Liver Flashcards
Shape of the liver ?
Wedge shaped
Site of the liver?
Rit hypochondrium and epiganstrium and may extend to rt lumbar and lt hypochondrium
Weight of liver?
1200 to 1800 gm in adults around 2 kilo
Border of liver?
Ill defined borders except inferior
Largest solid organ in the body ?
Liver
Liver is divided anatomically into ?
Rt and left lobes
Liver divided anatomically by ?
Falciform ligament (anterior) and ligamentum venosum (posterior)
Surgical importance of surgical lobes?
Each segment has its own arterial portal and hepatic duct branch which can be removed separately ( segmentectomy)
Boundries of caudate lobe ?
Between groove for IVC and fissure for ligamentum venous
Why is caudate lobe is special ?
Supplied by hepatic a and portal v branches from both sides … hence also drained directly by multiple small veins into the inferior vena cava
Why budd chiari syndrome doesn’t affect the caudate lobe?
Cause it drained directly to the IVC by multiple small veins
Peritoneal fixation of the liver?
- Anteriorly: to ant abdominal wall by falciform ligament and to the umblical by ligamentum teres(round ligament )
- Superiorly: to the diaphragm by rt and left coronary ligaments
- At the angles: to the diaphragm by rt and left triangular ligaments
- Lesser omentum: to stomach & 1st inch of the duodenum
- Posterior to the left : ligamentum venosum
- Posterior to the right .. coronary (interrupted) upper and lower coronary
Relation of the bare area of the liver ?
Suprarenal gland related to bare area without any intervention
Who divided the liver surgically ?
Cantlie
Extent of cantlie’s line ?
From gall bladde fossa to the left of IVC
Boundries of the quadrate lobe ?
Left: fissure for ligamentum teres
Right: gallbladder fossa
Ant: inferior border of the liver
Post: porta hepatis
Liver is completely covers by perituem except
- Bare area
- Fossa for gall bladder
- Groove for IVC
- Porta hepatis
Blood supply of the liver ? and what is major ?
Portal vein 70% and hepatic artery 30% (but the O2 saturation is equal)
Embryological origin of ligamentum teres?
Obliterated vestige of left umblical vein
What is the venous drainage of the liver ?
Hepatic veins: 3 veins , rt hepatic vein drains to IV while middle and left hepatic veins unite and drain into IV. They emerge from the back. And caudate lobe drains directly into IVC by small multiple veins
Structure of porta hepatis from ant to posterior ?
DAP… hepatic duct, hepatic artery and portal vein…also gives attachment ot the lesse omentum
Lymph drainage of liver ?
Post part follows IVC to end in diaphragmatic LN around the upper end of IVC and lymphatics of the remaining part follows the hepatic artery to end in the celiac LN
Surface anatomy of liver ?
Upper border: apex of heart , xiphysternum, 5thrib(MCL), 7th (MAL), 9th rib (rt SL)
Lower border: apex of heart, tip of 8th CC, midway xiphy and umbilicus, tip of rt 9th CC, and follor coastal margin to MAL
Right border: from 5th to 7th and 11th rib in MAL
Space used in liver biopsy?
Right 9th intercostal space in MAL
.. it passes thru, skin, fascia, ext oblique, intercostal ms, rt costodiaphragmatic recess, diaphragm, rt anterior subphrenic space
