Liver

Question 1

What is the liver?

Answer 1

Largest organ in the body

Question 2

Is the liver intraperitoneal and what does it mean?

Answer 2

Yes, and it means that it is contained in the peritoneal

Question 3

What is the function of the liver?

Answer 3

1. Metabolic activities
2. production and secretion of bile
3. filtration of the blood

Question 4

Where is the liver located?

Answer 4

Right hypchondrium, epigastric region, may extend to the left hypchondrium.

Might be located in the RUQ, with the potential of crossing over to the LUQ

Question 5

What is the surfaces of the liver like?

Answer 5

1. Diaphragmatic
2. Visceral

Question 6

What is the diaphragmatic surface of the liver?

Answer 6

Dome shaped (convex) and smooth

Question 7

Which part of the liver is in contact with the diaphragm?

Answer 7

Anterior, superior and posterior portion in contact with diaphragm

Question 8

What is the bare area of the liver?

Answer 8

Posterior surface which is not in contact with the peritoneum, and has boundaries formed by coronary and triangular ligaments. This includes groove for IVC

Question 9

What does the falciform ligament do?

Answer 9

Divides the anterior surface in the diaphragmatic surfaces of the liver.

Question 10

What is the visceral surface of the liver located?

Answer 10

1. inferior surfaces
2. covered by peritoneum
3. grooves and undulations due to contact with other abdominal organs

Question 11

The liver can be subdivided into small units called what?

Answer 11

Lobes

Question 12

To scan the liver what mode do we use in ultrasound?

Answer 12

Functional method

Question 13

In the traditional method what are the 4 lobes divided into?

Answer 13

1. Right lobe
2. Left lobe
3. Quadrate
4. Caudate

Question 14

What marks the boundary between the right and left lobe?

Answer 14

Falciform ligament

Question 15

Between the left and right lobe which is bigger?

Answer 15

Right lobe

Question 16

In the functional/ segmental method how is the liver divided?

Answer 16

It is divided into 3 lobes according to hepatic function. Each lobe has its own arterial and venous blood supply and biliary drainage.

Question 17

In the functional method how do we divide the left and right lobes?

Answer 17

Using an imaginary line joining the IVC with the GB

Question 18

How is the right lobe segmented in the functional method?

Answer 18

The right lobe is divided into anterior and posterior segments by the right intersegmental fissure

Question 19

What are landmarks of the right lobe of liver?

Answer 19

The right hepatic vein and the right portal vein run within the fissure and are used as ultrasound landmarks.

Question 20

How is the left lobe segmented/ divded?

Answer 20

The left lobe is divided into medial and lateral segments by the left intersegmental fissure

Question 21

What are landmarks used in the left lobe?

Answer 21

The left hepatic vein, portal vein and ligamentum teres run within the fissure and are used as ultrasound landmarks

Question 22

What is the caudate lobe?

Answer 22

Located posterior and superior in the liver and receives blood from both the right and left side of the liver

Question 23

What is Couinaud’s Classification?

Answer 23

Use to further subdivide the segments into 8 segments, which are numbered in clockwise fashion. Which is important for surgery.

Question 24

What is the smallest lobe in the liver?

Answer 24

Caudate lobe

Question 25

How is the caudate lobe marked in a ultrasound?

Answer 25

1. Anterior boundary marked by the Left Portal vein. 2. Posterior boundary marked by the IVC

Question 26

What is Reidel's Lobe?

Answer 26

Normal Variant which is an inferior extension of right lobe that can extend caudally to iliac crests.

Question 27

What are ligaments?

Answer 27

Fibrous, stretchy attachments, that tether liver to abdominal cavity.

Question 28

Why are ligaments good for liver ultrasounds?

Answer 28

Several form the boundaries for lobes and segments

Question 29

What is the ligamentum teres?

Answer 29

Ligament which divides the left lobe into medial and lateral portions.

Question 30

What does the ligamentum teres do in terms of segments?

Answer 30

Connects to falciform ligament on anterior and inferior surfaces. It also extends posteriorly on inferior surface to join to the ligamentum venosum.

Question 31

What is the Ligamentum teres a remnant of?

Answer 31

Left umbilical vein

Question 32

What is the ligamentum venosum?

Answer 32

Remnant of ductus venosus (fetus) which divides the left lateral lob and caudate lobe

Question 33

Where does the ligamentum venosum run?

Answer 33

Posteriorly from ligamentum teres at the level of the porta hepatis on the visceral surface

Question 34

What are fissures?

Answer 34

Groove, cleft or deep furrow in an organ.

Question 35

Does the liver have fissures?

Answer 35

It has several. Vessels and ducts travels within them

Question 36

What is the right intersegmental fissure?

Answer 36

Divides the right lobe into anterior and posterior segments

Question 37

What courses through the right intersegmental fissure?

Answer 37

1. right hepatic vein courses through this fissure superiorly 2. Right portal vein courses through this fissure more inferiorly

Question 38

What is the main lobar fissure?

Answer 38

Separates the functional right and left lobes

Question 39

What courses through the Main lobar fissure?

Answer 39

Main hepatic vein courses through this fissure superiorly and is used as an ultrasound landmark to divide the right and left lobes

Question 40

What is the left intersegmental fissures?

Answer 40

Divides the left lobe into medial and lateral segments.