Liver Flashcards
Overview of Liver Function
- Production of Bile
- Storage: Glycogen, Vit A, D, E, K (fat soluble), B12 (water soluble)
- Metabolism: CHO, protein & fat
- Detox: hormones/drugs
- Reticulo-endothelial function: Kupffer cells (immune response)
Ligaments of the Liver
- 2 lobes separated anterior by falciform
- posterior by ligamentum trees
Liver surfaces
- Diaphragmatic: Smooth, dome shaped, covered by visceral peritoneum (intraperitoneal)
- Bare area: located posterior/sup. NO pleura next to IVC (part of diaphragmatic)
- Visceral: Covered w/peritoneum EXCEPT gallbladder & porta hepatis
What are the contents of the Porta hepatis?
- Located on visceral surface (posterior/right lobe)
- Contains: IVC, Porta hepatis, Caudate lobe (superior) & Quadrate lobe (inferior), Gallbladder
Blood supply to liver
- Double supply (portal vein 70%/hepatic artery 30%)
- Enters through porta hepatis (inf/post. border)
- Includes the bile duct
- Located with in the HEPATODUODENAL ligament (lesser omentum)
Venous drainage of liver
- right/left hepatic veins emerge from back of liver–>immediately enter IVC (L4-T10) near right atrium
- Right/left lobes INDEPENDENT w/respect of arterial, portal, and bile drainage.
Bile production/secretion
- Cystic duct first duct out of gallbladder & storage/concentration of bile
- Contracts in response to Cholecystokinin (CCK) stimulated by presence of Chyme w/AA or lipids in Duodenum
- Sphincter of Oddi (releases bile into Duodenum) relaxes with CCK, Secretin, Gastrin
Anatomy of Biliary Tract
- right/left hepatic ducts = Porta hepatis
- Cystic ducts/heptic ducts = common bile ducts
- Enters duodenum @ ampulla of Vater
Major Blood Supply to abdomen
- Foregut: Celiac trunk/Superior mesenteric artery
- Midgut: Abdominal aorta
- Hindgut: Inferior mesenteric artery
Abdominal compartments (foregut)
Blood supply: Coeliac trunk @ T12
- Esophagus
- stomach
- prox.1/2 duodenum
- Pancreas
- Liver/gall bladder
- Spleen
Abdominal compartments (Midgut)
Blood supply: Sup. mesenteric @ L1
- Distal 1/2 duodenum
- Jejunum
- Illeum
- Caecum / appendix
- Ascending Colon
- Prox. 2/3 Transverse Colon
Abdominal compartments (hindgut)
Blood supply: Inf. mesenteric @ L3
- Distal 1/3 transverse colon
- Descending colon
- Sigmoid colon
- Sup. 1/2 rectum
Foregut Blood supply
-Abdominal aorta–>Coeliac trunk–>Common hepatic artery (portal triad)–>Left gastric artery (greater curvature)–>splenic (left side spleen)
Midgut Blood supply
- Abdominal aorta–>superior mesenteric–>Jejunal branches–>Arcades (loop back to branches)–>Vasa racta (branch off Arcades)
- Supply Jejunum/Ileum
- Sup. mesenteric: sup branch-middle colic, Middle branch-right colic, inferior branch-ileocolic
- MARGINAL branches anastomose Sup/inf
Hingut Blood supply
- Abdominal aorta–>inf. mesenteric artery–>Sup branch:left colic–>middle branch: sigmoid–>inf. branch: superior rectal
- MARGINAL branches anastomose Sup/inf
Liver venous drainage
- portal vein (inferior border of liver)
- Sup. mesenteric (inferior runs along w/ab. aorta)
- Inf. mesenteric (inferior crosses over abdominal aorta)
- Spelnic (left runs underneath tail of pancreas)
Esophageal varices
-Submucosal veins in lower 3rd appear due to hepatic hypertension (liver cirrhosis)
Rectum
- Rectal varices: submucosal veins appear due to hepatic hypertension
- Upper part = superior rectal vein (portal system)
- Lower part = Iliac Vein (systemic)
Umbilical vein
-Caput medusae: enlarged paraumbilical veins that spread all around umbilicus and make the umbilical distend outward
