Lecture 14 (Part A): Liver and Biliary system Flashcards
Whats the diverse function of the liver?
- Detoxification - CHO and glucose regulation - Bile drainage - Blood circulation and filtration - Synthesis and storage of acids/proteins/fats and vitamins. Endocrine/exocrine function
What is the dual blood supply of the liver?
1/4 Hepatic artery 3/4 Portal vein
Describe the location of the liver using surface anatomy;
- R hypochondrium into epigastric region - Sup. boundary Ribs 5/6 level - Gall bladder = 9th costal cartilage level mid clavicular line - Post. surface = Oesophagus, stomach, duodenum, R. colic flecture, R. kidney, suprarenal gland, gall bladder.
What is the legimentum teres (liver) a remnant of?
Umbilical vein
Whats the bare area of the liver?
No peritoneum
What are the lobes present on the posterior surface?
Left lobe Right lobe Caudate lobe (sup) Quadrate lobe (inf)
What attaches to the porta hepatis?
Free edge of lesser omentum attaches here and carries structures with it
Describe the structures found in the porta hepatis;
Artery; Ant. and LHS Bile duct; Ant. and RHS Portal vein; Posterior (inbetween)
Describe the portal vein;
Largest in porta hepatis - Divides in liver into R and L portal vein
Describe the common hepatic duct;
Splits into R and L hepatic duct in liver
Describe the proper hepatic artery;
Splits into R and L hepatic artery
Are there hepatic veins coming from the liver?
No. Theres direct drainage into the IVC.
Describe the peritoneum of the liver;
The liver is covered in visceral peritoeum except; - Fossa of gall bladder - Area attached to diaphragm (bare area) Peritoneum folds back on itself to form the falciform and R+L triangular ligaments
What are the ligaments of the liver?
- R+L triangular ligaments - Anterior/posterior coronary ligament - Falciform ligament -> Ligamentum teres
Describe the the blood passing to the liver;
25% Hepatic art. proper = Oxygenated 75% Portal vein = Nutrient rich
Describe the blood flow within the liver;
Arterial and venous blood are conducted to central vein of each liver lobule by sinusoids
Where do the veins drain to?
Central veins drain to R, L and central hepatic veins. Then directly into the IVC.
What generates the physiological lobes?
Each physiological lobe gets its own branch of the portal triad. This means each lobe can preserve function
Is there arterial/venous communication between the right and left halves of the liver?
No arterial communication between left and right halves of liver
How much does the liver contribute to lymph?
1/3-1/2 of total body lymph comes from the liver
Where does liver lymph go to?
Nodes at porta hepatis to coeliac nodes @ T12.
Whats the neural supply to the liver?
Visceral supply from celiac plexus - Parasymp via Vagus - Symp via greater splenic nerve (T5-9)
Where is liver pain referred to?
Referred to epigastric region (Small amount via diaphragm to right shoulder/chest)
Describe the gross morphology of the gall bladder;
Fundus hangs below the liver Body contacts visceral surface of the liver Neck joins the cystic duct
