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MET 2 > Liver anatomy > Flashcards

Liver anatomy Flashcards

1
Q

What structures can be seen if you reflect back the left lobe of the liver

A
  • oesophagus from stomach

- diaphragm

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2
Q

What is found to left of liver

A
  • Duodenum

- Right kidney

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3
Q

What is found behind the liver

A

IVC
Abdominal aorta/ coeliac trunk
Superior mesenteric vein and artery

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4
Q

Name the surfaces of the liver

A

Diaphragmatic surface

Visceral surface

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5
Q

Where is the visceral surface

A

Up against the organs behind the liver

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6
Q

What is the role of the subphrenic recess

A

Separates liver from the diaphragm

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7
Q

What divides the subphrenic recess longitudinally

A

Faciform liver

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8
Q

Where is the hepatorenal recess

A

Between the liiver and the kidney

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9
Q

Where do you 2 recesses join

A

Anterioly

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10
Q

How many lobes are in the liver

A

4

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11
Q

What is the largest lobe in the liver

A

Right lobe

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12
Q

What lobes are attached directly to right lobe

A

2 accesory lobes

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13
Q

What separates right and left lobes

A

Faciform ligament

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14
Q

What attaches the liver to anterior wall

A

Falciform ligament

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15
Q

How does the falciform ligament continue

A

Continues as the round ligament/ ligamentum teres

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16
Q

What other ligaments are formed peritoneum

A

Coronary

Triangular

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17
Q

Which surface of the liver is the fossa between right and left lobes found

A

Visceral

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18
Q

What is contained in the fossa between R and L lobes

A

Gall bladder and vena cava

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19
Q

Where is the caudate lobe found

A

Between fissure for ligamentum venosum and groove for IVC

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20
Q

How does the round ligament continue posteriorly

A

As the ligamentum venosum

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21
Q

Where is the quadrate lobe found

A

Between fissure for ligamentum teres and GB

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22
Q

Where is the bare area of the ligament

A

Anterior part of the liver

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23
Q

What kind of peritoneum on bare area of liverr

A

none

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24
Q

What is the porta-hepatis

A

Entrance into the liver

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25
Q

Where does the bile come out

A

Via bile duct

26
Q

What attaches the lesser curvature of the stomach to the liver

A

Hepatogastric part of the lesser omentum

27
Q

What attaches the liver to the duodenum

A

Hepatoduodenal part of the lesser omentum

28
Q

What is contained in the porta hepatis

A

Hepatic portal vein
Hepatic artery
Bile duct

29
Q

What is meant by the dual blood supply of the liver

A

Hepatic portal vein and the hepatic artery both go in

30
Q

How many segments does Couinauds segments divide liver into

A

8

31
Q

What transects the segments in horizontal plane

A

Left and right portal veins

32
Q

What transects the segments in the vertical plane

A

Hepatic veins

33
Q

What is meant by the pringle manoeuvre

A

Clamping the pedicle area by the hepato-duodenal ligament in order to buy time during a trauma

34
Q

What is the first midline branch of the abdominal aorta

A

Coeliac trunk

35
Q

What are the branches of the coeliac trunk

A

Left gastric
Splenic artery
Hepatic artery common

36
Q

What significant branch comes off of the splenic artery

A

Left gastroepiploic

37
Q

What branches come off the common hepatic artery

A

Gastroduodenal branch
Hepatic artery proper
Right and left hepatic artery

38
Q

Where is cystic artery from?

What does it supply

A

Right hepatic artery

Gall bladder`

39
Q

What % of blood supply to the liver is arterial

A

25

40
Q

What % of blood supply to the liver comes from the hepatic portal system

A

75

41
Q

Where does inferior mesenteric vein drain

A

Into the splenic

42
Q

How many sites of porto-systemic anastamoses are there

A

4

43
Q

How many capillary beds does the portal system have

A

2

44
Q

What are the 3 main regions that can drain either into hepatic or caval system

A
  • Oesophageal region
  • Anterior abdominal wall region
  • Rectal region
45
Q

In which 2 ways can blood from the anterior abdominal region drain?

A
  • Up to the umbilical and into hepatic portal system, through liver and then into IVC
  • Down inferior and superficial epigastrics which joins iliacs and into IVC
46
Q

In which 2 ways can blood from the rectal region drain

A
  • Midlde and inferior rectal veins go into the caval system into iliacs and into the IVC
  • Superior rectal vein goes into hepatic portal system
47
Q

How does oesophageal region drain

A

Into the azygos region and into the SVC then into the right heart
Flow into gastric branches into portal vein etc

48
Q

What problems are associated with having a dual drainage system

A

If there is damage to the liver there is a blockage of blood and back-up
It starts to course along collateral routes into caval system

49
Q

Where is the fourth anastomoses

A

Colic veins and retroperitoneal veins

50
Q

Define cirrhosis

A

Replacement of liver tissue by fibrosis, scar tissue amd regenerative nodules leading to loss of liver function

51
Q

What is normal portal pressure

A

9mmHg

52
Q

Define portal hypertension

A

When portain pressure gradient (difference between portal and IVC pressure) is more than 10

53
Q

How large must the spleen be before it is palpatable

A

5 times it normal size

54
Q

Where do oesophageal varices usually occur

A

Anastomoses of left gastric vein with oesophageal veins

Gastro-oesophageal junction

55
Q

Main cause of oesophageal varices

A

Portal hypertension

56
Q

Less common causes of oesophageal varices

A

Ulcers, tumours, erosision, gastroenteritis

57
Q

Define ascites

A

Fluid in peritoneal space

58
Q

How does liver cirrhosis lead to ascites

A

Non functioning liver means less albumin, so osmotic pressure not maintained
Fluid leaks from interstitial fluid into peritoneal cavity

59
Q

Are haemorrhoids the ano-rectal varies the same

A

No

60
Q

Why do ano-rectal varices happen

A

Swelling of vessels due to portal hypertension

MET 2 (32 decks)

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