Liver

Question 1

Shape of the liver ?

Answer 1

Wedge shaped

Question 2

Site of the liver?

Answer 2

Rit hypochondrium and epiganstrium and may extend to rt lumbar and lt hypochondrium

Question 3

Weight of liver?

Answer 3

1200 to 1800 gm in adults around 2 kilo

Question 4

Border of liver?

Answer 4

Ill defined borders except inferior

Question 5

Largest solid organ in the body ?

Answer 5

Liver

Question 6

Liver is divided anatomically into ?

Answer 6

Rt and left lobes

Question 7

Liver divided anatomically by ?

Answer 7

Falciform ligament (anterior) and ligamentum venosum (posterior)

Question 8

Surgical importance of surgical lobes?

Answer 8

Each segment has its own arterial portal and hepatic duct branch which can be removed separately ( segmentectomy)

Question 9

Boundries of caudate lobe ?

Answer 9

Between groove for IVC and fissure for ligamentum venous

Question 10

Why is caudate lobe is special ?

Answer 10

Supplied by hepatic a and portal v branches from both sides … hence also drained directly by multiple small veins into the inferior vena cava

Question 11

Why budd chiari syndrome doesn’t affect the caudate lobe?

Answer 11

Cause it drained directly to the IVC by multiple small veins

Question 12

Peritoneal fixation of the liver?

Answer 12

1. Anteriorly: to ant abdominal wall by falciform ligament and to the umblical by ligamentum teres(round ligament )
2. Superiorly: to the diaphragm by rt and left coronary ligaments
3. At the angles: to the diaphragm by rt and left triangular ligaments
4. Lesser omentum: to stomach & 1st inch of the duodenum
5. Posterior to the left : ligamentum venosum
6. Posterior to the right .. coronary (interrupted) upper and lower coronary

Question 13

Relation of the bare area of the liver ?

Answer 13

Suprarenal gland related to bare area without any intervention

Question 14

Who divided the liver surgically ?

Answer 14

Cantlie

Question 15

Extent of cantlie’s line ?

Answer 15

From gall bladde fossa to the left of IVC

Question 16

Boundries of the quadrate lobe ?

Answer 16

Left: fissure for ligamentum teres
Right: gallbladder fossa
Ant: inferior border of the liver
Post: porta hepatis

Question 17

Liver is completely covers by perituem except

Answer 17

1. Bare area
2. Fossa for gall bladder
3. Groove for IVC
4. Porta hepatis

Question 18

Blood supply of the liver ? and what is major ?

Answer 18

Portal vein 70% and hepatic artery 30% (but the O2 saturation is equal)

Question 19

Embryological origin of ligamentum teres?

Answer 19

Obliterated vestige of left umblical vein

Question 20

What is the venous drainage of the liver ?

Answer 20

Hepatic veins: 3 veins , rt hepatic vein drains to IV while middle and left hepatic veins unite and drain into IV. They emerge from the back. And caudate lobe drains directly into IVC by small multiple veins

Question 21

Structure of porta hepatis from ant to posterior ?

Answer 21

DAP… hepatic duct, hepatic artery and portal vein…also gives attachment ot the lesse omentum

Question 22

Lymph drainage of liver ?

Answer 22

Post part follows IVC to end in diaphragmatic LN around the upper end of IVC and lymphatics of the remaining part follows the hepatic artery to end in the celiac LN

Question 23

Surface anatomy of liver ?

Answer 23

Upper border: apex of heart , xiphysternum, 5thrib(MCL), 7th (MAL), 9th rib (rt SL)
Lower border: apex of heart, tip of 8th CC, midway xiphy and umbilicus, tip of rt 9th CC, and follor coastal margin to MAL
Right border: from 5th to 7th and 11th rib in MAL

Question 24

Space used in liver biopsy?

Answer 24

Right 9th intercostal space in MAL
.. it passes thru, skin, fascia, ext oblique, intercostal ms, rt costodiaphragmatic recess, diaphragm, rt anterior subphrenic space