Liver and gallbladder Flashcards
What are the two key external surfaces of the liver?
Diaphragmatic
Visceral
What is the ‘bare area’ of the liver?
Area of the diaphragmatic surface not covered by visceral peritoneum so is in direct contact with the diaphragm
What organs is the visceral surface of the liver in contact with?
Right kidney + adrenal gland Hepatic flexure of colon Transverse colon Duodenum (part 1) Gallbladder Oesophagus Stomach
What is the falciform ligament?
Ligament attaching the anterior surface of the liver to the anterior abdominal wall.
Forms natural division between right and left lobes of liver.
What is the ligamentum teres?
Remnant of the umbilical vein forming the free edge of the falciform ligament
Where are the subphrenic spaces?
Between the diaphragm and anterior/ superior surface of liver.
Divided into right and left by falciform ligament.
Where is the subhepatic space?
Peritoneal space between the inferior surface of the liver and the transverse colon.
What is Morison’s Pouch?
Potential space between the visceral surface of the liver and the right kidney
What is the clinical relevance of Morison’s Pouch?
Deepest part of peritoneal cavity so fluid most likely to collect here in supine patient (e.g. bleeding or ascites)
What is the Glisson’s capsule?
Fibrous layer covering the liver
What are the lobes of the liver?
Right
Left
Caudate (upper aspect of visceral surface)
Quadrate (lower aspect of visceral surface)
What is the porta hepatis?
Transverse fissure that transmits all vessels, nerves, and ducts entering or leaving the liver (with the exception of the hepatic veins)
What structures make up the portal triad?
Branch of Hepatic Artery
Branch of Hepatic Portal Vein
Branch of Bile Duct
[Also lymphatic vessels and Vagus nerve]
What is the venous drainage of the liver?
Central vein (drains each lobule) - form multiple hepatic veins which drain into IVC
What is the blood supply to the liver?
Hepatic artery proper (25%)
Hepatic portal vein (75%)
What is the nerve supply to the liver?
Hepatic plexus (containing sympathetic fibres from coeliac plexus and parasympathetic fibres from vagus nerve)
What nerve innervates the Glisson’s capsule?
lower intercostal nerves
What is the primary function of the gallbladder?
Concentration and storage of bile
What is the gallbladder divided into anatomically?
Fundus
Body
Neck (which becomes cystic duct)
What is a common area for gallstones to get lodged?
Hartmann’s Pouch (mucosal fold in neck)
What makes up the biliary tree?
Common bile duct = Common hepatic duct (formed by amalgamation of collecting ducts) + Cystic duct (from gallbladder)
Common bile duct + Pancreatic duct = Hepatopancreatic ampulla of Vater
Where does the biliary tree drain into?
Duodenum via the major duodenal papilla
What regulates drainage of bile into the duodenum?
Sphincter of Oddi
What is the blood supply to the gallbladder?
Cystic artery (branch of right hepatic artery)
