Liver, Portal Circulation, Billiary System and Spleen Flashcards
What ligaments can the lesser omentum be divided into?
Hepatoduodenal Ligament
Gastrohepatic Ligament
Which ligaments suspend the spleen?
Splenorenal ligament and Gastrosplenic ligament
In which mesentery does the liver develop?
Ventral mesentery
What connects the liver to the anterior abdominal wall?
Falciform Ligament
What connects the liver to the lesser curvature of the stomach?
Lesser Omentum
What is the region of the liver that makes direct contact with the diaphragm called?
Bare area of the liver
Which ribs are the liver deep to?
Deep to ribs 7-11
Which abdominal regions do the liver extend across?
The top three: right hypogastric, epigastric and left hypogastric
What is the structure at the end of the falciform ligament called and how did it originate?
Ligamentum Teres - it is a remnant of the umbilical vein
What are the ligaments on the superior surface of the liver called?
Coronary Ligament (anterior and posterior) Left and Right Triangular Ligaments
What defines the anatomical boundary (dividing the liver into anatomical lobes)?
The fissures of the foetal veins
What are the two accessory lobes of the liver and where are they located?
Quadrate - located between the gallbladder and the fissure of the ligamentum teres
Caudate - located between the IVC and the fissure of the ligamentum venosum
The porta hepatis divides the caudate and quadrate lobes.
What is the ligament on the posterior end of the inferior aspect of the liver?
Ligamentum venosum - remnant of the ductus venosum
What divides the liver into right and left functional lobes?
A line between the gallbladder and the IVC
What is special about the caudate lobe?
It is functionally independent - its blood supply is separate to the two main lobes
What vessels make up porta hepatis?
Common bile duct
Hepatic artery
Hepatic portal vein
What are the two parts of the coronary ligament?
Anterior and Posterior
What is the space between the superior surface of the liver and the diaphragm called?
Subphrenic Space
What are the branches of the coeliac trunk?
Left Gastric Artery
Splenic Artery
Common Hepatic Artery
What are the branches of the common hepatic artery?
Right gastric artery
Gastoduodenal Artery (branches into the anterior and posterior superior pancreaticoduodenal arteries and the right gastro-omental artery)
Supraduodenal Artery
Cystic Artery
Hepatic Artery Proper
NOTE: Superior Pancreaticoduodenal Arteries anastomose with the inferior pancreaticoduodenal arteries (which come off the superior mesenteric artery)
What connects the venous drainage of the liver to the IVC?
Three short hepatic veins
What are the four sites of portal-systemic anastomosis?
Oesophageal Veins - Left Gastric Vein
Inferior Rectal Vein - Superior Rectal Vein
Epigastric Veins - Paraumbilical Vein
Retroperitoneal Veins - Visceral Veins
What is the significance of these sites?
If there is a blockage causing hepatic portal tension, these sites of porto-systemic anastomoses could dilate and possibly bleed
At which of these anastomoses is haemorrhage common?
Oesophagus
Rectum
Describe the structure of the biliary tree.
The cystic duct from the gallbladder joins the hepatic duct (from the right and left hepatic ducts) to form the common bile duct
Where does the common bile duct and pancreatic duct enter into the duodenum?
Major Duodenal Papilla
NOTE: the pancreatic duct joins the common bile duct at a dilation in the common bile duct called the Ampulla of Vater
What is the clinical significance of the proximity of the gallbladder to the first part of the duodenum?
Gallstones can press on the duodenum and ulcerate causing a cholecystoduodenal fistula
The spleen lies on the underside of which ribs?
9-11
What are the two ligaments at the hilum of the spleen?
Splenorenal and Gastrosplenic
