Liver

Question 1

How much does the liver weigh?

Answer 1

1500-2000g

Question 2

Functions of the liver

Answer 2

Detoxification of ingested substances
Regulation of blood sugar
Bile drainage
Synthesis and storage of amino acids, fats

Question 3

Blood supply

Answer 3

1/4 hepatic artery

3/4 portal vein

Question 4

Surface anatomy

Answer 4

Rib 5-6 superior border.

Mostly in right hypochondrium and epigastric region.

Question 5

Two lobes divided by ligaments:

Answer 5

Falciform ligament (remnant of ventral mesogastrium)
Within falciform is ligament trees (remnant of umbilical vein)

Question 6

Posterior surface of the liver: name the lobes (clockwise)

Answer 6

Left, caudate, right, quadrate. Also bare area above right lobe where liver rubs against the diaphragm obliterating the peritoneum.

Question 7

Portal triad, name position of structures

Answer 7

Hepatic artery, most anterior and left
Common hepatic duct anterior and right
Portal vein most posterior

Question 8

Lesser omentum split into what ligaments?

Answer 8

The hepatoduodenal, hepato gastric

Question 9

Nerve supply to the liver

Answer 9

Coeliac plexus at T12. Parasympathetic from vagus nerve, sympathetic from greater splanchnic nerve. Pain referred to epigastric region.

Question 10

Name of gallstones and two types

Answer 10

Cholelithiasis. Cholesterol stones, white/ yellow. Pigment stones, bilirubin and calcium dark green

Question 11

Name of gallstones in the bile duct

Answer 11

Choledocolithiasis

Question 12

Porto-systemic shunting

Answer 12

When there is portal hypertension (e.g. in cirrhosis) blood gets pushed back into systemic circulation and passes through three main shunts- oesophageal (oesophageal varices), umbilicus (caput medusae), anus (anorectal varices)

Question 13

Blood supply to pancreas

Answer 13

Dual supply- Coelic and SMA
Coeliac:
Common hepatic-Gastroduodenal-Superiopancreatoduodenal.
Splenic- dorsal and greater pancreatic 
SMA:
Inferiopancreatoduodenal

Question 14

Structures at the transpyloric plane

Answer 14

Spinal level L1. Midway between suprasternal notch and pubic symphysis.

• Pyloric region of stomach
• 1st part of duodenum
• Fundus of gallbladder
• Hilia of kidneys
• Hilium of spleen
• neck of pancreas
• Transverse colon
• SMA origin
• Portal vein origin
• Where spinal cord ends