The Liver

C.Masina

The Liver

• The largest internal body organ• Largest gland• Largest organ apart from skin• Weighs about 1.5kg• Found in the upper abdominal cavity: extends from

right upper quadrant to left upper quadrant of the abdomen

• Attached to diaphragm by falciform and coronary ligamentsLeft and right triangular ligaments

Functions

• Bile production and secretion• Detoxification • Storage of glycogen• Protein synthesis• Production of heparin and bile pigments• Erythropoiesis (in fetus)

Liver surfaces

• Divided into 2 anatomical regions:1.Diaphragmatic surface:Smooth and dome-shaped surfaceAnterior liver partInferior to diaphragmSeparated from diaphragm by subphrenic recess

and from posterior organs {kidney and suprarenal glands} by hepatorenal recess

Covered by peritoneum except

1.Diaphragmatic surface

2. Visceral surface

Covered by visceral peritoneum except porta hepatis and gall bladder bed.

• The visceral surface is related to: Right side of the stomach i.e. gastric and pyloric areas Superior part of the duodenum i.e. duodenal area Lesser omentum Gall bladder Right colic flexor and right transverse area ; colic area Right kidney and suprarenal gland; Renal area

Posterior liver view

Liver lobesRight and left lobeFunctionally independent i.e. each with own blood and nerve supply

Blood supply in by:Hepatic arteryPortal vein

Blood out through:Vein and biliary drainage

Liver lobes1.The Right lobeDemarcated by :

1. Gall bladder fossa

2. Inferior vena cava fossa

3. Imaginary line from fundus of gall bladder and inferior vena cava

Liver lobes2. Left lobe

Divided into:Medial and lateral segments

1.Medial superior – caudate lobe

2.Medial inferior - quadrate lobe

2. Left lobe cont… The lateral segment

is separated from the medial segments by:

On visceral surface: 1. fissure of

ligamentum teres (round ligament)

2. fissure of ligamentum venosum

On diaphragmatic surface:

1. Attachment of falciform ligament

Visceral surface 1. The round ligament(ligamentum

teres) – obliterated umbilical vein 2. The ligamentum venosum – fibrous

remnant of fetal ductus vein3. The Porta hepatis (hepatic potal;

portal fissure) - transverse fissure on the visceral surface of the liver.– It gives passage to the:

1. Portal vein2. Hepatic artery 3. Hepatic nerve plexus4. Hepatic ducts5. Lymphatic vessels

Peritoneal relations of the LiverThe Lesser omentum • Encloses the portal triad (bile duct, hepatic artery and portal vein

)• Passes from the liver to lesser curvature of the stomach + 2 cm of

duodenum• Thick free edge -- hepatoduodenal ligament• Sheet like remainder – hepatogastric ligament

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