Liver

Question 1

Largest visceral structure
largest gland
® upper quadrant (RUQ)
most injured abdominal viscera

Answer 1

LIVER

Question 2

Anatomically separates the caudate (superior) and quadrate (inferior) love

Answer 2

Porta hepatis or hilum of the liver

Question 3

transverse fissure found on the inferior surface, where the major vessels and ducts enter or leave the liver

Answer 3

Porta hepatis or hilum

Question 4

Anterior superior surface of the liver
where peritoneal ligaments are found

Answer 4

DIAPHRAGMATIC SURFACE

Question 5

What are the peritoneal ligaments

Answer 5

LIGAMENTS
1.) Triangular
2.) Coronary
3.) Falciform

Question 6

Posterior surface of the Liver?

Answer 6

VISCERAL SURFACE
(irregular and flat)
Lies in contact with: Right kidney, Right adrenal, Duodenum, Hepatic flexure of colon, Transverse colon, Esophagus, Gall bladder and Stomach

Question 7

Posterior portion of the liver in its diaphragmatic surface
NO PERITONEAL COVERING
attached to the diaphragm via alveolar tissue

Answer 7

BARE AREA of the liver

Question 9

Sickle shaped ligament
Attaches the anterior surface of the liver to the anterior abdominal wall
Natural anatomical division between the right and left lobes of the liver

Answer 9

FALCIFORM LIGAMENT

Question 10

Free edges of the falciform ligament

Answer 10

Ligamentum Teres Hepatis (remnant of umbilical vein)
or round ligament of the liver

Question 11

Attaches the liver to the inferior surface of the diaphragm
Demarcates the “BARE AREA” of the liver

Answer 11

TRIANGULAR LIGAMENT

Question 12

Formed by the reflection of the peritoneum from the upper surface of the left lobe of the liver to the diaphragm

Answer 12

LEFT TRIANGULAR LIGAMENT

Question 13

Also known as right extremity of the coronary ligament▪ Connects the posterior surface of the right lobe of the liver to the diaphragm

Answer 13

RIGHT TRIANGULAR LIGAMENT

Question 14

Attaches the liver to the lesser curvature of the stomach

Answer 14

LESSER OMENTUM

Question 16

aka ARANTIUS’ LIGAMENT
Remnant of the ductus venosus
Attached to the left branch of the portal vein and ascends in the fissure on the visceral surface of the liver to be attached to the inferior vena cava

Answer 16

LIGAMENTUM VENOSUM

Question 17

Lobes of the ® Lobe

Answer 17

Caudate lobe
Quadrate lobe

Question 18

Imaginary line connecting the inferior Vena Cava (IVC) and the gall bladder
divide the liver into the functional right and left lobes.

Answer 18

CANTLIE’S LINE

Question 20

Lobe of the liver that is larger in size
60-70% of the liver mass
Highest point is @ the 5th year: 1 cm below the nipple

Answer 20

RIGHT LOBE

Question 21

Lobe of the liver that was lies in between the groove of gall bladder and fossa for the ligamentum teres hepatis

Answer 21

QUADRATE LOBE

Question 25

Inferior Left Lobe

Answer 25

Segment III

Question 26

Superior area of the falciform ligament using Cantlie’s line

Answer 26

Segment IVa

Question 28

Right anterior

Answer 28

Segment V and VIII

Question 29

Right posterior

Answer 29

Segment VI and VII

Question 30

Anatomical recesses between the liver and surrounding structures. ➢ SIGNIFICANCE: Infection may collect in these areas, forming abscess.

Answer 30

Hepatic Recess

Question 31

Located between the diaphragm and the anterior and superior surface of the liver Under normal conditions, these are POTENTIAL SPACES, and peritoneal surface are in contact

Answer 31

SUBPHRENIC RECESS

Question 32

Located between the inferior surface of the liver and transverse colon

Answer 32

SUBHEPATIC RECESS

Question 33

Potential space between the right liver (visceral surface)and the right kidney ➢ Deepest part of the peritoneal cavity when supine; “MARIANA’S TRENCH” ➢ Collection of blood or ascitic fluid is most likely to settle in this space on bedridden patients ➢ Space for placing a sponge during a surgery, must be check prior to closing and finishing the surgery

Answer 33

MORISON’S POUCH

Question 34

Arterial Supply of the Liver?

Answer 34

Hepatic Artery-branch of Celiac trunk

Question 35

Venous Drainage of the Liver

Answer 35

Portal Vein Divides to the left and right branches as it enters the porta hepatis behind the arteries *Each supply is then directed to the central vein of the sinusoidal structures of the liver parenchyma and drain into the hepatic veins; eventually dumped into the vena cava.

Question 37

Emerge from the posterior surface of the liver and drain into the vena cava (venous drainage of the liver)

Answer 37

HEPATIC VEINS

Question 38

BLOOD CIRCULATION Conveying blood to the liver for about 70% ○ Brings partially deoxygenated blood rich in the products of digestion, which has been absorbed from the GI tract. ○ Dominant blood supply to the liver

Answer 38

Portal vein

Question 39

BLOOD CIRCULATION Carries deoxygenated blood but is RICH IN NUTRITION absorbed from the gastrointestinal tract

Answer 39

PORTAL VEIN

Question 40

BLOOD CIRCULATION Blood vessels responsible for conveying blood to the liver for about 30%○ It supplies oxygenated blood to the liver

Answer 40

HEPATIC ARTERY

Question 41

Lymph vessels leave the liver and enter several lymph nodes in the porta hepatis ➢ Efferent vessels pass to the celiac nodes ➢ Some vessels pass from the bare area of the liver through the diaphragm to the posterior mediastinal lymph nodes.

Answer 41

LYMPHATIC DRAINAGE

Question 42

● CELIAC PLEXUS (Sympathetic plexus) ● VAGAL PLEXUS (Parasympathetic plexus)

Answer 42

Nerve Supply

Question 43

Glisson's Capsule

Answer 43

innervated by the lower intercostal nerves, hence if there is a distention of the capsule it will result in a sharp localized pain

Question 44

Clinical condition that influences portal systemic anastomoses. - Most common cause is cirrhosis of the liver- Enlargement of the portal- systemic connections is frequently accompanied by congestive enlargement if the spleen - Treatment can be in ways of PORTACAVAL SHUNTS

Answer 44

PORTAL HYPERTENSION

Question 45

Anastomosis of the portal vein that lies on the lesser omentum to the anterior wall of the vena cava behind the entrance of the lesser sac. The splenic vein may be anastomosed to the renal vein after removing the spleen

Answer 45

Porta caval shunts

Question 47

Inferior area of the falciform ligament using the Cantlie’s line (Quadrate lobe)S

Answer 47

Segment IVb I