Liver and Gallbladder Flashcards
Biliary ducts (R/L _____ ducts) unite to form the ______ and join with the _____ duct to form the _______
biliary ducts, r/l hepatic ducts, common hepatic duct, cystic duct, common bile duct
Normal liver lies deep to the ribs __ - ___ on the right side and crosses the midline toward the left nipple
7-11
The convex ____ and the concave _____ surfaces of the liver are separated by the its own sharp inferior border
diaphragmatic, visceral
The _____ recess, the most common site of accumulation of abscess (possibly due to appendicitis/ulcer) is separated into right and left recesses by the _______
subphrenic recess; falciform ligament
The gravity- dependent posterosuperior extension of the subphrenic recess is called the ______ aka _______. Fluid from the omental bursa drains into this recess
hepatorenal recess / Morison pouch
The smooth diaphragmatic surface of the liver is covered with visceral peritoneum except posteriorly in the _____ which is in direct contact with the diaphragm. It is demarcated superiorly and inferiorly by the ______
bare area of the liver; anterior/upper and posterior (lower) layers of the coronary ligament
The layers of the coronary ligament meet on the right to form the ___
right triangular ligament
Anterior layer of coronary ligament is continuous on the left with the ____
falciform ligament
Posterior layer of the coronary ligament is continuous with the right layer of the ______
lesser omentum
The bare area contains the ____ through which the IVC traverses
groove for vena cava
The visceral surface is covered with visceral peritoneum except for the ______
fossa for the gallbladder and the porta hepatis
anterior and posterior grooves/fossa that comprise the right sagittal fissure of the visceral surface
anterior: fossa for gallbladder
posterior: groove for vena cava
anterior and posterior fissures that form the umbilical (left sagittal) fissure of the visceral surface
anterior: fissure for round ligament of liver
posterior: fissure for ligamentum venosum
right and left sagittal fissures are connected by the ____ where portal/hepatic vessels, nerves, lymphatics enter and exit
porta hepatis
round ligament of the liver is a remnant of which fetal structure?
umbilical vein (oxygenated blood from placenta to fetus)
ligamentum venosum is a remnant of which fetal structure?
ductus venosus (shunts blood from umbilical vein to IVC)
double layered peritoneum that encloses the portal triad (bile duct, hepatic artery, hepatic portal vein)
lesser omentum
thickened, free edge of lesser omentum that lies between the porta hepatis and duodenum
hepatoduodenal ligament
the hepatogastric ligament, part of the lesser omentum connects / lies in between which structures of the liver?
groove for the ligamentum venosum (posterior/lower left sagittal fissure) and lesser curvature of the stomach
the falciform ligament divides the liver into these two anatomical lobes
right and left lobes
accessory lobes on the visceral surface (name and position)
caudate lobe: posterosuperior
quadrate lobe: anteroinferior
part of the caudate lobe that connects it to the right lobe
caudate process
functional division of the liver into left and right parts / portal lobes entails that each part receives its own ____ and is drained by its own ____
primary branch of hepatic artery and HPV; hepatic duct
why can the caudate lobe be considered as a third liver?
because its vascularization is independent of the bifurcation of the portal triad (receives blood from both and is drained by its own minor hepatic veins)
the division of the liver into functional right and left lobes is based on the
primary division of the portal triad into right and left branches at the main portal fissure (where middle hepatic vein lies)
The main portal fissure is demarcated on the visceral surface as the ______ and on the diaphragmatic surface as the _____
right sagittal fissure; Cantlie line
The Cantlie line is an imaginary line from the _____ to the ______
notch for the fundus of the gallbladder to the IVC
the right and left livers are vertically subdivided into the medial and lateral divisions by the _____ , where the _____ lie
right portal and umbilical fissures, hepatic veins
each of the the four divisions formed by the umbilical fissure, right portal fissure and the medial portal fissure receive which branches of the hepatic portal?
secondary portal branches
this plane subdivides the 3/4 of the divisions (excluding the left medial division)
transverse hepatic plane
subdivisions formed from the transverse hepatic plane receive which branches of the hepatic portal
tertiary portal branches
the HPV brings ____ % of the blood to the liver
75-80%
portal blood contains about ___% more oxygen than the blood returning to the heart from the systemic circuit
40%
hepatic portal vein carries the nutrients of blood from nutrients (except lipids) absorbed by the _____ to the _____
alimentary canal; sinusoids of the liver
lymphatic vessels of the liver occur as _____ in the ______ and the ______ in the connective tissue
superficial lymphatics; fibrous (Glisson) capsule of the liver; deep lymphatics
Most lymph is formed in the _____ and drains into the deep lymphatics in the surrounding ______
perisinusoidal spaces (of Disse);intralobular portal triads
path of the lymph in the superficial lymph nodes of the anterior aspect of the visceral and diaphragmatic surfaces
superficial lymph nodes –> hepatic lymph nodes (efferent lymphatic vessels) –> cysterna chyli
path of superficial lymphatics from the posterior aspect of the visceral and diaphragmatic surfaces
superficial lymph nodes –> enter bare area of the liver to drain into the phrenic lymph nodes –> pass through diaphragm to drain into posterior mediastinal lymph nodes –> right lymphatic / thoracic ducts
