Liver anatomy Flashcards

1
Q

Where is the liver in the body?

A

Peritoneal

Right upper quadrant (hypochondium) of the abdomen

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2
Q

What does the liver do?

A

Synthesis of bile
Glycogen storage
Clotting factor production

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3
Q

What is anterior to the liver?

A

Anterior abdominal wall and ribcage

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4
Q

What is superior to the liver?

A

Diaphragm

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5
Q

What us posterior to the liver?

A

Oesophagus, stomach, gall bladder, 1st part of duodenum

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6
Q

Name the liver surfaces.

A

Diaphragmatic and Visceral

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7
Q

Describe the diaphragmatic surface?

A

Smooth and convex, fitting beneath curvature of the diaphragm

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8
Q

What is the bare area?

A

A section of the diaphragmatic surface of the liver that is not covered by visceral peritoneum.

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9
Q

Describe the visceral peritoneum?

A

Moulded by the shape of the surrounding organs, so irregular and flat.

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10
Q

Name the ligaments of the liver.

A
Falciform
Right and left coronary
Triangular
Ligamentum teres
Lesser omentum - consists of hepatoduodenal and hepatogastric ligament
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11
Q

What does the Falciform ligament do?

A

Attaches anterior surface of the liver to the anterior abdominal wall.

The free edge of this ligament contains the ligamentum teres (remnant of umbilical vein)

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12
Q

What do the right & left coronary ligaments do?

A

Attach the superior surface of liver to the diaphragm

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13
Q

What do the triangular ligaments do?

A

Attach superior surface of liver to diaphragm

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14
Q

How is the liver secured posteriorly?

A

By the IVC, hepatic veins and fibrous tissue

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15
Q

Where is the Subphrenic space?

A

Right and left

Between diaphragm and liver, either side of Falciform ligament

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16
Q

Where is the Subhepatic space?

A

Between inferior surface of liver and transverse colon

17
Q

Where is Morison’s pouch?

A

The posterosuperior aspect of the right Subhepatic space.

Between visceral surface of liver and the right kidney

18
Q

What is the name given to the fibrous layer that covers the whole liver?

A

Glisson’s capsule

19
Q

Name the 4 lobes of the liver.

A

Right
Left
Quadrate
Caudate

(Q and C are accessory lobes)

20
Q

What separates the caudate and quadrate lobe?

A

A deep fissure called porta hepatis

21
Q

What does the porta hepatis do?

A

Transmits all vessels, nerves and ducts entering or leaving the liver

22
Q

What are cells of the liver called?

A

Hepatocytes

23
Q

How are hepatocytes arranged?

A

In lobules - which are the structural units of the liver

24
Q

Describe the structure of lobules of the liver?

A

Hexagonal

Each is drained by a venule in its centre, called a central vein

At the periphery of the hexagon is a portal triad

25
Q

What does a portal triad consist of?

A

Arteriole - branch of the hepatic artery
Venule - branch of hepatic portal
Duct - branch of bile duct leaving liver
Lymph vessels and Vagus nerve

26
Q

What special about the liver’s blood supply? Name the vessel(s).

A

It is dual!
Hepatic artery proper
Hepatic portal vein (dominant blood supply)

27
Q

What does the hepatic artery proper supply the liver with? Where is this artery from?

A

Arterial blood

Branch of coeliac trunk

28
Q

What does the hepatic portal vein supply the liver with?

A

Deoxygenated blood carrying nutrients supplied from the small intestine.
This allows liver to do its detoxification

29
Q

How is the liver drained of blood?

A

Three hepatic veins which drain into the inferior vena cava

30
Q

What innervates the parenchyma (bulk) of the liver?

A

Hepatic plexus:
Sympathetic (from coeliac plexus)
Parasympathetic - Vagus

31
Q

Describe the route of the nerves in the parenchyma of the liver?

A

They enter via porta hepatis and follow the route of the hepatic artery and portal vein

32
Q

What is the innervation of Glisson’s capsule?

A

Branches of lower intercostal nerves

33
Q

Name the impressions on the liver and what causes them.

A
Colic - hepatic flexure
Renal - R kidney & suprarenal gland
Suprarenal - R suprarenal
Duodenal - descending duodenum
Gastric - stomach
34
Q

What is Calot’s triangle?

A

A triangle bound by the cystic artery, the cystic duct and the hepatic duct.

35
Q

What is the ligamentum teres?

A

Remnant of umbilical vein in foetus which bypassed liver circulation to directly enter IVC

36
Q

What is the percentage contribution of each vessel that supplies the liver with blood?

A

Hepatic artery - 25%
Branch of coeliac - oxygenated

Portal vein - 75%
Veins from GI tract and spleen contain products of digestion for metabolism

37
Q

Describe the greater omentum? Blood supply?

A
  • Apron like fold attaching to greater curvature of stomach
  • 4 layers
  • Stores adipose tissue, cushions and protects organs
  • Supplied by R&L gastro-omental vessels
38
Q

Describe the lesser omentum. What are its divisions?

A

-Extends from lesser curvature and duodenum
-2 layers
-divided into
medial hepatogastric ligament
lateral hepatoduodenal ligament