Liver abdominal

liver occupies most of the right __ region

hypochondrium

liver occupies the greater part of the __ region

epigastric

liver occupies part of the __ hypochondrium

left

liver is the __ abdominal organ

largest

contour and shape of the liver can very with body __

habitus

the liver lies close to the __

diaphragm

ribs cover the majority of the __ lobe of the liver

right

the liver extends several centimeters below the __ in epigastric region

xyphoid process

the __ lies adjacent to the right lobe

duodenum

__ is just inferior to the liver

pancreas

liver is suspended from the diaphragm and the anterior abdominal wall by the __ ligament

falciform

liver is covered almost entirely by __

peritoneum

superior to the liver is the __

diaphragm

__ - a large area devoid of peritoneum where the diaphragm makes contact

bare area

list four other areas not covered by peritoneum

attachment for falciform ligament, GB fossa, porta hepatitis (portal vein entrance), IVC fossa

__ - dense, fibroelastic connective tissue layer surrounding liver

glissons capsule -

glissons capsule may cause __ due to certain diseases, may cause pain by stretching the capsule

liver distension

glissons capsule contains blood, __ vessels, and nerves

lymphatic

__ displacement frequently cause by:

* tumors
* cirrhosis
* subphrenic abscess

caudal

__ displacement frequently caused by:

* ascites
* excessively distended colon
* abdominal tumor

cephalad

__ displacement frequently caused by:

* retroperitoneal tumors

anterior

__ - largest lobe of the liver

right -

the right lobe exceeds the size of the left lobe by a ratio of __

6:1

the __ and __ surfaces of the liver are marked by three fossa

inferior, posterior

what are the three fossa the inferior and posterior surfaces are marked by:

porta hepatis, gallbladder fossa, IVC fossa

__ - where portal vein, proper hepatic artery and common bile duct enter the liver

portta hepatis

what three things enter the liver through the porta hepatis

portal vein, proper heptic artery, and common bile duct

__ - a congenital variation seen as an inferior projection of the right lobe of the liver extending as low as the iliac crest

riedel’s lobe

__ - lies in the epigastric and left hypochondriac regions

left lobe -

the upper surface of the left lobe is __ and molded onto the diaphragm

convex

the under surface of the left lobe includes the __ impression

gastric

__ - small lobe located on the posterior and superior surface of the left lobe

caudate lobe

the caudate lobe is __ to the IVC

anterior

the caudate lobe is __ to the porta hepatis (where portal vein enters the liver)

superior

the caudate lobe receives Its blood supply from the right and left __ branches, and from the __ artery

vascular, hepatic

the caudate lobe contains its own __ ducts and Its own __

bile, vein

the __ supply in caudate lobe has profound implications in pathology

blood

__ - the functional unit of the hepatic lobe

lobule

__- chief functional cells of the liver, perform multiple functions

hepatocytes

what is the lobule triad consist of?

hepatic artery, bile duct, portal vein

the couinauds anatomical divisions accurately localize liver __, usually prior to surgery

lesions

each of the __ segments has its own blood supply (arterial, portal venous, hepatic venous), lymphatics and biliary drainage.

8

the right, middle, and left __ veins divide the liver vertically into four sections

hepatic

the hepatic veins divide the liver __ into four sections

vertically

each of the sections are further divided by an imaginary plane through the right and left __ veins

portal

segment 1 - __

caudate lobe

segment 2 - __

left lobe lateral superior

segment 3 - __

left lobe lateral inferior

segment 4 (A) - __

left lobe medial superior

segment 4 (B) - __

left lobe medial inferior

segment 5 - __

right lobe anterior inferior

segment 6 - __

right lobe posterior inferior

segment 7 - __

right lobe posterior superior

segment 8 - __

right lobe anterior superior

__ - connects the posterior liver surface to the diaphragm

coronary ligament

__ - the obliterated ductus venosus of fetal circulation

* separates the caudate lobe from the medial segment of the left lobe

ligamentum venosum

__ - fold of peritoneum extends from liver to abdominal wall

falciform ligament

the falciform ligament and ligamentum teres divides the __ and __ segments of the left lobe

medial, lateral

__ - a remnant of the umbilical vein of fetal circulation,

ligamentum teres

the ligamentum teres attaches to the __ vein

left portal

__ - extends between the right portal vein and gallbladder neck

main lobar fissure

the main lobar fissure can also be called the __ fissure because It separates right and left lobes anatomically

interlobar

__ - approaches the porta hepatis (location) toward the right and anterior to IVC

main portal vein

the main portal vein enters the liver, divides into two branches - __ and __ portal veins

right, left

the MPV formed at the junction of __ and __

sma, splenic vein

the MPV is not a branch of __

IVC

__ - a fissure where the portal vein and proper hepatic artery enter the liver and the common hepatic duct leaves the liver

porta hepatis

the __ vein and __ artery enter the liver at the porta hepatis

portal vein, proper hepatic artery

the __ duct leaves the liver at the porta hepatis

common hepatic duct

the porta hepatis is also known as the __

liver hilum

the three structures of the porta hepatis are termed the __

portal triad

CHD (common hepatic duct) is anterior and to the __ of the PV

right

PHA (proper hepatic artery) is anterior and to the __ of the PV

left

the portal triad resembles the __ sign

mickey mouse

__ - larger of the two branches of PV.

right portal vein

the right portal vein runs __ into the right lobe

lateral

the right portal vein has __ and __ branches

anterior, posterior

the right portal vein requires a more __ and __ approach

lateral, inferior

__ - vein lies more anterior and superior to RPV

left portal vein

the left portal vein lies more __ and __ than the RPV

anterior, superior

the left portal vein has __ and __ branches

medial, lateral

__ - largest, and enters the right lateral aspect of IVC

right hepatic vein

__ - enters the anterior or right anterior aspect of the IVC

middle hepatic vein

__ - smallest, enters the left anterior surface of the IVC

left hepatic vein

the hepatic veins flow into the __

IVC

hepatic veins are __ as they drain into the IVC

larger

portal veins are largest at their __ near porta hepatis

origin

walls of the hepatic veins are less __, except RHV

echogenic

portal veins have __ echogenic walls than hepatic veins

more

__ - carry blood from the bowel to the liver - nutrients

portal veins

__ - drain blood from the liver to the IVC - part of the detoxification process

hepatic veins

__ - carry blood to the liver from the aorta - oxygen

hepatic arteries

__ - transport bile, manufactured in the liver, to the duodenum - digestion

bile ducts

walls of __ veins and __ ducts have echogenic walls

portal, biliary

biliary ducts sit __ to the portal veins

anterior

if biliary ducts and portal veins are imaged simultaneously, the appearance is referrred to as __ or __ sign

parallel channel, shotgun

the shotgun sign of biliary ducts and portal veins indicate __ ducts and is pathological sign

enlarged

Function of liver:

__ - complex substances are transformed into simple ones

metabolism

functions of the liver:

__ - fat breakdown

digestion

functions of the liver:

__ - various compounds such as iron, vitamins, copper.

* may be altered by hepatobiliary disease

storage