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Metabolism CC > Liver Anatomy > Flashcards

Liver Anatomy Flashcards

1
Q

Stomach is suspended from liver by..

A

Lesser omentum

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2
Q

Posterior to liver

A

Hepatic flexure
Superior MA + V
Right adrenal gland + kidney

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3
Q

Pouch of Morrison

A

Between liver + kidney

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4
Q

Liver Surfaces

A

Diaphragmatic Surface
Visceral Surface
Bare area of liver

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5
Q

Visceral surface of liver

A

Postero-inferior

Where vessels pass through

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6
Q

Bare area of liver

A

No visceral peritoneum

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7
Q

Subphrenic recess

A

Separates liver from diaphragm

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8
Q

Falciform ligament

A

Fold of peritoneum which attaches liver to anterior abdominal wall
Divides subphrenic recess longitudinally

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9
Q

Hepatorenal recess

A

Separates liver from right kidney
I.e. pouch of Morrison
Site for build up of fluid

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10
Q

Where do subphrenic and hepatorenal recesses meet

A

Anteriorly

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11
Q

Liver lobes

A

2 large lobes

2 accessory lobes

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12
Q

2 Large liver lobes

A

Large right lobe- includes 2 accessory lobes (caudate + quadrate lobes)
Large left lobe

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13
Q

Ligamentum teres

A

From falciform ligament

Continues inferiorly

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14
Q

Coronary ligament + left/right triangular ligaments

A

From falciform ligament

Continues anteriorly

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15
Q

R + L lobes separated posteriorly by

A

Caudate Lobe

Quadrate Lobe

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16
Q

Caudate Lobe

A

Between fissure for ligamentum venosum and groove for IVC superiorly

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17
Q

Quadrate Lobe

A

Between fissure for ligamentum teres and gall bladder

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18
Q

Bare area of liver

A

No peritoneum between A/P coronary ligaments

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19
Q

Porta hepatis

A

Where structures enter + leave the liver
Hepatic portal vein + hepatic artery enter
Hepatic duct leave

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20
Q

Lesser omentum

A

Fold of peritoneum

Made up of two parts- hepatoduodenal + hepatogastric ligament

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21
Q

Hepatoduodenal ligament

A

Connects liver to duodenum
Free edge of lesser omentum
Posteriorly can see structures entering porta hepatis

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22
Q

Hepatogastric ligament

A

Suspends stomach

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23
Q

Couinaud’s Segments

A

Divides liver into 8 segments
Divided horizontally by left and right portal veins
Divided vertically by hepatic vein
Each segment has its own portal triad
–> segments independent, has own venous return
Branches of hepatic artery + portal vein carry blood into sinusoids of the liver lobule

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24
Q

Pringle Manouvre

A

Close off structures in porta hepatis
If bleeding stop after Pringle manoeuvre –> bleed within hepatic portal vein or hepatic artery
Temporary occlusion of these vessels

25
Q

Coeliac Trunk

A 
Provides 25% of blood supply to liver
3 branches
Left gastric
Splenic artery
Common hepatic artery
26
Q

Common hepatic artery

A

Becomes hepatic artery proper after gastroduodenal branch comes off it
Divides into L + R hepatic artery proper
Cystic artery from right hepatic –> supply gall bladder

27
Q

Hepatic Portal system

A

Provides 75% blood to liver
Only about 50% oxygenated
Portal vein

28
Q

Portal Vein

A

Composed of splenic and superior mesenteric veins

–> prior to this, inferior mesenteric drains into splenic

29
Q

Portal system purpose

A

Pass digestive products of liver through liver for processing

30
Q

Anastamoses

A

Communication between hepatic portal system + systemic venous system
Only relevant when blood can’t pass through liver
–> will enter portosystemic anastomoses + drain into heart via systemic venous system

31
Q

Distal 1/3rd of oesophagus portosystemic anastomoses

A

Drain into hepatic portal vein

32
Q

Proximal 2/3rd oesophagus drain into

A

Caval system

33
Q

Superior 1/3rd rectum portosystemic anastomoses

A

Via superior rectal vein, drain into hepatic portal system

34
Q

Bottom 2/3rd rectum

A

Via internal iliac veins into caval system

35
Q

Umbilical anastamoses

A

Via umbilical vein

36
Q

Portal hypertension

A

Blood from portal system can’t get through liver –> backtracks + causes overload in systemic system in porto-systemic anastamoses

37
Q

Backtrack of blood

A

Oesophagus –> varices
Rectum –> haemorrhoids
Umbilical vein –> caput medusae

38
Q

Cirrhosis

A

Consequence of chronic liver disease characterised by replacement of liver tissue by fibrosis, scar tissue + regenerative nodules

  • -> blood can’t pass through sinusoids of liver
  • -> portal hypertension
39
Q

Normal portal pressure

A

5-10mmHg

40
Q

IVC normal pressure

A

2-6mmHg

41
Q

Portal hypertension pressure

A

Defined when portal pressure gradient (Diff. between portal vein + IVC) = >5mmHg

42
Q

Portal hypertension pressure

A

PPG 6-10mmHg

43
Q

Oesophageal varices pressure

A

PPG >10mmHg

44
Q

Ascites pressure

A

PPG >12mmHg

45
Q

Splenomegaly

A

Enlargement of spleen due to backup of blood into spleen

–> becomes hyperactive due to enlargement, starts to clear out WBC + RBC + platelets premature

46
Q

Splenomegaly consequences

A

Can cause:
Anaemia
Leukopenia
Thrombocytopenia

47
Q

Venous drainage of oesophagus

A

Inferiorly- drains into portal system

Superiorly- drains into systemic system

48
Q

Oesophageal Varices

A

Occur at anastomoses of left gastric vein with oesophageal veins at Gastro-oesophageal junction
Present with Haematemesis
Can be treated with oesophageal banding

49
Q

Ascites

A

Abnormal fluid accumulation in peritoneal cavity as a result of portal hypertension

50
Q

Ascites due to hypoalbuminaemia

A

Reduced production albumin
Albumin required for oncotic pressure within capillary
Fluid leaks out –> builds up in interstitium

51
Q

Ascites due to Portal hypertension

A

Splanchnic veins start to bulge as overfill with blood
Kidneys detect this as decreased circulating BV
Trigger response to hypovolaemic shock
Activates renin-angiotensin-aldosterone system
Aldosterone –> sodium retention –> water retention
BV expansion
Increased kidney work –> renal artery stenosis –> ischaemia –> renal failure

52
Q

Rectal varices

A

Caused by portal hypertension due to formation of portosystemic shunts

53
Q

Biliary tree

A 
L + R hepatic ducts
Join to form common hepatic
Joined by cystic duct
Form bile duct
Bile duct joined by major duodenal papilla from pancreas to enter duodenum
54
Q

Bile secretion

A

By liver
Constant rate
40ml/hour

55
Q

Cholecystitis

A

Blocked cystic duct

Inflamed gallbladder

56
Q

Murphy’s test

A

Investigate inflammation of gallbladder

57
Q

Jaundice

A

Occurs if gallstone lodge in common bile duct due to bile accumulation in liver
–> bilirubin accumulates causing yellowing of skin

58
Q

Blood supply to gallbladder

A

Cystic artery

–> branch of right hepatic

Metabolism CC (29 decks)

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