Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Human Anatomy ppt lectures Topic 67 Liver Notes. - anatomy ppt free download human anatomy ppt lectures, medicine notes ppt, anatomy handwritten notes pdf, mbbs 1st year anatomy notes pdf download, best anatomy notes pdf, human anatomy notes pdf, anatomy easy notes pdf, anatomy notes online, anatomy short notes, Anatomy ppt, Powerpoint Presentations and lecture notes.
Surface projection
of liver
LIVER ? HEPAR
Largest Gland, exocrine secretion (bile),
metabolic functions
Weight ?
1.6 kg , fragile tissue, 1.3kg females,
Reddish Brown C.
Newborn - 5% of body weight, Adult - 2.5% of body wt
Shape- wedge, four sided pyramid
laid on one side.
LIVER ? HEPAR
Position: right diaphragmatic dome --- left medioclavicular line
Rt. Hypochond. ? epigastric- Lt.hypochond.
Five surfaces- Ant., Post., Sup., Inf. & Right.
Coverings of the liver
1. T. SEROSA (X area nuda)
= visceral peritoneum
2. FASCIA GLISSONI
DIAPHRAGMATIC SURFACE
Two lobes - right and left l.
Ligaments:
Lig. teres hepatis
- obliterated umbilical vein
ligament falciforme hepatis
(attachment to the peritoneum of
anterior abdominal wall)
Coronary hepatic lig.
Triangular hepatic lig.
LIG.TERES HEPATIS
,,BARE AREA" ( ,,Area nuda") ? not
covered by peritoneum, fused with
diaphragm, bordered by ligaments
Ligaments:
- Lig. teres hepatis - obliterated
umbilical vein
-Falciform hepatic ligament
DIAPHRAGM
(attachment to the peritoneum
- of anterior abdominal wall)
- Coronary hepatic lig.
- Triangular hepatic lig.
VISCERAL SURFACE
LOBES :
1. Lobus dexter ? right lobe
2. l. sinister ? left l.
3. l. caudatus ? caudate l.
4. l. quadratus ? quadrate l.
PORTA
HEPATIS
Borders among lobes ? fissures
,,H"
Imprints of surrounding organs:
Right lobe-
duodenum, right kidney and suprarenal gland,
right colic flexure
Left lobe -
stomach, oesophagus
VISCERAL SURFACE
Caudate Lobe : post. Surf.
Rt. ? Groove fr IVC
Lt.- Fissure fr Lig. Ven.
Inf.- Porta hepatis
PORTA
HEPATIS
Quadrate Lobe : Inf. Surf.
Ant. ? Inf. Border
Post.- Porta hepatis
Rt.-fossa fr G.B.
Lt.- Fissure fr Lig. Teres
PORTA HEPATIS - hepatic triad
Inf. Surface
Deep ,Transverse fissure, 5 cm long.
Between Caudate l. & Quadrate l.
1. PORTAL VEIN
2. PROPER HEPATIC ARTERY (branch of
common HA)
3. Hepatic plexus of nerves
4. RIGHT and LEFT HEPATIC DUCT
- lymphatics, - vegetative nerve
Parasagittal section
through liver
Showing subphrenic
recess and
hepatorenal recess
(Rutherford-Morison pouch)
Liver
Surfaces of Liver
1. Diaphragmatic surface
2. Visceral surface : structures lie like `H'
Visceral
Surface
`H'
Liver
Visceral surface `H'
1. Cross-bar of H = Porta hepatis
?
Hepatic artery, Portal vein, Bile
ducts, Nerves and Lymphatic vss.
2. Lt. inferior of H = Ligamentum teres
hepatis or round ligament of liver
(Remnant of umbilical v.)
3. Lt. superior of H = Ligamentum
venosum (Remnant of ductus venosus)
4. Rt. inferior of H = Gall bladder
5. Rt. superior of H = Inferior vena cava
Visceral
Surface
`H'
Liver
Peritoneal relations
1. Peritoneal ligaments
?
Lesser omentum
?
Falciform ligament
?
Coronary ligaments
?
Triangular ligaments
2. Vascular ligaments
?
Round ligament of the liver
?
