Liver - Anatomy

Question 1

Where is the liver located in terms of abdomen surface markings?

Answer 1

Right hypochondrium and epigastric areas, extending into the left hypochondrium

Question 2

What are the 2 surfaces of the liver and what are they in contact with?

Answer 2

• Diaphragmatic: In contact with diaphragm.
• Visceral: In contact with oesophagus, stomach, duodenum, right kidney and adrenal gland, colic flexure and gallbladder.

Question 3

What are the 5 impressions of the liver and which surface are they on?

Answer 3

• On visceral surface.
• Gastric (on left lobe), duodenal (next to gallbladder), renal (centre of right lobe), suprarenal (above renal), colic (below renal.)

Question 4

What are the 4 lobes of the liver and their functions?

Answer 4

• Falciform ligament: attaches anterior part of liver to abdominal wall, free edge contains ligamentum teres, divides left and right lobes of liver.
• Left and right coronary ligaments: attaches superior surface of liver to diaphragm
• Left and right triangular ligaments: attaches superior surface of liver to diaphragm
• Lesser omentum: Made up of hepatogastric ligament - stomach to liver and hepatoduodenal ligament: stomach to duodenum.

Question 5

What fibrous membrane is the liver covered in?

Answer 5

Glisson’s capsule

Question 6

Where are the 4 lobes of the liver?

Answer 6

• Right and left: either side of falciform ligament
• Caudate: between inferior vena cava and fossa caused by ligamentum venosum
• Quadrate: between gallbladder and fossa caused by ligamentum teres

Question 7

What is the porta hepatis and what does it contain?

Answer 7

• Deep fissure between caudate and quadrate lobes.

- Contains: L+R hepatic ducts. L+R hepatic artery branches. Portal vein.

Question 8

What is the role of the hepatic artery and what is it derived from? How much blood does it supply?

Answer 8

Supplies the liver with oxygenated blood. Derived from coeliac trunk. 25%

Question 9

What is the role of the hepatic portal vein and what is it derived from? How much blood does it supply?

Answer 9

Supplies the liver with deoxygenated blood, rich with nutrients etc from small intestines. Derived from superior and inferior mesenteric veins and splenic vein. 75%

Question 10

What is the venous drainage of the liver?

Answer 10

Through three hepatic veins which drain into the inferior vena cava.

Question 11

What is the nerve supply of the liver?

Answer 11

Hepatic plexus (sympathetic: coeliac plexus, parasympathetic: vagus)

Question 12

What is the nerve supply of Glisson’s capsule?

Answer 12

Lower intercostal nerves

Question 13

What is the surface marking for the fundus of the gallbladder?

Answer 13

Right 9th costal cartilage, mid-clavicular line.

Question 14

What is Calot’s triangle?

Answer 14

A triangular space created by the cystic duct, common hepatic duct and the visceral surface of the liver.

Question 15

What is a liver lobule?

Answer 15

Area of liver draining into one central vein.

Question 16

What is a portal triad?

Answer 16

At the edge of each lobule, made up of:

• Branch of the hepatic artery
• Branch of the portal vein
• Branch of the bile duct

Question 17

What does the central vein lead to?

Answer 17

Interlobular veins –> hepatic veins –> IVC

Question 18

What is the role of the bile canaliculus and what does it lead to?

Answer 18

Bile flows away from liver cells and drains into bile duct, then goes to gall bladder.

Question 19

What is a sinusoid, what is its role and where does it lead to?

Answer 19

Where the branches of the hepatic artery and portal vein join and lead to the central vein.

Question 20

What is a liver acinus and what do the zones represent?

Answer 20

The area where two liver lobules join. The zones represent the distance from arterial blood supply (from the portal triad).

Question 21

Name the parts of the pancreas

Answer 21

Unicate process and head
Neck
Body
Tail

Question 22

Is the pancreas retroperitoneal or intraperitoneal?

Answer 22

Both - everything except tail is retroperitoneal

Question 23

Where is the pancreas in relation to the stomach?

Answer 23

Posterior (behind)

Question 24

Where is the duodenum in relation to the pancreas?

Answer 24

Anterior and medial (underneath, in the middle.)

Question 25

Where does the head of the pancreas lie?

Answer 25

In the curve of the duodenum.

Question 26

Where is the spleen in relation to the pancreas?

Answer 26

Posterior and lateral (behind and to the side) - connected to tail by ligaments

Question 27

Which vessels are near the pancreas and where do they pass?

Answer 27

Aorta and IVC both pass posteriorly to the head.

Question 28

How are secretions collected in the pancreas?

Answer 28

Acini are connected by intercalated ducts which drain into a network of intralobular collecting ducts which then drain into the pancreatic duct to pass into duodenum.

Question 29

What is the blood supply to the majority of the pancreas?

Answer 29

Pancreatic branches of the splenic artery.

Question 30

What is the venous drainage of the majority of the pancreas?

Answer 30

Splenic vein

Question 31

What supplies the head of the pancreas?

Answer 31

Superior and inferior pancreaticoduodenal arteries.

Question 32

What is the venous drainage of the head of the pancreas?

Answer 32

Superior mesenteric branches of the hepatic portal vein

Question 33

What is the lesser omentum made of?

Answer 33

Double layer of peritoneum