Anatomy of the Liver

Question 1

Give the 3 abdominal regions that the liver is found in:

Answer 1

Right hypochondrium
Right lumbar region
Epigastric

Question 2

What is the right MCL border of the liver?

Answer 2

5th rib cc to the 9th rib ccc

Question 3

What is the right MAL border of the liver?

Answer 3

7th rib to 11th rib.

Question 4

What is the Left MCL border of the liver?

Answer 4

2.5cm. Short of the 5th ICS and left nipple.

Question 5

What ligament is found down the middle of two liver lobes.

Answer 5

Falciform ligament

Question 6

What ligament extends from the falciform ligament of the liver?

Answer 6

Round ligament of the liver (Ligamentum teres)

Question 7

Name 7 structures found anterior to the liver.

Answer 7

Diaphragm 
Right and left costal margins 
Right and left pleural margins 
Lower border of the Lungs
Lower border of the xiphoid process 
Lower border of the Anterior abdominal wall
Lower border of the subcostal angle

Question 8

Name 8 structures found posterior to the liver.

Answer 8

Right kidney 
Diaphragm 
Inferior Vena Cava
Oesophagus 
Fundus of the stomach
Hepatic flexure of the colon 
Duodenum 
Gall bladder

Question 9

What is the sympathetic innervation of the liver?

Answer 9

Coeliac plexus -> Sympathetic branch

Question 10

What is the parasympathetic innervation of the liver?

Answer 10

Hepatic branch of the anterior vagus nerve

Question 11

What is the blood supply of the liver?

Answer 11

Oxygen rich blood
Abdominal aorta -> Celiac trunk-> Common hepatic artery->left and right hepatics

[The Abdominal aorta gives rise to the Coeliac trunk at the level of T12.
( Br of CT = Left gastric, common hepatic and Splenic a)
Common hepatic a veers off retroperitoneally to the right entering hepatoduodenal ligament.
(Divides into: Gastro duodenal and Hepatic artery proper)
The hepatic artery proper splits into left and right hepatic arteries]

Nutrient rich blood
Portal veins from the intestines carrying nutrient rich blood
Portal

Question 12

What is the venous drainage of the liver?

Answer 12

Right and left hepatic vein -> Inferior vena cava

Question 13

Explain what Riedels lobe is:

Answer 13

This is a variation in the right lobe of the liver.

It is a tongue like projection of the anterior edge of the right lobe to the right of the gallbladder

Question 14

What is Ascites?

Answer 14

Ascites is an increase in fluid in the peritoneal cavity

- Abdominal swelling caused by accumulation of fluid, most often related to liver disease

Question 15

What disorder can cause Ascites?

Answer 15

Cirrhosis

- Cirrhosis causing an increase in blood pressure bringing blood to the portal system

Question 16

What medical procedure can cause urinary Ascites?

Answer 16

Supra-Pubic cathetrization

Question 17

Name 3 practices that can relive Ascites:

Answer 17

1. Lifestyle changes
2. Surgery
3. Peritoneal dialysis- cleansing fluid -> dialysate is circulated through a catheter inside the peritoneal cavity

Question 18

What are the functions of the liver? (12)

Answer 18

(SHIP DUMB)
Storage of blood and metabolites 
Hormone production 
Immunity 
Plasma protein synthesis 

Detoxification
Urea production
Metabolism
Bile formation and excretion

Blood filter e.g bacteria from GIT is removed by kupffer cells.
Blood production in fetus
Destruction of old RBC
Stores iron

Question 19

Describe the lymphatic drainage of the liver:

Answer 19

Superficial lymphatics of the anterior aspects of the diaphragmatic surface + the visceral surfaces and deep lymphatics accompanying portal triad

• Drained into hepatic lymph nodes by lymphatic vessels
• Eventually draining into celiace lymph nodes

Superficial lymphatics of the posterior aspects of the diaphragmatic surface + visceral surfaces
- Drained into phrenic lymph nodes

Anterior central diaphragmatic surface:
- Parasternal lymph nodes

Posterior surface of the left lobe:
- Left gastric lymph nodes

Around round ligament
- Umbilicus and lymphatics of the anterior abdominal wall.