Ligamentum venosum
Parts of stomach and lesser omentum
Liver
Bare areas of the liver
peritoneum
1. b/t Ant. & Post. Coronary ligaments
2. Fossa for gall bladder
3. Porta hepatis
4. Fissure for round ligament
5. Fissure for ligamentum venosum
6. Fossa for IVC
Liver
Lobes of liver
1. Anatomical lobation
?
Right lobe
?
Left lobe
?
Caudate lobe
?
Quadrate lobe
2. Functional lobation
?
Right lobe
?
Left lobe
?
By a line passing the gal bladder and IVC
Anatomical lobes
Anatomical lobes
Functional lobes
Functional lobes
Liver
Blood supply of liver
1. Rt. & Lt. hepatic arteries carry
oxygenated blood (25%)
2. Portal vein carries venous blood
(75%) rich in nutrients
3. Hepatic veins drain venous blood
to IVC
Nerve
Anterior vagal trunk
? Hepatic plexus
contains symp. +
parasympath. Or vagal
fibers
? Nerve also reach liver
via various peritoneal
ligaments.
Celiac plexus
Liver
Lymphatic drainage of liver
Liver is a major lymph-producing organ
(1/4 -1/2 of lymph Thoracic duct)
?
Diaphragmatic surface of liver drains
to Phrenic nodes
?
Visceral surface & deep lymphatics
along portal triads drains to Porta
Hepatis Hepatic nodes Coeliac
nodes Cisterna chyli Thoracic
duct
Lymphatic drainage of liver
Lymphatic
drainage of GI
tract
Arterial Supply-
Hepatic artery
Portal vein
Rt& Lt. Branches -> segmental vessels ->
Interlobular ? Hepatic sinusoids. Mixes
Venous Drainage- Hepatic sinusoids-
interlobular + sublobular v. + Hepatic v. -
> I.V.C.
Nerve Supply- Hepatic plexus contains
symp. + parasympath. Or vagal fibers
Nerve also reach liver via various
peritoneal ligaments.
Gal bladder & Biliary tracts
Gal bladder & Biliary tracts
Biliary system consists of
1. Gall bladder
2. Biliary tracts
Cystic duct, hepatic ducts,
common hepatic duct and
common bile duct
Gal bladder
? Length 7-10 cm.
? Capacity 30-50 ml
? b/t Rt. lobe & Quadrate
lobe of liver
? Surface projection
Fundus of gallbladder =
Murphy's point
Gal bladder
Spiral valve
Neck
Body
Gallbladder has 4 portions
1. Fundus
2. Body
3. Neck Infundibulum :
Hartmann's pouch
Hartmann's
pouch
Internal surface : folds, spiral
folds and crypts of Luschka
Fundus
Crypts
of
Luschka
Gal bladder
Gal bladder
Blood supply of gallbladder
Cystic artery
1. Cystic artery from
Right Hepatic artery
(in Calot's triangle
Cholecystectomy)
2. Cystic vein : tributary of
Portal vein
Calot's triangle
Biliary tract
1. Cystic duct : ~ 3-4 cm
: spiral valve of Heister
2. Common hepatic duct
: ~ 3.5 cm
: from Rt. & Lt. hepatic
ducts
3. Common bile duct
: ~ 7-8 cm, Dia- 6mm
1+2 3
Biliary tract
Common bile duct has 4 parts
? Supraduodenal- Liver---portal
v. epi. For.? Hep. Art.
? Retroduodenal
? Infraduodenal
? Intraduodenal
Common bile duct + Major pancreatic duct
Hepatopancreatic ampulla (Ampulla of Vater)
Opening is Greater duodenal papilla in 2nd
part of duodenum (surrounded by Sphincter of Oddi)
Icteric sclera
Compression of common
bile duct resulted in
obstructive jaundice
Biliary tract]
Anterior vagal trunk
Nerves of Gallbladder
? Symp : Celiac plexus
? Parasymp : Ant. and
Post. vagal trunks
Celiac plexus
Biliary tract
Lymphatic drainage of Gallbladder
? Drain to Hepatic nodes of cystic nodes
Celiac nodes
Applied Anatomy
? Cholelithiasis
? Cholecystitis
? Murphy's sign
? Courvoisier's law- dilatation
of the G.B. occurs only in
extrinsic obst. Of CBD ,
fibrosis
? Jaundice
Radiograph of gallbladder
& biliary tracts
This post was last modified on 05 April 2022