Liver and Gall Bladder Flashcards by Matthew Archer

Which abdominal regions is the liver situated in

Right Hypochondrium
Epigastrium
Right Lumbar
Left Hypochondrium (sometimes)

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What is the weight of the liver?

4 - 1.8kg ::: males

1. 2 - 1.4kg ::: females

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What are the surfaces of the liver?

Diaphragmatic and Visceral

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What are the relations of the anterior diaphragmatic surface of the liver

Diaphragm separates it from:

6-10 costal cartilages on Right
7-8 costal cartilages on Left

Has falciform ligament

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What are the relations of the superior diaphragmatic surface of the liver

Diaphragm separates it from:

Lung on Right
Heart on Left

Has:

Bare area
IVC

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What are the relations of the posterior diaphragmatic surface of the liver

Lies against vertebral column

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What are the main features on the visceral surface of the diaphragm

Porta hepatis
Gall bladder
IVC
Fissure for Ligamentum Teres Hepatis
Fissure of Ligamentum Venosum

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What are the structures going through the Porta Hepatis

Hepatic A (Right and Left)
Portal V
Hepatic Ducts (Right and Left)
Lymphatics
Hepatic nerve plexus

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What does the ligamentum teres hepatis develop from?

Remnant of Umbilical Vein

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What does the ligamentum venosum develop from?

Remnant of Ductus Venosus

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What are the anatomical lobes as seen on the visceral surface of the liver?

Right
Left
Caudate
Quadrate

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Which side of the liver does the Gall Bladder lie

In a fosssa on the anterior side of the liver

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Regarding the caudate and quadrate lobes of the liver, which lies posterior and which lies anterior

cadate - posterior

quadrate - anterior

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Which is the line that divides the liver into left and right functional halves?

cholescysto-vena-caval line

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Describe the functional division system of the liver?

Couinaud’s segments divide the liver into independent functional lobes.

Each lobe has an independent:

Bile Duct
Portal Vein
Hepatic Artery

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What are the impressions of the visceral surface of the liver?

Impressions for:

Stomach
Pyloric
Duodenum (1st/sup. part)
Transverse Colon
Rt Colic (hepatic) Flexure
Rt kidney and adrenal gland

What are the ligaments that attach to the liver?

Falciform ligament

Round ligament of liver (Ligamentum teres hepatis)

Coronary Ligament (Ant. and Post.)

Triangular Ligaments (Right and Left)

Describe the Ligamentum Teres Heaptis

AKA Round ligament of liver

1: Runs on the lateral side of the caudate lobe
2: Runs to Umbilicus

Describe the course of the Falciform Ligament

1: Runs on Ant. surface of Liver
2: Splits Liver into Medial and Lateral surfaces
3: Encloses Round Ligament along its margin
4: Runs along inner/posterior Right RA sheath
5: Ends at Umbilicus

Describe the blood supply of the Liver

Left and Right Hepatic Artery (20%)
Portal Vein (80%)

Right and Left Hepatic Vein (runs in Parenchyma to connect with IVC)

IN 25% OF CASES, SMA CONTRIBUTES TO ARTERIAL SUPPLY OF THE LIVER

Explain the lymphatic drainage of the liver

Superficial vessels: (in sub-serosa areolar tissue)
-hepatic LN
-coeliac LN
-para-aortic LN
ALL DRAIN INTO THORACIC DUCT

Deep vessels:
-End in nodes around the IVC

Explain the nerve supply of the liver and its course

Nerve supply comes from: Hepatic Plexus (from Coeliac Plexus)

This plexus accompanies hepatic artery and its branches

What shape is the Gallbladder

Piriform-shaped

What is the size of the Gallbladder

Length: 7-10cm
Breadth: 3cm (at widest point)
Capacity: 30-50ml

What are the parts of the gallbladder? Also, explain their relations

Fundus: - Projects beyond inferior border of liver - Related to Ant. Abd. Wall - Posteriorly, related to Transverse Colon Body: - Upper surface related to liver - Underside related to Transverse Colon and Duodenum Neck: -Sometimes, a small pouch projects at the junction between the Neck and Cystic Duct called "Hartmann's Pouch"

Describe the anatomy of the cystic duct

3-4cm long Runs inferio-posteriorly from Neck of GB to join Common Hepatic Duct forming the Bile Duct Mucous membrane from Neck to Bile Duct contains 5-6 oblique projections into lumen -Called "Spiral Folds" or "Valves of Reister"

Describe the arterial supply of the Gallbladder

``` Cystic Artery (from Right Hepatic A. - or Common Hepatic A. or Gastroduodenal A.): -Supplies Gallbladder and Cystic Duct ``` Right Hepatic Artery -Supplies Hepatic Ducts and upper part of Common Bile Duct

Describe the venous drainage of the Gallbladder

Cystic Veins: ``` -Run into Liver directly OR -Run into Hepatic Vein OR -Run into veins draining upper part of Bile Duct ```

What is the nerve supply to the Gallbladder

Coeliac Plexus

What is the lymphatic drainage of the Gallbladder

Hepatic LN | Cystic LN

What is the failure of canalization of the Bile Duct called?

Congeintal Atresia OR Stenosis

What can cause obstruction of the Gallbladder

Tunours in Pylorus or Pancreas causing Pressure Gallstone formation

Which part of the duodenum does the Bile Duct drain?

Descending (2nd part)