Liver anatomy

Question 1

Where is the liver in the body?

Answer 1

Peritoneal

Right upper quadrant (hypochondium) of the abdomen

Question 2

What does the liver do?

Answer 2

Synthesis of bile
Glycogen storage
Clotting factor production

Question 3

What is anterior to the liver?

Answer 3

Anterior abdominal wall and ribcage

Question 4

What is superior to the liver?

Answer 4

Diaphragm

Question 5

What us posterior to the liver?

Answer 5

Oesophagus, stomach, gall bladder, 1st part of duodenum

Question 6

Name the liver surfaces.

Answer 6

Diaphragmatic and Visceral

Question 7

Describe the diaphragmatic surface?

Answer 7

Smooth and convex, fitting beneath curvature of the diaphragm

Question 8

What is the bare area?

Answer 8

A section of the diaphragmatic surface of the liver that is not covered by visceral peritoneum.

Question 9

Describe the visceral peritoneum?

Answer 9

Moulded by the shape of the surrounding organs, so irregular and flat.

Question 10

Name the ligaments of the liver.

Answer 10

Falciform
Right and left coronary
Triangular
Ligamentum teres
Lesser omentum - consists of hepatoduodenal and hepatogastric ligament

Question 11

What does the Falciform ligament do?

Answer 11

Attaches anterior surface of the liver to the anterior abdominal wall.

The free edge of this ligament contains the ligamentum teres (remnant of umbilical vein)

Question 12

What do the right & left coronary ligaments do?

Answer 12

Attach the superior surface of liver to the diaphragm

Question 13

What do the triangular ligaments do?

Answer 13

Attach superior surface of liver to diaphragm

Question 14

How is the liver secured posteriorly?

Answer 14

By the IVC, hepatic veins and fibrous tissue

Question 15

Where is the Subphrenic space?

Answer 15

Right and left

Between diaphragm and liver, either side of Falciform ligament

Question 16

Where is the Subhepatic space?

Answer 16

Between inferior surface of liver and transverse colon

Question 17

Where is Morison’s pouch?

Answer 17

The posterosuperior aspect of the right Subhepatic space.

Between visceral surface of liver and the right kidney

Question 18

What is the name given to the fibrous layer that covers the whole liver?

Answer 18

Glisson’s capsule

Question 19

Name the 4 lobes of the liver.

Answer 19

Right
Left
Quadrate
Caudate

(Q and C are accessory lobes)

Question 20

What separates the caudate and quadrate lobe?

Answer 20

A deep fissure called porta hepatis

Question 21

What does the porta hepatis do?

Answer 21

Transmits all vessels, nerves and ducts entering or leaving the liver

Question 22

What are cells of the liver called?

Answer 22

Hepatocytes

Question 23

How are hepatocytes arranged?

Answer 23

In lobules - which are the structural units of the liver

Question 24

Describe the structure of lobules of the liver?

Answer 24

Hexagonal

Each is drained by a venule in its centre, called a central vein

At the periphery of the hexagon is a portal triad

Question 25

What does a portal triad consist of?

Answer 25

Arteriole - branch of the hepatic artery Venule - branch of hepatic portal Duct - branch of bile duct leaving liver Lymph vessels and Vagus nerve

Question 26

What special about the liver's blood supply? Name the vessel(s).

Answer 26

It is dual! Hepatic artery proper Hepatic portal vein (dominant blood supply)

Question 27

What does the hepatic artery proper supply the liver with? Where is this artery from?

Answer 27

Arterial blood | Branch of coeliac trunk

Question 28

What does the hepatic portal vein supply the liver with?

Answer 28

Deoxygenated blood carrying nutrients supplied from the small intestine. This allows liver to do its detoxification

Question 29

How is the liver drained of blood?

Answer 29

Three hepatic veins which drain into the inferior vena cava

Question 30

What innervates the parenchyma (bulk) of the liver?

Answer 30

Hepatic plexus: Sympathetic (from coeliac plexus) Parasympathetic - Vagus

Question 31

Describe the route of the nerves in the parenchyma of the liver?

Answer 31

They enter via porta hepatis and follow the route of the hepatic artery and portal vein

Question 32

What is the innervation of Glisson's capsule?

Answer 32

Branches of lower intercostal nerves

Question 33

Name the impressions on the liver and what causes them.

Answer 33

``` Colic - hepatic flexure Renal - R kidney & suprarenal gland Suprarenal - R suprarenal Duodenal - descending duodenum Gastric - stomach ```

Question 34

What is Calot's triangle?

Answer 34

A triangle bound by the cystic artery, the cystic duct and the hepatic duct.

Question 35

What is the ligamentum teres?

Answer 35

Remnant of umbilical vein in foetus which bypassed liver circulation to directly enter IVC

Question 36

What is the percentage contribution of each vessel that supplies the liver with blood?

Answer 36

Hepatic artery - 25% Branch of coeliac - oxygenated Portal vein - 75% Veins from GI tract and spleen contain products of digestion for metabolism

Question 37

Describe the greater omentum? Blood supply?

Answer 37

- Apron like fold attaching to greater curvature of stomach - 4 layers - Stores adipose tissue, cushions and protects organs - Supplied by R&L gastro-omental vessels

Question 38

Describe the lesser omentum. What are its divisions?

Answer 38

-Extends from lesser curvature and duodenum -2 layers -divided into medial hepatogastric ligament lateral hepatoduodenal ligament