Liver A&P

Question 1

2 methods of identifying liver anatomy

Answer 1

1. traditional lobar anatomy
2. couinaud’s anatomy

Question 2

what is traditional lobar anatomy?

Answer 2

identifying structures based on the outer surface of the liver (external superficial anatomy)

Question 3

what is couinaud’s anatomy?

Answer 3

identifying liver structures based on internal vasculature (HVS & PVS)

Question 4

location of liver?

Answer 4

mainly on RUQ
upper abdomen adjacent to diaphragm
some patients, extends to LUQ

Question 5

what is ascites?

Answer 5

fluid accumulation below the diaphragm

Question 6

what is morrison’s pouch?

Answer 6

type of ascites between right kidney & liver

Question 7

what is pleural effusion?

Answer 7

fluid accumulation in the pleural space

Question 8

what is the capsule that covers the entire liver?

Answer 8

glisson’s capsule

Question 9

what is the bare area?

Answer 9

the only part of the liver not covered by the peritoneum

Question 10

where is the bare area?

Answer 10

on the posterosuperior surface of the liver
it connects to the diaphragm

Question 11

how do you measure the liver?

Answer 11

from the midclavicular line in SAG
cranial to caudal

Question 12

normal liver measurement

Answer 12

13-15cm
based on body habitus & how small/large patient is
can be up to 17cm on larger patients

Question 13

what is considered an enlarged liver (ARDMS)

Answer 13

greater than 18.5cm

Question 14

what are the 4 lobes of the liver?

Answer 14

1. left lobe
2. right lobe
3. caudate lobe
4. quadrate lobe

Question 15

what lobe can’t be seen on ultrasound?

Answer 15

quadrate lobe

Question 16

where is the quadrate lobe?

Answer 16

between the GB fossa & falciform ligament

Question 17

how does the liver receive blood?

Answer 17

1. portal vein
2. hepatic artery

Question 18

what type of blood does the portal vein supply?

Answer 18

nutrient rich blood

Question 19

what % of O2 requirements does the portal vein give to hepatocytes?

Answer 19

50-60%

Question 20

the portal vein is the liver’s drainage system but also feeds nutrient rich blood to the liver. true/false?

Answer 20

true

Question 21

how does the portal vein look in transverse?

Answer 21

it’s elongated

Question 22

what type of blood does the hepatic artery feed to the liver?

Answer 22

oxygen rich blood

Question 23

which artery does the hepatic artery branch from?

Answer 23

aorta –> celiac artery –> hepatic artery

Question 24

what veins drain blood from the liver?

Answer 24

R, M, L hepatic veins

Question 25

the left hepatic vein/left intersegmental fissure divides the left lobe into:

Answer 25

medial & lateral sections

Question 26

the middle hepatic vein/falciform ligament divides the whole liver into:

Answer 26

left & right sections

Question 27

the right hepatic vein/right intersegmental fissure divides the right lobe into:

Answer 27

anterior & posterior sections

Question 28

what makes up the portal triad?

Answer 28

bile duct
hepatic artery
portal vein

Question 29

where can you find the main lobar fissure?

Answer 29

between the GB & main PV
won’t be seen when GB is filled with bile

Question 30

what is the obliterated umbilical vein called?

Answer 30

ligamentum teres/round ligament

Question 31

what 3 ligaments anchor the liver in the abdomen?

Answer 31

1. coronary ligament
2. right triangular ligament
3. left triangular ligament

Question 32

what do liver function tests indicate?

Answer 32

deranged liver function

Question 33

what does aspartate aminotransferase (AST) indicate?

Answer 33

liver cell necrosis
can also relate to some other organ

Question 34

what does alanine aminotransferase (ALT) indicate?

Answer 34

liver cell necrosis
specific to liver

Question 35

what does a decrease in albumin indicate?

Answer 35

liver cells can’t synthesize albumin

Question 36

what does increased bilirubin indicate?

Answer 36

cell synthesis defect

Question 37

what lab values indicate a cancerous liver tumor?

Answer 37

1. alpha fetoprotein (AFP)
2. carcinoembryonic antigen (CEA)

Question 38

what are the 4 liver anatomic variants?

Answer 38

1. riedel’s lobe
2. caudate lobe size
3. hepatic veins (diff amount than 3)
4. situs inversus

Question 39

list the 6 abdominal organs from darkest to brighest

Answer 39

1. renal medulla
2. renal cortex
3. liver
4. spleen
5. pancreas
6. renal sinus