6 Liver & biliary passages.pdf

6 Liver & biliary passages.pdf - THE LIVER AND BILIARY...

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THE LIVER AND BILIARY PASSAGES Dr. Gil L. Apacible XUSOM
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Learning Objectives: At the end of this lecture, the student must -know the location, surfaces of liver and important relations of liver. -describe the location of subphrenic spaces and hepato-renal pouch. -know the lobation and segmentation of liver. - know the blood supply of liver and clinical correlations. - have a basic knowledge of anatomy of hepatic duct, bile duct and cystic duct. - Know the parts and relations of Gall Bladder. - Describe the relations of cystic duct, cystic artery and liver. - Know the clinical correlation of anatomy of biliary apparatus. - Know sites of porto-caval shunts and their clinical significance.
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Location of Liver deep to ribs 7-11 on the right side occupies most of the right hypochondrium and upper epigastrium and extends into the left hypochondrium
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The liver has a convex diaphragmatic surface (anterior, superior) and a relatively flat or even concave visceral surface (posteroinferior), which are separated anteriorly by its sharp inferior border
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The subphrenic recesses are separated into right and left recesses by the falciform ligament , which extends between the liver and the anterior abdominal wall. This ligament divides the liver into anatomical right and left lobes.
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Subphrenic recesses superior extensions of the peritoneal cavity (greater sac) exist between diaphragm and the anterior and superior aspects of the diaphragmatic surface of the liver.
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The portion of the supracolic compartment of the peritoneal cavity immediately inferior to the liver is the subhepatic space .
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The hepatorenal recess (hepatorenal pouch; Morison pouch ) is the posterosuperior extension of the subhepatic space, Lies between the right part of the visceral surface of the liver and the right kidney and suprarenal gland. The hepatorenal recess is a gravity-dependent part of the peritoneal cavity in the supine position ; fluid draining from the omental bursa flows into this recess.
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The diaphragmatic surface of the liver is covered with visceral peritoneum, except posteriorly in the bare area of the liver , where it lies in direct contact with the diaphragm.
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The visceral surface of the liver is covered with peritoneum, except at i. the fossa for the gallbladder and ii. the porta hepatis a transverse fissure where the vessels (hepatic portal vein, hepatic artery, and lymphatic vessels), the hepatic nerve plexus, and hepatic ducts that supply and drain the liver enter and leave it.
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Impressions on the visceral surface reflect the liver's relationship to the: Right side of the anterior aspect of the stomach ( gastric and pyloric areas ). Superior part of the duodenum ( duodenal area ). Gallbladder (fossa for gallbladder).
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