Liver/Gallbladder General Procedures

when does the portal vein develop?

8th embryonic week

from what part of the primitive gut does the liver form?

foregut

what drains bile from the liver?

bile canaliculus, right/left hepatic ducts

what is bile made of?

water, salts, pigments

homogenous texture

less echogenic than diaphragm, pancreas, spleen

more echogenic than kidney

liver echogenicity

what separates the right and left lobe of the liver?

main lobar fissure, main portal vein

what separates the left lobe and caudate lobe?

ligamentum venosum

what separates the right lobe into anterior and posterior segments?

right intersegmental fissure

what separates the left lobe into medial and lateral segments?

left intersegmental fissure, falciform ligament, ligamentum teres

tongue-like projection of right lobe which elongates it, more common in women

Riedel’s lobe

what covers the liver?

Glisson’s capsuleq

where is the gallbladder in reference to the liver?

posterior, inferior

what are the extrahepatic ducts?

common bile duct, some CHD/cystic duct

what are the intrahepatic ducts?

right posterior and anterior sectoral duct, right/left hepatic duct, common hepatic duct

line sinusoids (vascular spaces between hepatocytes)

break down hemoglobin into bilirubin

conjugate bilirubin

break down old RBCs, bacteria

Kuppfer cells

what is the umbilical vein after birth?

ligamentum teres

separates right and left lobe, contains middle hepatic vein (cephalic) and gallbladder fossa (caudal)

main lobar fissure

inflammation of the gallbladder, often due to gallstones

may necessitate cholecystectomy

cholecystitis

what makes the mickey mouse sign?

common bile duct, hepatic artery, portal vein

moderate to severe increase in AST, ALT

miniminal to moderate increase in alk phos

minimal to severe increase in bilirubin

signs of hepatocellular disease

mild increase in AST, ALT, alk phos

severe increase in bilirubin

signs of obstructive disease

what combines to form the common bile duct?

common hepatic duct, cystic duct

what combines to form the common hepatic duct?

right and left hepatic ducts

what may cause increase in the size of the gallbladder?

age, gallbladder removal