in the cystic duct…where will you feel pain?
right upper quadrant
The superior mesenteric vessels cross the pancreas at which portion?
the neck of the pancreas
Embryologically, the pancreas forms as 2 different buds. What are they & what do they form?
Dorsal Bud: becomes the main gland
Ventral Bud: forms the uncinate process (head of the pancreas)
Explain the blood supply to the head of the pancreas.
Celiac: Common Hepatic Artery Gastroduodenal Artery **Superior Pancreaticoduodenal arteries SMA: **Inferior Pancreaticoduodenal arteries
Explain the blood supply to the neck, body & tail of the pancreas.
Celiac:
Splenic Artery
**Dorsal Pancreatic Artery
Where does most of the pancreas drain?
**most of it drains into the splenic vein
What are the 3 lymph nodes that drain the pancreas?
pancreaticosplenic
pyloric
celiac
What attaches the spleen to the stomach?
gastrolineal ligament
What attaches the spleen to the left kidney?
lienorenal ligament
Explain the division of the spleen.
Divided into 2 poles, superior & inferior by the central portion w/ blood vessels
Explain the arterial blood supply of the spleen.
Celiac:
Splenic Artery
3-5 branches @ hilum (all end arteries)
Explain the venous drainage of the spleen.
smaller veins drain into the splenic vein
this unites w/ the SMV–>Portal Vein
