Liver and Gallbladder

Question 1

Biliary ducts (R/L _____ ducts) unite to form the ______ and join with the _____ duct to form the _______

Answer 1

biliary ducts, r/l hepatic ducts, common hepatic duct, cystic duct, common bile duct

Question 2

Normal liver lies deep to the ribs __ - ___ on the right side and crosses the midline toward the left nipple

Answer 2

7-11

Question 3

The convex ____ and the concave _____ surfaces of the liver are separated by the its own sharp inferior border

Answer 3

diaphragmatic, visceral

Question 4

The _____ recess, the most common site of accumulation of abscess (possibly due to appendicitis/ulcer) is separated into right and left recesses by the _______

Answer 4

subphrenic recess; falciform ligament

Question 5

The gravity- dependent posterosuperior extension of the subphrenic recess is called the ______ aka _______. Fluid from the omental bursa drains into this recess

Answer 5

hepatorenal recess / Morison pouch

Question 6

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 ______

Answer 6

bare area of the liver; anterior/upper and posterior (lower) layers of the coronary ligament

Question 7

The layers of the coronary ligament meet on the right to form the ___

Answer 7

right triangular ligament

Question 8

Anterior layer of coronary ligament is continuous on the left with the ____

Answer 8

falciform ligament

Question 9

Posterior layer of the coronary ligament is continuous with the right layer of the ______

Answer 9

lesser omentum

Question 10

The bare area contains the ____ through which the IVC traverses

Answer 10

groove for vena cava

Question 11

The visceral surface is covered with visceral peritoneum except for the ______

Answer 11

fossa for the gallbladder and the porta hepatis

Question 12

anterior and posterior grooves/fossa that comprise the right sagittal fissure of the visceral surface

Answer 12

anterior: fossa for gallbladder
posterior: groove for vena cava

Question 13

anterior and posterior fissures that form the umbilical (left sagittal) fissure of the visceral surface

Answer 13

anterior: fissure for round ligament of liver
posterior: fissure for ligamentum venosum

Question 14

right and left sagittal fissures are connected by the ____ where portal/hepatic vessels, nerves, lymphatics enter and exit

Answer 14

porta hepatis

Question 15

round ligament of the liver is a remnant of which fetal structure?

Answer 15

umbilical vein (oxygenated blood from placenta to fetus)

Question 16

ligamentum venosum is a remnant of which fetal structure?

Answer 16

ductus venosus (shunts blood from umbilical vein to IVC)

Question 17

double layered peritoneum that encloses the portal triad (bile duct, hepatic artery, hepatic portal vein)

Answer 17

lesser omentum

Question 18

thickened, free edge of lesser omentum that lies between the porta hepatis and duodenum

Answer 18

hepatoduodenal ligament

Question 19

the hepatogastric ligament, part of the lesser omentum connects / lies in between which structures of the liver?

Answer 19

groove for the ligamentum venosum (posterior/lower left sagittal fissure) and lesser curvature of the stomach

Question 20

the falciform ligament divides the liver into these two anatomical lobes

Answer 20

right and left lobes

Question 21

accessory lobes on the visceral surface (name and position)

Answer 21

caudate lobe: posterosuperior

quadrate lobe: anteroinferior

Question 22

part of the caudate lobe that connects it to the right lobe

Answer 22

caudate process

Question 23

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 ____

Answer 23

primary branch of hepatic artery and HPV; hepatic duct

Question 24

why can the caudate lobe be considered as a third liver?

Answer 24

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)

Question 25

the division of the liver into functional right and left lobes is based on the

Answer 25

primary division of the portal triad into right and left branches at the main portal fissure (where middle hepatic vein lies)

Question 26

The main portal fissure is demarcated on the visceral surface as the ______ and on the diaphragmatic surface as the _____

Answer 26

right sagittal fissure; Cantlie line

Question 27

The Cantlie line is an imaginary line from the _____ to the ______

Answer 27

notch for the fundus of the gallbladder to the IVC

Question 28

the right and left livers are vertically subdivided into the medial and lateral divisions by the _____ , where the _____ lie

Answer 28

right portal and umbilical fissures, hepatic veins

Question 29

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?

Answer 29

secondary portal branches

Question 30

this plane subdivides the 3/4 of the divisions (excluding the left medial division)

Answer 30

transverse hepatic plane

Question 31

subdivisions formed from the transverse hepatic plane receive which branches of the hepatic portal

Answer 31

tertiary portal branches

Question 32

the HPV brings ____ % of the blood to the liver

Answer 32

75-80%

Question 33

portal blood contains about ___% more oxygen than the blood returning to the heart from the systemic circuit

Answer 33

40%

Question 34

hepatic portal vein carries the nutrients of blood from nutrients (except lipids) absorbed by the _____ to the _____

Answer 34

alimentary canal; sinusoids of the liver

Question 35

lymphatic vessels of the liver occur as _____ in the ______ and the ______ in the connective tissue

Answer 35

superficial lymphatics; fibrous (Glisson) capsule of the liver; deep lymphatics

Question 36

Most lymph is formed in the _____ and drains into the deep lymphatics in the surrounding ______

Answer 36

perisinusoidal spaces (of Disse);intralobular portal triads

Question 37

path of the lymph in the superficial lymph nodes of the anterior aspect of the visceral and diaphragmatic surfaces

Answer 37

superficial lymph nodes –> hepatic lymph nodes (efferent lymphatic vessels) –> cysterna chyli

Question 38

path of superficial lymphatics from the posterior aspect of the visceral and diaphragmatic surfaces

Answer 38

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