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Abdomen Anatomy > Liver surfaces and attachments (Dave's notes) > Flashcards

Liver surfaces and attachments (Dave's notes) Flashcards

1
Q

What are the divisions of the diaphragmatic surface of the liver?

A
  • Anterior
  • posterior
  • superior
  • right surfaces.

Covered mostly in peritoneum but peels off in places to join the diaphragm

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2
Q

What are the relations of the anterior surface of the liver?

A

Diaphragm, lung, pleura, and ribs - 6-9R and 6-7L, curves back at the superior surface

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3
Q

What are the relations of the superior surface of the liver?

A
  • Centrally: Heart and pericardium
  • Laterally: lung and pleura
  • The lower border slopes up along the right rib border and then across the epigastrium
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4
Q

Describe the position of the falciform ligament relative to the liver.

A
  • The falciform ligament lies from the centre to the ligamentum teres notch
  • left to the fundus of the gall bladder.
  • It splits and sweeps to the right as the upper layer of the coronary ligament
  • and to the left as the left triangular ligament
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5
Q

What are the relations of the right surface of the liver?

A
  • Ribs 7-11
  • lower 1/3rd to the ribs and diaphragm
  • middle 1/3rd also to pleura
  • upper 1/3rd also to lung
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6
Q

Describe the visceral (inferior) surface of the liver

A
  • The visceral surface of the liver slopes downwards, forwards and to the right. - - Its main feature is an H-pattern of structures.
  • Contains the portahepatis, lesser omentum extending into the ligamentum venosum and impressions of lower organs
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7
Q

What forms the H pattern of structures on the visceral surface of the liver?

A
  • The crosspiece of the H is the portahepatis enclosed by the two layers of the lesser omentum.
  • Left upper end: is the ligamentum venosum. The lesser omentum passes down from here to enclose the stomach and the first 2cm of the duodenum.
  • left lower end: is the round ligament (umbilical vein).
  • Right upper end: is the IVC/groove for IVC.
  • Right lower end: gallbladder fossa.
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8
Q

Describe the porta

A
  • The porta hepatis is a transverse slit perforated by the right and left hepatic ducts
  • and the right and left branches of the hepatic artery and portal vein ( ducts in front).
  • The cystic duct lies in loose contact with the right end of the porta.
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9
Q

What constitutes the right limb of the H?

A

the right limb is incomplete and consists of the IVC and GB

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10
Q

What constitutes the left limb of the H?

A

The ligamentum venosum and the ligamentum teres

The ligamentum venosum and the ligamentum teres

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11
Q

Describe the posterior surface of the liver

A
  • The posterior surface of the liver blends with the visceral surface of the liver.
  • It contains the bare area
  • the bounding ligaments
  • the right suprarenal impression
  • the IVC groove
  • caudate lobe and process
  • the ligamentum venosum fissure
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12
Q

Describe the bare area of the liver

A
  • The bare area is triangular and lies to the right of the IVC (its base).
  • The sides are formed by upper and lower layers of the coronary ligament.
  • The apex is at the right triangular ligament.
  • From here peritoneum sweeps down over the right kidney.
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13
Q

What encloses the caudate lobe?

A

The lower layer of the coronary ligament in the upper recess of the lesser sac

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14
Q

What are the relations of the caudate lobe?

A

In in contact with the diaphragm??? in front of the thoracic aorta, left of the IVC an dright of the oesophagus and ligamentum venosum

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15
Q

List the lobes of the liver

A

Left, caudate, quadrate, and right

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16
Q

What does the falciform divide?

A

The anatomical left and right lobes

17
Q

What is the location and relations of the caudate lobe?

A

The caudate lobe lies between the IVC and ligamentum venosum and is connected to the right lobe via the caudate process

18
Q

What is the location and relations of the quadrate lobe?

A

The quadrate lobe lies between the gall bladder fossa and the fissure for the ligamentum teres.

19
Q

Which lobe to the caudate and quadrate belong to functionally?

A

The left lobe

20
Q

Describe one simple way of dividing the liver into segments

A

Left lateral (1), left medial (2), right anterior (2), and right posterir (2)

21
Q

Location of segment 1 (8 segment division)

A

Caudate

22
Q

Location of segment 2 (8 segment division)

A

left lateral

23
Q

Location of segment III (8 segment division)

A

Lateral part of left medial

24
Q

Location of segment IV (8 segment division)

A

Medial part of left medial

25
Q

Location of segment V (8 segment division)

A

Lower part of right anterior

26
Q

Location of segment VI (8 segment division)

A

Lower part of right posterior

27
Q

Location of segment VII (8 segment division)

A

Upper part of right posterior

28
Q

Location of segment VIII (8 segment division)

A

Upper part of right anterior

29
Q

Describe the artery and portal vein divisions

A

The hepatic artery division is Y-shaped, the portal vein division is T-shaped

30
Q

The right hepatic artery divides into what?

A

Anterior and posterior branches

31
Q

The left hepatic artery divides into what? What abberation may occur?

A

Medial and lateral branches. The commonest aberration is a left hepatic artery arising from the left gastric (20%)

32
Q

What arterial mixing occurs between the left and right halves of the liver?

A

There is no communication between the arterial supply of the left and right halves of the liver

33
Q

What venous mixing occurs between the left and right halves of the liver?

A

There is left, right and central venous drainage, with mixing. The central veins drain left and right, and ?? are the main structural support

34
Q

Describe the lymphatic drainage of the liver

A

The lymphatic drainage of the liver is to nodes at the porta hepatis that drain down the hepatic artery to retropyloric and coeliac nodes.

35
Q

What is the nerve supply of the liver and by what route?

A

Via sympathetic and vagus pathways, vagal from anterior/left branches across ???

36
Q

Describe the development of the liver

A

The development of the liver is by way of cells proliferating from the blind-ended Y-shaped diverticulum (bile duct) into the ventral mesogastrium

Abdomen Anatomy (33 decks)

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