Liver - Anatomy and physiology

Question 1

What is the anatomical position of the liver?

Answer 1

Occupies most of the RHC, Upper epigastrium and extents into LHC

Extends from the fifth intercostal space to the right costal margin in the midclavicular line

Question 2

Porta hepatis structures

Answer 2

Common hepatic duct (leaving)

Hepatic artery proper (entering)

Hepatic portal vein (entering)

Hepatic nerve plexus and lymphatic vessels

Question 3

What are the ligaments of the liver?

Answer 3

1. Falciform ligament
2. Coronary ligament
3. Right triangular ligament
4. Left triangular ligament
5. Ligamentum venosum
6. Ligamentum teres hepatis (Round ligament)
7. Hepatoduodenal ligament
8. Hepatogastric ligament

Question 4

Falciform ligament

Answer 4

Attaches the anterior part of the liver to the anterior abdominal wall and diaphragm.

Question 5

Coronary ligament

Answer 5

A double layer that connects the diaphragm to the liver, divided into:

Anterior part
Posterior part

Question 6

Right triangular ligament

Answer 6

The right lateral free margin of the coronary ligament.

Question 7

Left triangular ligament

Answer 7

The left lateral free margin of the coronary ligament.

Question 8

Ligamentum venosum

Answer 8

A fibrous remnant of the fetal ductus venosus, which connected the left umbilical vein to the inferior vena cava.

Question 9

Ligamentum teres hepatis (Round ligament)

Answer 9

A fibrous remnant of the left umbilical vein, which runs within the free edge of the falciform ligament.

Question 10

Hepatoduodenal ligament

Answer 10

Connects the liver to the first part of the duodenum and encloses the portal triad: hepatic artery, portal vein, and common bile duct.

Question 11

Attaches the anterior part of the liver to the anterior abdominal wall and diaphragm.

Answer 11

Falciform ligament

Question 12

A double layer that connects the diaphragm to the liver, divided into:

Anterior part
Posterior part

Answer 12

Coronary ligament

Question 13

The right lateral free margin of the coronary ligament.

Answer 13

Right triangular ligament

Question 14

The left lateral free margin of the coronary ligament.

Answer 14

Left triangular ligament

Question 15

A fibrous remnant of the fetal ductus venosus, which connected the left umbilical vein to the inferior vena cava.

Answer 15

Ligamentum venosum

Question 16

A fibrous remnant of the left umbilical vein, which runs within the free edge of the falciform ligament.

Answer 16

Ligamentum teres hepatis (Round ligament)

Question 17

Connects the liver to the first part of the duodenum and encloses the portal triad: hepatic artery, portal vein, and common bile duct.

Answer 17

Hepatoduodenal ligament

Question 18

Hepatogastric ligament

Answer 18

Connects the liver to the lesser curvature of the stomach.

Question 19

Connects the liver to the lesser curvature of the stomach.

Answer 19

Hepatogastric ligament

Question 20

What are the primary arteries supplying the liver?

Answer 20

Hepatic artery proper (20-40% of blood supply)

Portal vein (60-80% of blood supply)

Question 21

From where does the hepatic artery proper originate?

Answer 21

The hepatic artery proper is a branch of the common hepatic artery, which branches off the celiac trunk of the abdominal aorta.

Question 22

What constitutes the portal vein and what does it supply?

Answer 22

The portal vein is formed by the union of the superior mesenteric vein (SMV) and the splenic vein. It collects blood from the gastrointestinal tract, spleen, and pancreas.

Question 23

Even though the blood from the portal vein is deoxygenated, what significant function does it serve for the liver?

Answer 23

Despite being deoxygenated, the blood from the portal vein supplies the liver with about half its oxygen demands and delivers nutrients and other metabolites.

Question 24

How is the liver drained of blood?

Answer 24

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

Question 25

Which lymph nodes are primarily associated with the lymphatic drainage of the liver?

Answer 25

The celiac lymph node cluster.

Question 26

What is the significance of the liver's dual blood supply?

Answer 26

The liver receives both oxygenated blood (from the hepatic artery proper) and nutrient-rich, deoxygenated blood (from the portal vein) which is essential for its metabolic, detoxification, and synthetic functions.

Question 27

What covers the liver and provides it with a fibrous layer?

Answer 27

The Glisson’s capsule is a thin layer of connective tissue that surrounds the liver and its vessels, providing a protective sheath. It's a significant anatomical feature of the liver, often mentioned in medical contexts.

Question 28

What are the surfaces of the liver?

Answer 28

Two surfaces: Diaphragmatic surface Visceral surface

Question 29

What is the primary anterior-facing surface of the liver in contact with the abdominal wall?

Answer 29

Diaphragmatic surface (or superior surface)

Question 30

Which part of the liver rests against the diaphragm and is convex in shape?

Answer 30

Diaphragmatic surface

Question 31

Describe the covering of the Diaphragmatic surface of the liver

Answer 31

It's covered with visceral peritoneum except for the "bare area of the liver" The bare area of the liver is pressed against the diaphragm and lacks visceral peritoneum

Question 32

Describe the covering of the Visceral surface of the liver

Answer 32

covered with peritoneum except at the fossa for gallbladder and the porta hepatis

Question 33

Which surface of the liver is oriented posteriorly and inferiorly and is in contact with various abdominal organs?

Answer 33

Visceral surface (or inferior surface)

Question 34

Which liver surface has impressions from the stomach, duodenum, right adrenal gland, right kidney, and gallbladder?

Answer 34

Visceral surface

Question 35

On which surface of the liver can you find the porta hepatis

Answer 35

Visceral surface

Question 36

What is the porta hepatis?

Answer 36

The porta hepatis, or hilum of the liver, is a transverse fissure where the main vessels and ducts enter and exit the liver.

Question 37

What is the significance of the porta hepatis in surgeries and clinical procedures?

Answer 37

It's a key reference point for liver surgeries and other procedures due to its proximity to vital vessels and ducts.

Question 38

Relations of the liver

Answer 38

Question 39

What is the primary omental relationship of the liver?

Answer 39

The liver is connected to the lesser curvature of the stomach by the lesser omentum.

Question 40

What are the two main ligaments of the lesser omentum that connect the liver to other structures?

Answer 40

Hepatogastric ligament - connects the liver to the stomach. Hepatoduodenal ligament - connects the liver to the first part of the duodenum.

Question 41

What key structures run within the hepatoduodenal ligament of the lesser omentum?

Answer 41

Portal vein, common bile duct, and hepatic artery proper.

Question 42

What is the role of the lesser omentum in relation to the liver?

Answer 42

The lesser omentum helps stabilize the position of the liver and provides a pathway for structures entering and leaving the liver at the porta hepatis.