Liver Flashcards
What is the liver?
Largest organ in the body
Is the liver intraperitoneal and what does it mean?
Yes, and it means that it is contained in the peritoneal
What is the function of the liver?
- Metabolic activities
- production and secretion of bile
- filtration of the blood
Where is the liver located?
Right hypchondrium, epigastric region, may extend to the left hypchondrium.
Might be located in the RUQ, with the potential of crossing over to the LUQ
What is the surfaces of the liver like?
- Diaphragmatic
- Visceral
What is the diaphragmatic surface of the liver?
Dome shaped (convex) and smooth
Which part of the liver is in contact with the diaphragm?
Anterior, superior and posterior portion in contact with diaphragm
What is the bare area of the liver?
Posterior surface which is not in contact with the peritoneum, and has boundaries formed by coronary and triangular ligaments. This includes groove for IVC
What does the falciform ligament do?
Divides the anterior surface in the diaphragmatic surfaces of the liver.
What is the visceral surface of the liver located?
- inferior surfaces
- covered by peritoneum
- grooves and undulations due to contact with other abdominal organs
The liver can be subdivided into small units called what?
Lobes
To scan the liver what mode do we use in ultrasound?
Functional method
In the traditional method what are the 4 lobes divided into?
- Right lobe
- Left lobe
- Quadrate
- Caudate
What marks the boundary between the right and left lobe?
Falciform ligament
Between the left and right lobe which is bigger?
Right lobe
In the functional/ segmental method how is the liver divided?
It is divided into 3 lobes according to hepatic function. Each lobe has its own arterial and venous blood supply and biliary drainage.
In the functional method how do we divide the left and right lobes?
Using an imaginary line joining the IVC with the GB
How is the right lobe segmented in the functional method?
The right lobe is divided into anterior and posterior segments by the right intersegmental fissure
What are landmarks of the right lobe of liver?
The right hepatic vein and the right portal vein run within the fissure and are used as ultrasound landmarks.
How is the left lobe segmented/ divded?
The left lobe is divided into medial and lateral segments by the left intersegmental fissure
What are landmarks used in the left lobe?
The left hepatic vein, portal vein and ligamentum teres run within the fissure and are used as ultrasound landmarks
What is the caudate lobe?
Located posterior and superior in the liver and receives blood from both the right and left side of the liver
What is Couinaud’s Classification?
Use to further subdivide the segments into 8 segments, which are numbered in clockwise fashion. Which is important for surgery.
What is the smallest lobe in the liver?
Caudate lobe
How is the caudate lobe marked in a ultrasound?
- Anterior boundary marked by the Left Portal vein.
- Posterior boundary marked by the IVC
What is Reidel’s Lobe?
Normal Variant which is an inferior extension of right lobe that can extend caudally to iliac crests.
What are ligaments?
Fibrous, stretchy attachments, that tether liver to abdominal cavity.
Why are ligaments good for liver ultrasounds?
Several form the boundaries for lobes and segments
What is the ligamentum teres?
Ligament which divides the left lobe into medial and lateral portions.
What does the ligamentum teres do in terms of segments?
Connects to falciform ligament on anterior and inferior surfaces. It also extends posteriorly on inferior surface to join to the ligamentum venosum.
What is the Ligamentum teres a remnant of?
Left umbilical vein
What is the ligamentum venosum?
Remnant of ductus venosus (fetus) which divides the left lateral lob and caudate lobe
Where does the ligamentum venosum run?
Posteriorly from ligamentum teres at the level of the porta hepatis on the visceral surface
What are fissures?
Groove, cleft or deep furrow in an organ.
Does the liver have fissures?
It has several. Vessels and ducts travels within them
What is the right intersegmental fissure?
Divides the right lobe into anterior and posterior segments
What courses through the right intersegmental fissure?
- right hepatic vein courses through this fissure superiorly
- Right portal vein courses through this fissure more inferiorly
What is the main lobar fissure?
Separates the functional right and left lobes
What courses through the Main lobar fissure?
Main hepatic vein courses through this fissure superiorly and is used as an ultrasound landmark to divide the right and left lobes
What is the left intersegmental fissures?
Divides the left lobe into medial and lateral segments.
