Liver Flashcards by Amber Dabill

What is the largest visceral structure in the abdominal cavity

Liver

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What is the largest gland in the human body

Liver

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Where is the liver located

Right hypochondrium
Epigastric areas
Some in left hypochondrium

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Name the external surfaces of the liver

Diaphragmatic surface
Visceral surface

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Describe the diaphragmatic surface

Anterosuperior surface of the liver

Smooth and convex

Fits beneath the curvature of the diaphragm

Posterior aspect is not covered by visceral peritoneum - in direct contact with the diaphragm itself (known as the bare area of the liver)

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What is known as the bare area of the liver

Posterior aspect of the diaphragmatic surface - only in contact with the diaphragm itself

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Describe the visceral surface

Posteroinferior surface of the liver

Exception of the fossa of the gallbladder and porta hepatis - it is all covered by peritoneum

Moulded to the shape of the surrounding organs

Irregular and flat

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What does the visceral surface lie in contact with

Right kidney
Right adrenal gland
Right colic flexure
Transverse colon
First part of the duodenum
Gallbladder
Oesophagus
Stomach

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Name the ligaments of the liver

Falciform ligament

Coronary ligament (anterior and posterior folds)

Triangular ligaments (left and right)

Lesser omentum

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What are the roles of the ligaments of the liver

Attach the liver to surrounding structures

Formed by a double layer of peritoneum

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Describe the falciform ligament

Sickle-shaped ligament attaches the anterior surface of the liver to the anterior abdominal wall

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What does the free edge of the falciform ligament contain

Ligamentum teres

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What is the ligamentum teres

Remnant of the umbilical vein

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Describe the coronary ligament (anterior and posterior folds)

Attaches the superior surface of the liver to the inferior surface of the diaphragm

Sets the boundaries of the bare area of the liver

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What forms the triangular ligaments on the left and the right sides of the liver

Anterior and posterior folds

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How many triangular ligaments are there

Left and right

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Describe the left triangular ligament

Formed by the union of the anterior and posterior layers of the coronary ligament at the apex of the liver

Attaches the left lobe of the liver to the diaphragm

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Describe the right triangular ligament

Formed in a similar fashion adjacent to the bare area

Attached the right lobe of the liver to the diaphragm

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Describe the lesser omentum

Attaches the liver to the lesser curvature of the stomach and first part of the duodenum

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What does the lesser omentum consist of

Hepatoduodenal ligament

Hepatogastric ligament

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Describe the hepatduodenal ligament

Extends from the duodenum to the liver

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Describe the hepatogastric ligament

Extends from the stomach to the liver

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What surrounds the portal triad

Hepatoduodenal ligament

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How is the posterior surface of the liver secured to the inferior vena cava

By hepatic veins and fibrous tissue

Define hepatic recess

Anatomical spaces between the liver and surrounding structures

Why are the hepatic recesses important

Infection may collect in these areas - form abscesses

Name the hepatic recesses

Subphrenic spaces Subhepatic spaces Morison's pouch

Describe subphrenic spaces

Located between the diaphragm and the anterior and superior aspects of the liver Divided into left and right by the falciform ligament

Describe the subhepatic space

Subdivision of the supracolic compartment (above the transverse mesocolon) Peritoneal space - located between the inferior surface of the liver and transverse colon

Describe morison's pouch

Potential space between the visceral surface of the liver and right kidney Deepest part of the abdominal cavity when supine (lying flat)

What covers the liver

Fibrous layer Known as Glisson's capsule

What is the liver comprised of

Larger right lobe Smaller left lobe Two smaller 'accessory lobes' from the right lobe - caudate lobe - quadrate lobe

Describe the caudate lobe

Located on the upper aspect of the visceral surface Lies between the inferior vena cava and a fossa produced by the ligamentum venosum

Define the ligamentum venosum

Remnant of the fetal ductus venosus

What are the two accessory lobes of the liver

Caudate lobe Quadrate lobe

Describe the quadrate lobe

Located on the lower aspect of the visceral surface Lies between the gallbladder and a fossa produced by the ligamentum teres

Define ligamentum teres

Remnant of the fetal umbilical vein

What separates the caudate and quadrate lobes

Porta hepatis Deep, transverse fissure

What is the role of the porta hepatis

Transmits all vessels, nerves and ducts entering or leaving the liver with the exception of the hepatic veins

What does the porta hepatis not transmit

Hepatic veins

What are the cells of the liver

Hepatocytes

How are hepatocytes arranged

Lobules - structural units of the liver

What are the structure units of the liver

Lobules

Describe lobule

Hexagonal-shape Drained by the central vein Periphery of the hexagon - portal triad

Describe the portal triad

Arteriole Venule Bile duct Also contains: Lymphatic vessels Vagus nerve

What is the arteriole in the portal triad

A branch of the haptic artery entering the liver

What is the venule of the liver

Branch of the hepatic portal vein entering the liver

What is the bile duct of the liver

Branch of the bile duct leaving the liver

What nerve does the portal triad contain

Vagus nerve

Describe the vasculature of the liver

25% hepatic artery proper 75% hepatic portal vein

What % blood supply to the liver is from the hepatic artery proper

25%

What % blood supply to the liver is from the hepatic portal vein

75%

Describe the blood supply to the liver from the hepatic artery proper

Supplies the non-parenchymal structures of the liver with arterial blood Derived from the coeliac trunk

Describe the blood supply from hepatic portal vein

Supplies the liver with partially deoxygenated blood - carrying nutrients absorbed from the small intestine Allows the liver to perform its gut-related functions

What is the venous drainage of the liver

Hepatic veins Open into the inferior vena cava

What is the nerve supply to the parenchyma of the liver

Hepatic plexus - sympathetic - coeliac plexus - parasympathetic - vagus nerve

What is the nerve supply to the glisson's capsule

Branches of the lower intercostal nerves

What is the lymphatic drainage of the liver

Into the hepatic lymph nodes - empty into the coeliac lymph nodes