Lesson 4A Flashcards
What do the couinaud segmental anatomy do? (2)
- Provides the basis for surgical resections
2. Diagnostic designation of lesions on US and CT
What is couinaud segmental anatomy based on?
Venous anatomy
What divides the couinaud segmental anatomy in the liver? (2)
- Both the hepatic veins
2. Portal vein
Why can each segment in the liver be resected without damage?
Because they are based on their blood supply
- each segment has its own porta hepatis
What is in the centre of each segment in the liver? (3)
A branch that consists of…
- Portal vein
- Hepatic artery
- Hepatic duct
What is in the periphery of each branch segment?
Vascular flow through the hepatic veins
How many segments are there in the couinaud segmental anatomy?
8
What is in segment 1 of the couinaud segmental anatomy?
Caudate lobe
Where is segments 2 and 3 of the couinaud segmental anatomy?
Left lateral lobe
Where is segment 4 on the couinaud segmental anatomy?
Medial left lobe
- divides into 4a (superiorly) and 4b (inferiorly)
Where is segment 5 and 8 of the couinaud segmental anatomy?
Right anterior lobe
Where is segment 6 and 7 on the couinaud segmental anatomy?
Right posterior lobe
What veins divide the segments 4a and 2 on the couinaud segmental anatomy?
Left hepatic vein
What veins divide the segments 7 and 8 on the couinaud segmental anatomy?
Right hepatic vein
What veins divide the left and right lobe of the liver?
Middle hepatic vein
What do the portal veins divide?
The upper (superior) and lower (inferior) portions
What does the right hepatic vein divide?
The right lobe into anterior and posterior sections
What plane does the middle hepatic veins run from?
The IVC to the gallbladder
- sagittally
What does the left hepatic vein divide?
The left lobe into medial and lateral sections
Which portal vein is more superior?
Left portal veins
What do the hepatic veins do?
They drain blood from the segments and lobes of the liver into the IVC
Where are the hepatic veins located?
Interlobar and intersegmental
Where are you on the liver if you can see the hepatic veins?
Superior
What are the superior segments of the liver? (5)
- 7
- 8
- 4a
- 2
- 1
What does it mean if you can still see the portal vein?
This tells you you have not yet reached segments 5 and 6
- because the left portal vein is more superior than the right portal vein
What do you see if you are more in the mid region of the liver?
The IVC and hepatic veins more distally
What segments are above the portal vein? (2)
- 2
2. 4a
What segments are below the portal vein? (2)
- 3
2. 4b
What does it mean when you can see the right portal vein?
We are between segments 7 and 8 superiorly and 6 and 5 inferiorly
What is the horizontal divider for segments 4a/4b and 2/3?
The left hepatic vein
What does it mean when the hepatic veins are superficial and you can see some organs?
You are quite inferior
- 6, 5, 4b, and 3 segments
What does IV mean?
4
What does VI mean?
6
What does VII mean?
7
What does VIII mean?
8
