Week 5- foregut 2 Flashcards
Describe the lobes that make up the liver?
You have 4 lobes- right, left, caudate and quadrate.
The caudate lobe is superior and posterior whereas the quadrate lobe is posterior but inferior.
Which ligament on the liver is a remnant of an embryological component?
The ligamentum teres is a remnant of the umbilical vein.
Which two ligaments run on the superior surface of the liver?
What do they join to form?
The right and left triangular ligaments.
Join together to form the falciform ligament.
What is continuous with the falciform ligament inferiorly?
Continuous with the ligamentum teres (it thickens here).
Which vein runs alongside the caudate lobe?
The inferior vena cava.
What is the porta hepatis?
What does it contain?
Sort of like the lung hilum in the sense that its where the vessels enter/exit the liver.
The porta hepatis contains the portal vein, the left and right hepatic arteries and the right and left hepatic ducts (also lymph nodes and nerves).
What forms the boundaries of the porta hepatis?
The lesser omentum.
What sits on the posterior surface of the liver?
Oesophagus, stomach, duodenum, right colic flexure, right kidney, supra-renal gland, gall bladder.
What peritoneal lining covers the liver? What is the area not covered by this called?
Covered by visceral peritoneum.
Bare area is the area superiorly on the right lobe that isn’t covered by visceral peritoneum.
How are the right and left triangular ligaments and the falciform ligament formed?
The peritoneum folds back on itself to form a double layer which is these ligaments.
Where does the falciform ligament pass from and to?
Formed by the joint of the right and left triangular ligaments in the groove between the right and left lobes of the liver. Attaches at the umbilicus.
What does the right layer of the falciform ligament form?
It creates the coronary ligament.
What does the left layer of the falciform ligament form?
The left triangular ligament.
Where does the liver obtain its blood supply from?
30% from hepatic arteries- oxygen rich, nutrient deficient.
70% from portal vein- nutrient rich, oxygen deficient
When in the liver, where does the arterial and venous blood get sent too?
Goes through liver sinusoids to their central vein.
The central veins then drain into the right and left hepatic veins and then into the IVC.
Where does lymph from the liver drain too?
It drains to the nodes at the porta hepatis then to the coeliac nodes.
Where is pain from the liver referred too?
To the epigastric region or small amount via the diaphragm to the right shoulder.
Where is bile stored and concentrated?
Gall bladder.
Describe the bile drainage of the liver?
Right and left bile ducts join. The cystic duct then connects to form the common bile duct. The pancreatic duct joins at the ampulla of vater. They can then be secreted into the duodenum by the sphincter of Oddi.
How long is the bile duct and where does it end?
Bile duct is 8cm long and ends by piercing the medial wall of the 2nd part of the duodenum.
Describe the structure of the gall bladder?
It has a neck, a body and a fundus (this part hangs below the liver)
What sort of peritoneum covers the gall bladder?
Visceral peritoneum.
What causes the gallbladder to release bile?
If there is fat in the duodenum, a hormone called cholecystokinin is released causing the gall bladder to contract. This causes the smooth muscle in the sphincter to relax allowing bile into the duodenum.
Describe the blood supply to the gallbladder?
Arterial- cystic artery from the right hepatic artery.
Vein-cystic vein which drains into portal vein.
