Lecture 5 - Liver Anatomy & Physiology

Question 1

What regions does the liver occupy?

Answer 1

R. Hypochondrium, Epigastrium, L. Hypochondrium

Question 2

Fundus of the stomach lies __ to the __

Answer 2

Posterior & Lateral — L. Lobe of the Liver (LLL)

Question 3

The __ is adjacent to the __

Answer 3

Duodenum — R. Lobe of the Liver (RLL)

Question 4

Body of the Pancreas is __ to the __

Answer 4

Inferior — L. Lobe of the Liver

Question 5

Right Kidney, IVC & AO contact the __

Answer 5

Posterior border of the Liver

Question 6

What can cause inferior displacement of the Liver?

Answer 6

Tumor infiltration, Cirrhosis, or a Subphrenic abscess

Question 7

Dilation of __ can elevate the Liver

Answer 7

Colon or Abdominal Tumor

Question 8

What specifically can shift the position of the Liver?

Answer 8

Ascites - due to its fluid accumulation

Question 9

Part of the Liver not covered by peritoneum?

Answer 9

Bare Area - it is in direct contact with diaphragm

Question 10

What is fluid accumulation below the diaphragm?

Answer 10

Ascites (think A for Abdomen)

Question 11

What is fluid accumulation above the diaphragm?

Answer 11

Pleural Effusion (pleura-thin tissue covering lungs)

Question 12

What are sites for abscess formation or fluid accumulation?

Answer 12

Subphrenic spaces

Question 13

Morrisons pouch is a site for fluid accumulation - describe its location.

Answer 13

Upper Pole of R kidney & Posterior aspect of R. Lobe of Liver

Question 14

How does Anatomical Division divide the Liver and what landmark does it use?

Answer 14

Falciform Ligament divides liver into larger R Lobe and smaller L Lobe

Question 15

Where and How is Riedel’s lobe identified?

Answer 15

Anterior Inferior projection of the Right Lobe
DURING NORMAL RESPIRATION

Question 16

How does the L. Lobe vary?

Answer 16

Varies Considerably in size & shape

Question 17

Quadrate lobe is __ and refers to the __

Answer 17

Obsolete term — medial segment of L. Lobe

Question 18

Caudate lobe is situated on __ with IVC as it’s __ and Ligamentum __ as its __ border

Answer 18

Posterior of L. Lobe — Posterior Border — Venosum — Anterior Border.

Question 19

The Caudate Lobe may __ the IVC with caudate lobe __

Answer 19

Compress — Enlargement

Question 20

Couinaud’s System aka __ based on __

Answer 20

Functional Division — Vasculature

Question 21

R. Lobe is separated from L. Lobe by the __

Answer 21

Main Lobar Fissure
(courses obliquely dividing R & L Lobes)

Question 22

How many functional segments are there?

Answer 22

8 self contained units
(has a hepatic artery, vein, bile duct & portal vein)

Question 23

Name the locations of the 8 functional segments:

Answer 23

1. Caudate Lobe
   - may receive R & L Portal veins
   - may have 1 or more Hepatic veins draining into IVC
2. L Lateral Superior
3. L Lateral Inferior
   4a. L Medial Superior
   4b. L Medial Inferior
4. R Anterior Inferior
5. R Posterior Inferior
6. R Posterior Superior
7. R Anterior Superior

Question 24

Hepatic Veins are __ and divide liver into 4 segments

Answer 24

Intersegmental (between segments)

Question 25

Portal Triad is __ and courses to the center of each segment

Answer 25

**Intra**segmental (within segments)

Question 26

Sonographic appearance of ligaments and fissures

Answer 26

Echogenic or Hyperechoic - due to collagen and fat within and around the structures

Question 27

Name of connective tissue covering liver

Answer 27

Glisson’s Capsule

Question 28

The bare are is covered by __

Answer 28

Glisson’s capsule -bare area is covered by Glisson’s capsule Glisson’s capsule (connective tissue) **NOT** peritoneum

Question 29

__ divides liver into R. and L. Lobes *functionally*

Answer 29

Main Lobar Fissure

Question 30

__ is a hyperechoic line and connects the neck of the gallbladder to the Portal vein

Answer 30

Main Lobar Fissure

Question 31

How can ligament shadowing be avoided during a scan?

Answer 31

Adjusting positioning of probe or patient

Question 32

Falciform ligament is a __ peritoneum

Answer 32

2 layer

Question 33

Liver attaches to the anterior abdominal wall and inferior surface of diaphragm by the __

Answer 33

Falciform Ligament

Question 34

Falciform ligament extends from the diaphragm to the umbilicus and **contains the** __

Answer 34

Ligamentum Teres

Question 35

Falciform ligament attached to the __ and the __ of the diaphragm

Answer 35

Anterior Abdominal Wall — Inferior Surface