Liver Anatomy
what are the functional segments of the liver?
- the right lobe containing anterior and posterior segments - the left lobe containing medial and lateral segments - the caudate lobe - the right hepatic vein
in 1957, a physician named _______ further divided the liver into ___ segments
-Couinad -8
the caudate lobe is both ____ and _____ divided from the right and left lobes
-anatomically -functionally
the ligament venosum divides the ______ lobe from the ______ lobe
-caudate -left
Hepatic veins drain ________ into the ______
-deoxygenated -IVC
the right lobe is separated from the left lobe what 2 landmarks?
-falciform ligament on its diaphragmatic surface -main lobar fissure on its visceral surface
the ascending portion of the left portal vein (before it divides into the medial and lateral branches) is the only portion of the portal veins that run ________ and separates the ....
-intersegmental -medial and lateral segments of the left lobe
the left hepatic vein lies in the ______ intersegmental fissure, and divides the....
-left -medial segments from the lateral segment of the left lobe
within the main lobar fissure lies the ________ hepatic vein which runs ______
-middle -intersegmentally
what are the 8 sections of couinaud's system?
1. caudate segment 2. left superior lateral 3. left inferior lateral 4. a. left superior medial b. left inferior medial 5. right inferior anterior 6. right inferior posterior 7. right superior posterior 8. right superior anterior
the greatest AP measurements of the liver ranges from ...
10-12.5 cm
what is the liver weights for men and women, approximately?
1200g for women 1600 g for men
the greatest length of the right surface of the liver is ...
15-17 cm
the greatest transverse portion of the liver ranges from ...
20-22.5 cm
how many segments of liver are there?
4
the right lobes is ____ larger then the left
6 x
besides the peritoneum , what is the liver completely covered by?
Glisson's capsule
emissary veins of the caudate lobe, enter directly into the ...
IVC
the caudate lobe is separated from the right lobe by the ...
IVC
contained within the left intersegmental fissure are the ...
LHV, ascending portion of the LPV, falciform ligament, and the ligamentum teres
the _______ lies within the fissure and acts as a landmark for the main lobar fissure
MHV
what fissure is an incomplete boundary that passes from the GB to the IVC?
Main Lobar fissure
the right lobe occupies the ...
RUQ
what quadrant is the liver located in?
RUQ and extends across the midline into the LUQ
What is Glisson's capsule?
a dense, fibroelastic connective tissue layer that completely covers the liver
sono identifies Reidels lobe as ...
a small handle or tongue projection on the right lobe that extends distally
in patients with ascites, the falciform ligament may be seen as ...
an echogenic band connecting the liver to the anterior abd. wall
the liver is divided into lobes both _______ and _________
anatomically , segmentally
the falciform ligament attaches the liver to the ...
anterior abdominal wall and the diaphragm
the area of the liver that is not covered by peritoneum is called the ...
bare area
what does the Glisson's capsule contain?
blood and lymphatic vessels and nerves
segmentally/functionally, the liver is divided into segments based on...
blood supply and biliary drainage
the right portal vein divides into the anterior and posterior branches of the right lobe and supplies...
blood to each segment respectively
how would you distinguish a Redials lobe from a tumor sonographically?
by observing normal liver echotexture
the middle hepatic vein usually forms the _________________ with the left hepatic vein
common trunk
the coronary ligament is __________ with the falciform ligament
continuous
the right and left triangular ligaments are continuous with the ___________ ligament
coronary
with age the liver will _______ in size
decrease
the right and left triangular ligaments connects ....
diaphragm
the Ligament Venosum is a remnant from the fetal ...
ductus venosus
sonographically, the main lobar fissure can be seen as an ...
echogenic line connecting the portal vein to the neck of the gallbladder
the caudate lobe is drained by small veins called
emissary veins
the left lobes is situated in the
epigastric and LUQ regions
the anatomic division of the liver is based on ....
external markings
the _______ ligament contains the ligamentum teres
falciform
what is the left lobe separated by the right lobe by?
falciform ligament
a ____________ is a long, narrow opening or a normal groove that divides the liver into lobes
fissure
what structure of the liver are located in the bare area?
