Liverspleen Flashcards
What is meant by the bare area of the liver
Superior surface of liver has direct contact with the inferior surface of the diaphragm
No intervening peritoneum
Visceral peritoneum reflects at bare area.
Describe the boundaries of the bare area of the liver
Anterior boundary- reflection of the peritoneum- anterior coronary ligament
Posterior boundary- reflection of peritoneum- posterior coronary ligament
Where the two coronary ligaments come together laterally they form the right and left triangular ligaments
Describe the Mesenteries in Relation to the Stomach, Liver, and Spleen
Liver is attached to stomach and duodenum via folds of peritoneum (lesser omentum- hepatogastric and hepatoduodenal ligaments respectively)
Stomach is attached to spleen via gastrosplenic ligament
Spleen attached to left kidney via splenorenal ligament
They are folds in peritoneum
Describe the liver mesenteries and bare areas
Liver develops in the ventral foregut mesentery
Connected to anterior abdominal wall by Falciform Ligament- derived from ventral mesentery in the embryo
Connected to stomach by Lesser Omentum
Direct contact with part of Diaphragm (Bare Area of Liver)
Describe the location of the liver
Largest visceral organ in the body- primarily in the right hypochondrium and epigastric region, extending into the left hypochondrium (RUQ and LUQ)
Describe the surface anatomy of the liver
Deep to: ribs 7 -11
Mostly under the cover of ribs
Epigastrium- covered by rectus abdominis muscle- can’t palpate here
palpate under ribs
Describe the two surfaces of the Liver
Diaphragmatic- anterior, superior and posterior directions
visceral- inferiorly
Describe the recesses of the diaphragmatic surfaces of the liver
Diaphragmatic surface is smooth and domed
Subphrenic recess- separates diaphragmatic surface of the liver from the diaphragm- and is divided into right and left areas by the falciform ligament- a structure derived from the ventral mesentery
hepatorenal recess- part of the peritoneal cavity on the right side between the liver and right kidney and right suprarenal gland
Both recesses are continuously anteriorly
Describe the anatomical lobes of the liver
The liver is divided into right and left lobes by fossae for the gallbladder and IVC. The right lobe is the largest
The quadrate and caudate lobe arise from the right lobe and are functionally distinct.
Describe the ligaments of the Liver
Visceral peritoneum reflects off the liver in the form of the falciform ligament and the coronary ligaments which reflect off the right and left lobes of the liver
Superior surface of left lobe- left triangular ligament
Superior surface of right lobe- coronary ligament
All these ligaments attach the liver to the diaphragm (anterior abdominal wall)
What is attached to the falciform ligament
Ligamentum teres (round ligament of liver)- remnant of the obliterated left umbilical vein This joins the ligamentum venosum- now a fissure on the visceral surface (fissure of ligamentum venosum)
Essentially, what forms the lobes
The peritoneal reflections divide the liver externally into two main lobes and 2 accessory lobes
Summarise the visceral surface of the liver
Covered in visceral peritoneum except in the fossa for the gallbladder and at the porta hepatis
Porta hepatis serves as a point of entry into the liver for the hepatic arteries, and portal veins, and an exit point for the hepatic ducts
Describe the right anatomical lobe of the liver and its posterior relations
Inferior to posterior coronary ligament- renal impression
Inferior to this colic impression
Medial to colic impression- gall bladder
medial to this- quadrate lobe
Gall bladder moves superiorly (fundus, body, neck) into porta hepatis
IVC superiorly
Caudate lobe just medial to falciform ligament in the middle
See diagram!
Describe the left anatomical lobe of the liver and its relations
Gastric impression just inferior to the left triangular ligament
Esophageal impression medial to this
Describe the quadrate lobe
Visible on the anterior part of the visceral surface- bounded on the left by the fissure of ligamentum teres and on the right the fossa of the gall bladder
Functionally- it is related to the left lobe but anatomically to the right
Describe the caudate lobe
Visible on the posterior part of the liver
bounded on the left by the fissure of ligamentum venosum and on the right by the groove for the IVC
Functionally distinct from the right and left lobes
Describe the functional lobes of the liver
Divided into right and left functional lobes by fossae for the IVC and gallbladder