Liver anatomy

Question 1

Where is the liver located?

Answer 1

Mainly in the R hypochondium region, overlaps into R lumbar, epigastric and umbilical

Question 2

What ligaments are in the liver?

Answer 2

Falciform ligaments divides the R and L lobes

Question 3

Describe the lobes of the liver

Answer 3

R lobe (separates by falciform ligament)

• larger lobe
• made of caudate and quadrate lobe

Question 4

Describe the liver’s visceral relations?

Answer 4

L
stomach
duodenum
oesophagus

R
R kidney
hepatic flexure
R colic flexure

Question 5

What is calots triangle?

Answer 5

Triangle that forms between cystic duct and common hepatic duct

Question 6

What are the main functional cells of the liverq

Answer 6

• Hepatocytes
• Joined together in cords towards the central vein, separated by sinusoids
• have a granular appearance due to mitochondria

Question 7

Describe the lobule structure of the liver?

Answer 7

Contains:

• central vein
• portal triad = proper hepatic artery, hepatic portal vein, common bile duct (VAD)

also contains
lymphatic vessels, these drain into the celiac lymph nodes
branch of the vagus nerve, sym and parasym nerves

Question 8

What is the biliary canaliculi?

Answer 8

a thin tube that collects bile secreted by hepatocytes. The bile canaliculi merge and form bile ductules, which eventually become common hepatic duct.

Question 9

What is the ampulla of vater?

Answer 9

The ampulla opens into the duodenum via the major duodenal papilla
It is how bile is secreted from the liver via the common bile duct
* it is controlled by the spincter of Oddi

Question 10

Describe the blood supply of the liver

Answer 10

-25% is oxygenated from the hepatic arteries
-75% is nutrient-rich, deoxygenated blood from the hepatic portal vein
The hepatic veins then join the IVC

Question 11

Describe the portal system

Answer 11

• nutrient-rich, deoxygenated blood from the hepatic portal vein (via the inferior mesentric vein from large intestine and the superior mesentric vein from the small intestine)
• -25% is oxygenated from the hepatic arteries - celiac trunk from the aorta, and blood from splenic artery

Question 12

What can be seen in hepatocyte ultrastructure?

Answer 12

N - Nucleus
GI - Glycogen deposits
M - Mitochondria
BC - Biliary canaliculi

Question 13

What are Sinusoids

Answer 13

Sinusoids are fenestrated, made up of endothelial cells, kupffer cells and ito cells.

Kupffer cells are the resident tissue macrophages of the liver. They display phagocytic activity against blood borne materials entering the liver. The ito cells store fat and are also known as Stellate cells. The sinusoids are a combination of arterial and venous blood.
They are supported by a reteculin mesh (which is collagen III). The sinusoids are separated from hepatocytes by the space of Disse - where transfer of materials takes place