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Metabolism CC > Liver Anatomy > Flashcards

Liver Anatomy Flashcards

1
Q

Stomach is suspended from liver by..

A

Lesser omentum

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2
Q

Posterior to liver

A

Hepatic flexure
Superior MA + V
Right adrenal gland + kidney

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3
Q

Pouch of Morrison

A

Between liver + kidney

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4
Q

Liver Surfaces

A

Diaphragmatic Surface
Visceral Surface
Bare area of liver

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5
Q

Visceral surface of liver

A

Postero-inferior

Where vessels pass through

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6
Q

Bare area of liver

A

No visceral peritoneum

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7
Q

Subphrenic recess

A

Separates liver from diaphragm

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8
Q

Falciform ligament

A

Fold of peritoneum which attaches liver to anterior abdominal wall
Divides subphrenic recess longitudinally

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9
Q

Hepatorenal recess

A

Separates liver from right kidney
I.e. pouch of Morrison
Site for build up of fluid

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10
Q

Where do subphrenic and hepatorenal recesses meet

A

Anteriorly

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11
Q

Liver lobes

A

2 large lobes

2 accessory lobes

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12
Q

2 Large liver lobes

A

Large right lobe- includes 2 accessory lobes (caudate + quadrate lobes)
Large left lobe

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13
Q

Ligamentum teres

A

From falciform ligament

Continues inferiorly

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14
Q

Coronary ligament + left/right triangular ligaments

A

From falciform ligament

Continues anteriorly

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15
Q

R + L lobes separated posteriorly by

A

Caudate Lobe

Quadrate Lobe

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16
Q

Caudate Lobe

A

Between fissure for ligamentum venosum and groove for IVC superiorly

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17
Q

Quadrate Lobe

A

Between fissure for ligamentum teres and gall bladder

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18
Q

Bare area of liver

A

No peritoneum between A/P coronary ligaments

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19
Q

Porta hepatis

A

Where structures enter + leave the liver
Hepatic portal vein + hepatic artery enter
Hepatic duct leave

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20
Q

Lesser omentum

A

Fold of peritoneum

Made up of two parts- hepatoduodenal + hepatogastric ligament

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21
Q

Hepatoduodenal ligament

A

Connects liver to duodenum
Free edge of lesser omentum
Posteriorly can see structures entering porta hepatis

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22
Q

Hepatogastric ligament

A

Suspends stomach

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23
Q

Couinaud’s Segments

A

Divides liver into 8 segments
Divided horizontally by left and right portal veins
Divided vertically by hepatic vein
Each segment has its own portal triad
–> segments independent, has own venous return
Branches of hepatic artery + portal vein carry blood into sinusoids of the liver lobule

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24
Q

Pringle Manouvre

A

Close off structures in porta hepatis
If bleeding stop after Pringle manoeuvre –> bleed within hepatic portal vein or hepatic artery
Temporary occlusion of these vessels

25
Coeliac Trunk
``` Provides 25% of blood supply to liver 3 branches Left gastric Splenic artery Common hepatic artery ```
26
Common hepatic artery
Becomes hepatic artery proper after gastroduodenal branch comes off it Divides into L + R hepatic artery proper Cystic artery from right hepatic --> supply gall bladder
27
Hepatic Portal system
Provides 75% blood to liver Only about 50% oxygenated Portal vein
28
Portal Vein
Composed of splenic and superior mesenteric veins | --> prior to this, inferior mesenteric drains into splenic
29
Portal system purpose
Pass digestive products of liver through liver for processing
30
Anastamoses
Communication between hepatic portal system + systemic venous system Only relevant when blood can't pass through liver --> will enter portosystemic anastomoses + drain into heart via systemic venous system
31
Distal 1/3rd of oesophagus portosystemic anastomoses
Drain into hepatic portal vein
32
Proximal 2/3rd oesophagus drain into
Caval system
33
Superior 1/3rd rectum portosystemic anastomoses
Via superior rectal vein, drain into hepatic portal system
34
Bottom 2/3rd rectum
Via internal iliac veins into caval system
35
Umbilical anastamoses
Via umbilical vein
36
Portal hypertension
Blood from portal system can't get through liver --> backtracks + causes overload in systemic system in porto-systemic anastamoses
37
Backtrack of blood
Oesophagus --> varices Rectum --> haemorrhoids Umbilical vein --> caput medusae
38
Cirrhosis
Consequence of chronic liver disease characterised by replacement of liver tissue by fibrosis, scar tissue + regenerative nodules - -> blood can't pass through sinusoids of liver - -> portal hypertension
39
Normal portal pressure
5-10mmHg
40
IVC normal pressure
2-6mmHg
41
Portal hypertension pressure
Defined when portal pressure gradient (Diff. between portal vein + IVC) = >5mmHg
42
Portal hypertension pressure
PPG 6-10mmHg
43
Oesophageal varices pressure
PPG >10mmHg
44
Ascites pressure
PPG >12mmHg
45
Splenomegaly
Enlargement of spleen due to backup of blood into spleen | --> becomes hyperactive due to enlargement, starts to clear out WBC + RBC + platelets premature
46
Splenomegaly consequences
Can cause: Anaemia Leukopenia Thrombocytopenia
47
Venous drainage of oesophagus
Inferiorly- drains into portal system | Superiorly- drains into systemic system
48
Oesophageal Varices
Occur at anastomoses of left gastric vein with oesophageal veins at Gastro-oesophageal junction Present with Haematemesis Can be treated with oesophageal banding
49
Ascites
Abnormal fluid accumulation in peritoneal cavity as a result of portal hypertension
50
Ascites due to hypoalbuminaemia
Reduced production albumin Albumin required for oncotic pressure within capillary Fluid leaks out --> builds up in interstitium
51
Ascites due to Portal hypertension
Splanchnic veins start to bulge as overfill with blood Kidneys detect this as decreased circulating BV Trigger response to hypovolaemic shock Activates renin-angiotensin-aldosterone system Aldosterone --> sodium retention --> water retention BV expansion Increased kidney work --> renal artery stenosis --> ischaemia --> renal failure
52
Rectal varices
Caused by portal hypertension due to formation of portosystemic shunts
53
Biliary tree
``` L + R hepatic ducts Join to form common hepatic Joined by cystic duct Form bile duct Bile duct joined by major duodenal papilla from pancreas to enter duodenum ```
54
Bile secretion
By liver Constant rate 40ml/hour
55
Cholecystitis
Blocked cystic duct | Inflamed gallbladder
56
Murphy's test
Investigate inflammation of gallbladder
57
Jaundice
Occurs if gallstone lodge in common bile duct due to bile accumulation in liver --> bilirubin accumulates causing yellowing of skin
58
Blood supply to gallbladder
Cystic artery | --> branch of right hepatic

Metabolism CC (29 decks)

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