Liver: Surfaces

Question 1

Anterior surface: related to diaphragm

Answer 1

Separates it from lung bases and pleurae

Question 2

Anterior surface: related to anterior abdominal wall

Answer 2

Part of it 1 hand’s breadth below xiphoid process and another part 1 finger’s breadth below right costal margin lowest point directly related

Question 3

Anterior surface: attachment

Answer 3

Gives attachment to falciform ligament base

Question 4

Superior surface relations

Answer 4

Related to diaphragm which separates it from:
1. Right lung base and pleura
2. Pericardium and heart inferior surface
3. Small part of left lung and pleura

Question 5

Superior surface: attachments

Answer 5

Upper part of falciform ligament base

Question 6

Right surface

Answer 6

Related to diaphragm which separates it from:
1. Right lung and pleura
2. Right 7th to 11th ribs

Question 7

Posterior surface

Answer 7

Shows the following from left to right:
1. Esophageal groove
2. Ligamentum venosum fissure
3. Caudate lobe
4. IVC
5. Bare area proper

Question 8

Esophageal groove

Answer 8

1. On left lobe posterior aspect just to left of upper part of Ligamentum venosum fissure
2. Related to esophagus abdominal part

Question 9

Ligamentum teres fissure

Answer 9

1. Lodges Ligamentum venosum which is obliterated ductus venosus that connects portal vein left branch to IVC during intrauterine fetal life
2. After birth, ductus venosus is fibrosed and transformed into Ligamentum venosum

Question 10

Ligamentum teres fissure attachment

Answer 10

It’s margins give attachment to lesser omentum

Question 11

Caudate lobe boundries

Answer 11

1. Left side: Ligamentum venosum fissure
2. On right side: IVC groove
3. Above: liver superior surface
4. Below: porta hepatis

Question 12

Caudate lobe relations

Answer 12

1. Related to diaphragm, which separates it from descending thoracic aorta
2. It is separated from diaphragm by lesser sac superior recess

Question 13

Caudate lobe processes

Answer 13

1. Inferior and to left: papillary process
2. Inferior and to right: caudate process, which connects caudate lobe with right lobe rest and forms epiploic foramen upper boundary

Question 14

IVC groove

Answer 14

1. Deep vertical groove lodging IVC upper part
2. It is devoid of peritoneal covering (bare area)
3. Its upper part is pierced by right and left hepatic veins
4. Occasionally bridged over by liver tissue part (pons hepatis), transforming it into a tunnel

Question 15

Bare area proper

Answer 15

1. Triangular area on right lobe back
2. Devoid of peritoneal covering
3. It is directly related to diaphragm and right Suprarenal gland upper part

Question 16

Bare area proper boundries

Answer 16

1. IVC groove: to left and from its base
2. Coronary ligament upper layer: above
3. Coronary ligament lower layer: below
4. Right triangular ligament: forms apex (meeting of coronary ligament both layers on right side)

Question 17

Bare area proper lymphatics

Answer 17

Lymph vessels from bare area, ascend through diaphragm vena caval opening to end in thoracic duct

Question 18

Inferior (visceral) surface

Answer 18

Shows the following from left to right:
1. Gastric impression
2. Tuber omentale
3. Ligamentum teres (round ligament of liver) fissure
4. Quadrate lobe
5. Gall bladder fossa
6. Duodenum 2nd part
7. Right colic flexure
8. Right kidney front
9. Suprarenal gland lower part

Question 19

Gastric impression site

Answer 19

On left lobe inferior aspect

Question 20

Gastric impression relation

Answer 20

1. Stomach fundus
2. Stomach body

Question 21

Tuber omentale

Answer 21

Elevation in left lobe inferior surface

Question 22

Tuber omentale site

Answer 22

Between gastric area and ligament venosum fissure

Question 23

Tuber omentale relation

Answer 23

Lesser omentum

Question 24

Tuber omentale types

Answer 24

1. Liver tuber omentale: related to lesser omentum anterior surface
2. Pancreas tuber omentale: related to lesser omentum posterior surface

Question 25

Ligamentum teres fissure

Answer 25

Represents obliterated left umbilical vein which transmits blood from placenta via umbilical cord to portal vein left branch during intrauterine fetal life

Question 26

Ligamentum teres course

Answer 26

1. It passes from umbilicus To 2. Falciform Ligamentum free border Then 3. Ligamentum teres fissure floor on liver inferior surface To End in 4. Portal vein left branch

Question 27

Quadrate lobe boundries

Answer 27

1. On left side: Ligamentum teres fissure 2. On right side: gall bladder 3. Above: porta hepatis lies transversely separating caudate from quadrate lobes 4. Below: liver inferior border

Question 28

Quadrate lobe relation

Answer 28

1. Transverse colon 2. Pyloroduodenal junction 3. Lesser omentum (from below upwards)

Question 29

Gall bladder fossa

Answer 29

Related to gall bladder anterior surface

Question 30

Duodenum 2nd part

Answer 30

Just to right of gall bladder neck

Question 31

Right colic flexure

Answer 31

Just to right of duodenum close to liver inferior border

Question 32

Right kidney front

Answer 32

To right side of duodenal impression and above colic impression

Question 33

Right Suprarenal gland lower part

Answer 33

Above right kidney

Question 34

Porta hepatis (Liver Hilum)

Answer 34

1. Transverse fissure between liver posterior and inferior surfaces 2. Lies between quadrate lobe anterior and caudate lobe with its caudate process posterior 3. Its margins give attachment to lesser omentum

Question 35

Contents

Answer 35

1. Right and left hepatic ducts 2. Hepatic artery right and left branches 3. Hepatic nerve plexus 4. Portal vein right and left branches 5. Lymph vessels and nodes 6. Extraperitoneal fat

Question 36

Right and left hepatic ducts

Answer 36

Most anterior and near Hilum right end

Question 37

Hepatic artery right and left branches

Answer 37

In middle and near hilum left end

Question 38

Hepatic nerve plexus

Answer 38

Along hepatic artery

Question 39

Portal vein right and left branches

Answer 39

Most posterior