gallbladder fossa, the aorta, the aorta hepatic, and areas surrounding the IVC
what affects the variation of size of the liver?
height, weight, and age
the segmental division of the liver is based on ....
hepatic function
the right_____ lies within the right intersegmental fissure and acts like a landmark for the fissure
hepatic vein
Reidels lobe is an anatomic variant in which an unusually large lobe give the impression of ...
hepatomegaly
where is the ligamentum teres located?
in the falciform ligament
are the hepatics inter or intra segmental
intersegmental
the ligamentum teres courses within the left ______________ fissure, dividing the left lobe into medial and lateral segments
intersegmental
the right hepatic vein lies _________________ and divides the right lobe into anterior and posterior segments
intersegmental
the right hepatic vein runs _____________ between the two segments
intersegmentally
liver is a ________ organ
intraperitoneal
are the portals inter or intra segmental
intrasegemental
the left portal vein runs ________ within the segments of the left lobe
intrasegmental
the right lobe is divided ________ by the portal veins
intrasegmentally
the caudate lobe is functionally distinct from the other lobes because ...
it receives its own blood supply and has its own bile ducts
situs inverses can be a cause of congenital absence of ...
left lobe
the left intersegmental fissure divides the ....
left lobe into medial and lateral segments
the ligamentum venosum runs from the ____________ to the IVC
left portal vein
the caudate lobe is separated from the left lobe by the....
ligament venosum
shortly after birth, the umbilical vein contracts down to form the ...
ligamentum teres
what is the left lobe separated form the caudate lobe by?
ligamentum venosum
what is the largest visceral organ of the body?
liver
the left lobe is divided form the right lobe by the ...
main lobar fissure
the left lobe is also divided into _____ and _____ segments
medial and lateral
the portal vein divides into the medial and later branches which supply blood to the ___ and ___ segments of the left lobe
medial and lateral
is the falciform ligament visualized on US?
no, but you can visualize the Ligament Teres
how can the ligamentum venosum be visualized sonnographicallly?
on either a long or trans view as an echogenic line dividing the left and caudate lobes
where is the bare area located?
on the posterior surface of the liver
liver is almost completely covered by ...
peritoneum
with portal HTN, the teres recannalizes to form a ...
portosystemic venous collateral
the caudate lobes lies ______________ to the medial segment of the left lobe
posterior
the coronary ligament connects the ....
posterior surface of the liver to the diaphragm
the medial segment of the left lobe used to be called the _________ lobe due to its anatomic position
quadrate
the main lobar fissure separates the ...
right and left lobes
the falciform ligament divides the ....
right and left lobes of the liver on the diaphragmatic surface
the right intersegmental fissure divides the ...
right lobe into anterior and posterior
before the bifurcation of the anterior and posterior branches of the right lobe, an imaginary line can be drawn out from the ....
right portal vein to also divide the anterior and posterior segments
what are the 3 lobes of the liver?
right, left, caudate
the ligamentum teres is AKA
round ligament
when major visceral organs are mirrored or reversed in their positions, it is called .....
situs inversus
situs inversus can result in variations in _______ and _________ of the liver
size and shape
the caudate lobe is ______. than the right and left lobes
smaller
the left lobe is _______ than the right
smaller
the right and left triangular ligaments are seen on the _________ surface of the liver
superior
which segment of the liver is concave?
the abdominal visceral side
the right lobe is divided into which 2 segments?
the anterior and posterior segments both intersegmentally and intrasegemental
which segments of the liver are the diaphragmatic surface which is convex?
the anterior, superior, and posterior
the liver is tethered by ligaments to what structures?
the undersurface of the diaphragm, the anterior abdominal wall of the abdomen, the stomach, and the retroperitoneum
anatomically the liver is divided into ...
three lobes
the main portal vein brings blood _________ the liver
towards
sonographically, the Teres Ligament is best visualized in the ....
transverse view as a rounded echogenic structure just to the right of midline
the ligamenetum teres is a remnant of the fetal ...
umbilical vein
the falciform ligament extends from the _______ to the diaphragm
umbilicus