Liver: Peritoneal Relations, Folds, And Ligaments

Question 1

Liver is completely covered with peritoneum except the following:

Answer 1

1. Bare area proper
2. IVC groove
3. Gall bladder fossa

Question 2

Bare area proper

Answer 2

On right lobe posterior surface

Question 3

IVC groove

Answer 3

On right lobe posterior surface

Question 4

Gall bladder fossa

Answer 4

On right lobe inferior surface

Question 5

Ligaments

Answer 5

1. Lesser omentum (gastrohepatic) ligament
2. Falciform ligament
3. Coronary ligament
4. Right triangular ligament
5. Left triangular ligament

Question 6

Lesser omentum

Answer 6

Peritoneal fold representing ventral mesogastrium posterior part

Question 7

Lesser omentum ligament extent

Answer 7

Extends between stomach and liver where it is attached to:
1. Porta hepatis margins
2. Margins of Ligamentum venosum fissure

Question 8

Falciform ligament

Answer 8

Sickle shaped peritoneal fold representing ventral mesogastrium anterior part

Question 9

Falciform ligament extent

Answer 9

Extends from anterior abdominal wall and diaphragm to liver

Question 10

Falciform ligament: layers

Answer 10

Formed of 2 layers:
1. Anterior layer: in contact with anterior abdominal wall
2. Posterior layer: in contact with liver

Question 11

Borders

Answer 11

2 attached and 1 free:
1. Concave border
2. Convex upper border
3. Lower free border

Question 12

Concave border

Answer 12

Attached to liver anterior and superior surfaces

Question 13

Convex upper border

Answer 13

Attached to:
1. Diaphragm undersurface
2. Anterior abdominal wall in median plane

Question 14

Lower free border

Answer 14

1. Both layers are continuous
2. Enclose Ligamentum teres and paraumbilical veins
3. Extends from umbilicus back to Ligamentum teres fissure on liver inferior surface

Question 15

Contents

Answer 15

1. Ligamentum teres and paraumbilical veins: in free border
2. Lymph vessels draining umbilicus deep surface: run along Ligamentum teres to drain into porta hepatis nodes
3. Extraperitoneal fatty tissue: between both layers

Question 16

Coronary ligament

Answer 16

Consists of 2 layers which enclose liver bare area:
1. Upper layer
2. Lower layer

Question 17

Upper layer

Answer 17

Peritoneal reflection from diaphragm to liver right lobe upper surface

Question 18

Lower layer

Answer 18

Peritoneal reflection from liver right lobe lower surface to posterior abdominal wall

Question 19

Right triangular ligament

Answer 19

Coronary ligament both layers meet together at their right ends forming right triangular ligament

Question 20

Right triangular ligament extent

Answer 20

Short triangular peritoneal extending from back of liver right lobe at bare area right end to diaphragm

Question 21

Coronary ligament right extension

Answer 21

Right triangular ligament

Question 22

Left triangular

Answer 22

Short triangular peritoneal fold

Question 23

Left triangular ligament extent

Answer 23

Extending from upper surface of liver left lobe to diaphragm undersurface