Anatomy of liver


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Anatomy of liver

  1. 1. Hajnalka Heged s, MD
  2. 2. covered by the Glissons capsule; intraperitonealorgan (except the bare area [ area nuda hepatis] )diaphragmatic surface inferior border of livervisceral surface notch for round ligament of liverright lobe(located in the right hypochondrium)left lobe falciform ligament(in the epigastrium and left hypochondrium) derivative of the embryonic ventral mesogastrium
  3. 3. right lobe left lobe Lig. teres hepatis Lig. teres hepatis Lig. teres hepatis falciform ligament round ligament
  4. 4. Visceral surface ( 1) H - shaped set of groovescross-bar of the H is the porta hepatis: - common hepatic duct (on the right) - hepatic portal vein - hepatic artery proper (on the left) left-hand limb of right-hand limb of the H : the H : - in the anterior half - in the anterior half fossa for gallbladder: fissure for round lig.: gallbladder round lig. (remnant of the umbilical vein) - in the posterior half - in the posterior half fissure for lig. venosum: groove for vena cava: lig. venosum (remnant of _inferior vena cava the ductus venosus)
  5. 5. Anterior to the porta Posterior to the porta hepatis, there is a lobe hepatis, there is another (between the fissure for lobe (between the fissure round lig. and the fossa for lig. venosum and the for gallbladder): groove for venae cava): * *QUADRATE LOBE CAUDATE LOBE (papillary and caudate processes)
  6. 6. remnant of ductus venosus inferior vena cava porta hepatis connective tissue bundle gallbladder
  7. 7. Peritoneal attachments of liver ( intraperitoneal expect for the BARE AREA)falciform lig. of liver LESSER OMENTUM(remnant of the ventral - hepatogastric lig.mesogastrium) - hepatoduodenal lig.a/ left coronary lig. lefttriangular lig. fibrousappendixb/ right coronary lig.hepatorenal lig. right - bile duct (choledochal duct)triangular lig. / on the right/BARE AREA of LIVER - hepatic portal v. / behind the other two items/ - a. hepatica propria / on the left/ ChoVA!
  8. 8. Blood supply to Lymphatic drainage and innervation of the the liver , and its liver venous drainage - lymphatics originate in the interlobularhepatic a. proper (from common connective tissue, the larger lymphatic vessels hepatic a. ; from coeliac trunk) leave the liver in some pathways:hepatic portal v. - via the porta hepatis hepatic lymphatic nodesinterlobar a. and v. - along the hepatic vv. media- stinal lymphatic nodesinterlobular a. and v. - in the falciform lig. para- sternal lymphatic nodesi and nodesperilobular a. and v. around the aortahepatic sinuses (mixture)central v. Innervation: coeliac ganglion vagus n. ( cranial n. X)sublobular v.hepatic veins inferior vena cava
  9. 9. gallbladder / bile cyst / cholecysta Parts: fundus body neck cystic duct common hepatic duct bile duct Peritoneal attachments Blood supply and venous drainage cystic a. hepatic a. proper cystic v. hepatic portal v. Lymphatic drainage: lymph nodes of porta hepatis
  10. 10. Practical assignments ( liver )Study the peritoneal attachments of the liver, surfaces, items of the H-shaped set of grooves and their contents.Inferior margin of the liver is lifted, and the following items should be found:- hepatoduodenal lig. containing (1) bile duct / choledochal duct on the right (2) hepatic portal v. between and behind the other two structures (3) hepatic a. proper on the left) ChoVA!- porta hepatis
  11. 11. 1-2 Parts of pancreas Excretory ducts of the pancreashead of pancreas - pancreatic duct ( Wirsung duct) uncinate process of pancreas (in the tail and body) opens into the hepatopancreatic ampullapancreatic notch major duodenal papilla ( papilla of Vater)body of pancreas omental eminence - accessory pancreatic duct ( Santorini ( bulges into the omental bursa) duct) (in the head)tail of pancreas minor duodenal papilla ( papilla of Santorini)at its superior margin splenicvessels (a. and v.)
  12. 12. Topographical relationships ofthe duodenum and the pancreas
  13. 13. Pancreas: blood supply, venous and lymphatic drainage and innervation superior pancreaticoduodenal a. (supply the head) inferior pancreaticoduodenal a. splenic a. (supplies the body and tail) splenic v. to the hepatic portal v.Lymphatic drainage: preaortin lymph nodesInnervation: coeliac ganglion vagus nerve
  14. 14. Practical assignments ( pancreas)Study the topographical anatomy of the pancreasFind the superior mesenteric vessels (a. and v.)Explore the vicinity of the superior margin of thepancreas; examine the splenic a., and theaccompanying splenic v.)Follow the splenic v. to the hepatic portal v.Isolate the coeliac trunk above the superior margin aofthe pancreas