Liver & Biliary Tree

Question 1

What layer of peritoneum does the liver form within?

Answer 1

• a double layer of peritoneum called the ventral mesogastrium

Question 2

What separates the right and left anatomical lobes of the liver?

Answer 2

• the falciform ligament

Question 3

What are the two surfaces of the liver?

Answer 3

• the diaphragmatic surface and the visceral/inferior surface

Question 4

Which two lobes are found on the visceral/inferior surface of the liver?

Answer 4

• the quadrate lobe and the caudate lobe

Question 5

The hilum of the liver is found on which surface? What is it also known as? What does it contain?

Answer 5

• found on the visceral/inferior surface
• also known as the porta hepatis
• contains the hepatic ducts, portal vein, and hepatic artery proper

Question 6

What is the thicker cord of the falciform ligament called? What is it the remnant of?

Answer 6

• the ligamentum teres, which is the obliterated umbilical vein

Question 7

The quadrate lobe is bordered by ________ and ________. The caudate lobe is bordered by ________ and ________.

Answer 7

• quadrate: gall bladder and fissure for ligamentum teres

- caudate: IVC and fissure for ligamentum venosum (remnant of ductus venosum)

Question 8

What is the double layer of peritoneum between the liver and the stomach?

Answer 8

• the lesser omentum

Question 9

The hepatorenal recess is also known as:

Answer 9

• Morrison’s pouch (between the liver and right kidney)

- (fluid can accumulate in here during surgery)

Question 10

What are the three main areas of portosystemic anastomoses/varice formation?

Answer 10

• lower esophagus: esophageal varices can bleed profusely
• rectum and anal canal: hemorrhoids
• paraumbilical veins: caput medusae

Question 11

The _________ and _________ form the the common hepatic duct, while the _________ and __________ form the common bile duct.

Answer 11

• right hepatic duct + left hepatic duct –> common hepatic duct
• common hepatic duct + cystic duct –> common bile duct

Question 12

The common bile duct joins with the main pancreatic duct to form a dilatation known as the ____________, which empties in the ___ part of the duodenum via the _______ duodenal papilla.

Answer 12

• dilatation of the two ducts = hepatopancreatic ampulla (AKA ampulla of Vater)
• bile duct empties into the 2nd part of the duodenum via the major duodenal papilla

Question 13

The minor duodenal papilla lies ______ the major duodenal papilla and drains the _____________.

Answer 13

• minor is ABOVE the major

- drains the accessory pancreatic duct

Question 14

The sphincter of Oddi is the sphincter around the:

Answer 14

• hepatopancreatic ampulla (ampulla of Vater)
• (in addition: the common bile duct has a sphincter of the bile duct; the pancreatic duct has a sphincter of the pancreatic duct; when these two merge into the ampulla of Vater, you now have the sphincter of Oddi surrounding them)

Question 15

Which artery supplies the gallbladder? Where does it branch from?

Answer 15

• the cystic artery, which is usually a branch of the right hepatic artery

Question 16

The cystohepatic triangle is more commonly known as the __________. What is it made up of?

Answer 16

• known as the triangle of Calot

- formed by the cystic duct, the inferior/visceral surface of the liver, and the common hepatic duct

Question 17

Name the parts of the pancreas. What “passes through” the pancreas?

Answer 17

• the uncinate process, the head, the neck, the body, and the tail
• the superior mesenteric artery and vein “pass through” the pancreas (they pass behind the neck/body and then in front of the uncinate process)

Question 18

Which major arterial branches arise from the splenic artery near the hilum of the spleen? Which organs do they supply?

Answer 18

• the short gastric arterial branches supply the fundus of the stomach
• the left gastroepiploic artery supplies the greater curve of the stomach