Lesson 4A

Question 1

What do the couinaud segmental anatomy do? (2)

Answer 1

1. Provides the basis for surgical resections

2. Diagnostic designation of lesions on US and CT

Question 2

What is couinaud segmental anatomy based on?

Answer 2

Venous anatomy

Question 3

What divides the couinaud segmental anatomy in the liver? (2)

Answer 3

1. Both the hepatic veins

2. Portal vein

Question 4

Why can each segment in the liver be resected without damage?

Answer 4

Because they are based on their blood supply

- each segment has its own porta hepatis

Question 5

What is in the centre of each segment in the liver? (3)

Answer 5

A branch that consists of…

1. Portal vein
2. Hepatic artery
3. Hepatic duct

Question 6

What is in the periphery of each branch segment?

Answer 6

Vascular flow through the hepatic veins

Question 7

How many segments are there in the couinaud segmental anatomy?

Answer 7

8

Question 8

What is in segment 1 of the couinaud segmental anatomy?

Answer 8

Caudate lobe

Question 9

Where is segments 2 and 3 of the couinaud segmental anatomy?

Answer 9

Left lateral lobe

Question 10

Where is segment 4 on the couinaud segmental anatomy?

Answer 10

Medial left lobe

- divides into 4a (superiorly) and 4b (inferiorly)

Question 11

Where is segment 5 and 8 of the couinaud segmental anatomy?

Answer 11

Right anterior lobe

Question 12

Where is segment 6 and 7 on the couinaud segmental anatomy?

Answer 12

Right posterior lobe

Question 13

What veins divide the segments 4a and 2 on the couinaud segmental anatomy?

Answer 13

Left hepatic vein

Question 14

What veins divide the segments 7 and 8 on the couinaud segmental anatomy?

Answer 14

Right hepatic vein

Question 15

What veins divide the left and right lobe of the liver?

Answer 15

Middle hepatic vein

Question 16

What do the portal veins divide?

Answer 16

The upper (superior) and lower (inferior) portions

Question 17

What does the right hepatic vein divide?

Answer 17

The right lobe into anterior and posterior sections

Question 18

What plane does the middle hepatic veins run from?

Answer 18

The IVC to the gallbladder

- sagittally

Question 19

What does the left hepatic vein divide?

Answer 19

The left lobe into medial and lateral sections

Question 20

Which portal vein is more superior?

Answer 20

Left portal veins

Question 21

What do the hepatic veins do?

Answer 21

They drain blood from the segments and lobes of the liver into the IVC

Question 22

Where are the hepatic veins located?

Answer 22

Interlobar and intersegmental

Question 23

Where are you on the liver if you can see the hepatic veins?

Answer 23

Superior

Question 24

What are the superior segments of the liver? (5)

Answer 24

1. 7
2. 8
3. 4a
4. 2
5. 1

Question 25

What does it mean if you can still see the portal vein?

Answer 25

This tells you you have not yet reached segments 5 and 6 | - because the left portal vein is more superior than the right portal vein

Question 26

What do you see if you are more in the mid region of the liver?

Answer 26

The IVC and hepatic veins more distally

Question 27

What segments are above the portal vein? (2)

Answer 27

1. 2 | 2. 4a

Question 28

What segments are below the portal vein? (2)

Answer 28

1. 3 | 2. 4b

Question 29

What does it mean when you can see the right portal vein?

Answer 29

We are between segments 7 and 8 superiorly and 6 and 5 inferiorly

Question 30

What is the horizontal divider for segments 4a/4b and 2/3?

Answer 30

The left hepatic vein

Question 31

What does it mean when the hepatic veins are superficial and you can see some organs?

Answer 31

You are quite inferior | - 6, 5, 4b, and 3 segments

Question 32

What does IV mean?

Answer 32

4

Question 33

What does VI mean?

Answer 33

6

Question 34

What does VII mean?

Answer 34

7

Question 35

What does VIII mean?

Answer 35

8