Liver

Question 1

Site of liver

Answer 1

• Right Hypochondrium
• Epigastrium
• (May extend to) left Hypochondrium

Question 2

Liver borders are all ill-defined except

Answer 2

Inferior border

Question 3

Describe the structures dividing Liver into right large & left small lobes

Answer 3

• Falciform ligament: divides Anterior & superior surfaces
• Round ligament/Ligamentum teres: divides inferior surface
• Fissure for Ligamentum venosum: divides posterior surface

Question 4

Relations of Anterior surface of Liver

Answer 4

Mostly Diaphragm, seperating it from pleura and lung, except:
* Area 1 hand breadth below xiphoid process
* Area 1 finger breadth below Right Costal margin
* These areas are directly related anteriorly to Anterior Abdominal wall

Gives attachement to falciform ligament

Question 5

Relations of Superior Surface of Liver

Answer 5

Diaphragm, seperating it From:
* Right lung & pleura
* Pericardium & heart
* small portion of Left lung & pleura

Gives attachement to Falciform ligament

Question 6

Relations of Right surface of Liver

Answer 6

Diaphragm, seperating it from:
* Right lung & pleura
* right 7th to 11th Ribs

Question 7

Enumerate features shown on Posterior surface of Diaphragm from left to right

Answer 7

1. Eosophageal groove
2. Ligamentum venosum
3. Caudate lobe
4. Groove for IVC
5. Bare Area

Question 8

eosophageal groove is located left to —- & is directly related to —-

Answer 8

• groove for ligamentum venosum
• Abdominal Eosophagus

Question 9

In intrauterine life, ductus venosus connected

Answer 9

left branch of potral vein to IVC

Question 10

Margins of Ligamentum venosum fissure gives attachement to

Answer 10

Lesser omentum

Question 11

Boundaries of Caudate lobe

Answer 11

• Ligamentum venosum (left side)
• IVC groove (right side)
• Porta Hepatis (inferiorly)
• Superior surface of liver (superiorly)

Question 12

Structures related to Caudate lobe (in order from Anterior to posterior)

Answer 12

• Superior recess of Lesser sac
• Diaphragm
• Abdominal Aorta

Question 13

2 processes formed by Caudate lobe of liver

Answer 13

• Inferior & to left: papillary proccess
• Inferior & to the right: Caudate process

Caudate process connects Caudate lobe with right lobe + formes Upper boundary of Epiploic foramen

Question 14

Peritoneal Covering of IVC groove

Answer 14

• Not Covered by peritoneum (bare area)
• it is occasionaly bridged over by pons hepatis, transforming the fissure into a tunnel
• its upper part is peirced by right & left hepatic veins

Question 15

Bare area proper is directly related to

Answer 15

• Diaphragm
• Right Suprarenal gland (upper part)

Question 16

Boundaries of bare area proper of liver

Answer 16

• Left(base):IVC groove
• Above: Upper layer of coronary ligament
• Below: Lower layer of Coronary ligament
• (right) Apex: right triangular ligament

triangular in shape

Question 17

Enumerate features/ direct relations of Inferior/ visceral surface of liver from left to right

Answer 17

9 features/relations
2. 1. Gastric impression (stomach body & fundus)
2. Tuber omental (related to anterior surface of lesser omentum)
3. Ligamentum teres fissure
4. Quadrate Lobe
5. Gall bladder fossa
6. duodenal impression (2nd part duodenum)
7. Colic impression (right colic flexure)
8. Renal impression (right kidney)
9. Supra renal Impression (lower part of right suprarenal gland)

Question 18

In intrauterine life, ligamentum teres was—-, it passes in—- for draining in left portal vein

Answer 18

• left Umbilical Vein
• Free border of Falciform ligament

Question 19

Border (boundaries) of Quadrate lobe

Answer 19

• Left: Ligamentum teres fissure
• Right: gall bladder fossa
• Above: porta Hepatis
• Below: inferior border of Liver

Question 20

Quadrate lobe is directly related to (from below upwards)

Answer 20

• Transverse Colon
• Pyloroduodenal Junction
• Lesser Omentum

Question 21

Site of Porta hepatis

Answer 21

Between Caudate lobe of posterior surface of liver & Quadrate lobe of Inferior surface of liver

Question 22

Margins of Porta hepatis give attachement to

Answer 22

lesser omentum

Similar to Fissure for ligamentum teres

Question 23

Contents of Porta Hepatis (from anterior to posterior)

Answer 23

1. Right & left hepatic Ducts
2. Right & left branches of Hepatic Artery
3. Hepatic N plexus (around Hepatic A)
4. Right & left branches of Portal Vein
5. Lymph vessels, nodes & extraperitoneal Fat

Question 24

Liver is completely Covered in peritoneum except

Answer 24

1. Bare Area proper
2. IVC Groove
3. Gall bladder fossa

Question 25

Enumerate peritoneal Ligament of the liver

Answer 25

5 peritoneal Ligaments: * Lesser Omentum (Gastro-hepatic Ligament) * Falciform ligament * Coronary ligament * Right Triangular ligament * Left triangular ligament

Question 26

Layers of Falciform ligament & their attachement

Answer 26

* Anterior layer: to anterior abdominal wall * Posterior layer: to liver (anterior & superior surface)

Question 27

Borders of Falciform ligament & their attachements

Answer 27

* Concave border (facing liver): attached to superior & anterior surface of liver * Convex border (facing away from liver): attached to Diaphragm & Anterior abdominal wall * Lower free border: surrounds ligamentum teres & paraumbilical Veins

Question 28

Contents of Falciform ligament

Answer 28

* Ligamentum teres * Paraumbilical Veins * Lymph vessels * Extraperitoneal fat

Question 29

Describe blood supply & drainage of Liver

Answer 29

* 70% from portal Vein * 30% from Hepatic A blood is mixed inside **sinusoids**, then collected in a **central vein**, which form 3 hepatic veins that drain into **IVC** (**Right, left & middle Hepatic Veins**)