Penny - Chapter Two

Hemopoiesis

formation and development of blood cells in early embryonic life

• bare area

• falciform ligament

• gallbladder fossa

• porta hepatis

• an area adjacent to the IVC

parts of the liver not covered by intraperitoneal

Glisson’s Capsule

thin, fibrous capsule covering the entire liver

Kupffer Cells

specialized macrophages within the liver that engulf pathogens and any damaged cells

Bile duct, Portal vein, Hepatic artery

Portal Triad

Hepatic Artery

branches from the celiac trunk - drains blood into the liver from the abdominal aorta

low-resistance

normal flow patterns of the hepatic artery

Liver Lobes

Right, Left, Quadrate

Couinaud Classification

system used to divided the liver up into 8 surgical segments

Quadrate Lobe

an anatomical lobe found on the medial aspect of the LEFT lobe - located between the gallbladder fossa and the round ligament

Right Hepatic Vein

separates the right lobe into anterior and posterior - lies within the right inner segmental fissure

Mid Hepatic Vein

seperates the right and left lobes - lies in the main lobar tissue

Left Hepatic Vein

divides the the left lobe into lateral and medial - lies within the left intersegmental fissure

Ligamentum Teres and Falciform Ligament

separates liver segements in the medial aspect

Caudate Lobe

• smallest lobe

• bounded by the ligament venous anteriorly

• has its own blood supply and venous drainage

Portal Vein and Splanchnic Circulation

main blood sources of the liver

Splanchnic Circulation

brings blood flow to gastrointestinal organs such as the liver, pancreas, spleen, small intestines and large intestines

Superior Mesenteric Vein and Splenic Vein

portal confluence (creation of the portal vein)

Portal Splenic Confluence, Portovenous Confluence

other names for the merger of the vessels that create the main portal vein

13mm (1.3cm)

the normal diameter of the main portal vein

Hepatopetal and Monophasic with some respiratory variation

normal blood flow of the portal veins

IVC

Triphasic

place hepatic veins drain into and their doppler flow characteristics

Right-Sided Heart Failure

causes hepatic vein and IVC enlargement

Budd-Chiara Syndrome

results in the occlusion of the hepatic veins and possibly the IVC

Ligamentum Venous

collapses and closes of after birth - referred to as the ductus venosus (right branch of the umbilical vein bifurcation in the fetal liver) during pregnancy and shunts blood to the fetal IVC

Ligamentum Teres/Round Ligamentum

left umbilical vein branch that connects directly to the portal vein - after birth becomes a fibrous cord

Recanalization

happens to the paraumbilical vein in the presence of portal hypertension

Diaphragmatic Slip appearing as a Pseudo-mass

typically occurs in older patients caused by hypertrophied diaphragmatic muscle bundles - appears as a hyperechoic band in sag but as a mass in transverse