Practical 3 Flashcards
(31 cards)
How is the position of the liver maintained?
By the attachment of the hepatic veins posteriorly. Sometimes the vena cava is embedded in the liver
How superior does the liver reach?
To the upper margin of the 5th rib, mid clavicular line on the R side
How inferior does the liver reach?
To the lowest point of the right costal margin
What is the hilum of the liver called?
Porta hepatis (door to the liver)
When looking posteriorly, what structures are adjacent to the IVC and gall bladder?
Lesser omentum and falciform ligament (that comes anteriorly)
What is the area of the liver found between the IVC and lesser omentum root (posteriorly)
Caudate lobe
What is the fold of peritoneum to the L of the lesser omentum root called?
L triangular ligament
What is the area of the liver between the anterior coronary ligament, R triangular ligament and posterior coronary ligament called?
Bare area, in contact with diaphragm via areolar tissue
What structured are found in the embryo to bypass the liver?
Umbilical vein (to hepatic portal vein) and ductus venosus (to IVC)
What is the umbilical vein called in adulthood?
Ligamentum teres (connects umbilicus to porta hepatis, running within the free edge of the falciform ligament)
What does the ductus venosus turn into in adulthood?
Ligamentum venosum (found in root of lesser omentum)
What marks the anatomical lobes of the liver?
Saggital plane passing through the falciform ligament and lesser omentum (+fissures for ligamentum teres and venosum)
Where is the caudate lobe?
Lobe of liver between IVC and root of lesser omentum/fissure for ligamentum venosum
Where is the quadrate lobe?
Lobe of liver between gall bladder bed and the ligamentum teres
What is another name for the right posterior subphrenic space?
Hepatorenal pouch
What is the visceral surface of the right lobe of the liver related to?
R suprarenal gland, R kidney and transverse mesocolon
What is the visceral surface of the left lobe of the liver related to?
Stomach snd oesophagus
Describe the course of the hepatic artery proper
Celiac artery->hepatic artery proper enters mesentery of initial part of duodenum then curves upwards in lesser omentum with bile duct and HPV to the liver
How are the three vessels arranged in the lesser omentum?
Hepatic portal vein medially
Bile duct laterally
Describe the hepatic veins
Usually 3, embedded in liver tissue
Drain all the sinusoids->IVC
Devoid of valves
Where is the hepatic portal vein formed?
Behind the neck of the pancreas by the union of the superior mesenteric vein and the splenic vein (which already has inf. mesenteric vein)
Why is the oesophageal venous drainage clinically relevant?
Mid part of the oesophagus= azygous vein system
Lower part of oesophagus= L gastric-> HPV
If HPV blocked or hypertensive then blood can be diverted to azygous system via oesophagus
= oesophageal varices
In liver cirrhosis, where are varices seen?
At points of porto-systemic anastomoses
Oesophagus, anal canal (haemorrhoids) and umbilicus (caput medusae)
Where is the sympathetic supply of the liver from?
Celiac ganglia (afferents can transmit pain)
