The Liver

LIVER

Liver is the largest visceral structure in the abdominal cavity, and the largest gland in the human body.

Functions = synthesis of bile, glycogen storage and clotting factor production.

SUPERFICIAL LOCATION: mainly at RUQ, right hypochondriac & epigastric regions.

Multiple Choice

A patient is suspected with tumour of the right lobe of the liver. An early imaging diagnosis using an ultrasonography is suggested. As a sonographer, which area of the abdomen you must put the transducer to scan?

• Right upper quadrant

• Left upper quadrant

• Right lower quadrant

• Left lower quadrant

Liver Surface

• Diaphragmatic surface – the antero-superior surface of the liver. Simply known as anterior view.

• Visceral surface – the postero-inferior surface of the liver. Simply called posterior view.

Anterior surface of liver

• devide by right and left lobes.

• falciform ligament, coronary ligament & round ligament between right and left lobes.

• lower of the right lobe = lower part of gallbladder demonstrated

• superior part between right and left lobes = bare area (diaphragmatic surface, triangle shape, not cover by peritoneum layer, attached directly to the diaphragm)

Recess

• spaces between the liver and surrounding structures. 

• Subphrenic recess = space between liver & diaphragm.

• Subhepatic recess = space between liver & transverse colon

• Hepatorenal recess = space ebtween liver and right kidney

Multiple Choice

Which liver surface covered by the diaphraghm?

• Diaphragmatic surface

• Visceral surface

Multiple Choice

Which ligament is NOT located between right and left lobes of the liver

• Falciform ligament

• Coronary ligament

• Anterior cruciate ligament

• Round ligament

Multiple Choice

The surface area on the liver that did not covered by peritoneum is called __________

• subphrenic recess

• subhepatic recess

• hepatorenal recess

• bare area

Multiple Choice

Hepatorenal recess or also known as Morison's pouch is a space between the liver and _________

• duodenum

• stomach

• right kidney

• left kidney

Posterior surface of liver

• At the right lobe, can see inferior vena cava (IVC) at the upper part and gallbladder at the lower part.

• On the right lobe, IVC separate the right lobe into another smaller lobe called = caudate lobe.

• On the right lobe, gallbladder separate the right lobe into another smaller lobe called = quadrate lobe.

• On the right lobe (between caudate lobe & quadrate lobe), there is a structure known as porta hepatis. This structure where 3 main vessel/duct insert into the liver which are (i) common hepatic duct, (ii) hepatic artery proper & (iii) hepatic portal vein.

Multiple Choice

TRUE or FALSE

Based on the posterior surface of liver, abdominal aorta separate caudate lobe to right lobe of the liver

• TRUE

• FALSE

Multiple Choice

TRUE or FALSE

Based on the posterior surface of liver, gallbladder separate quadrate lobe to right lobe of the liver

• TRUE

• FALSE

Multiple Choice

TRUE or FALSE

Based on the posterior surface of liver, porta hepatis separate quadrate lobe to caudate lobe.

• TRUE

• FALSE

Multiple Choice

Which ONE structure does NOT enter the liver through porta hepatis?

• Common hepatic duct

• Common bile duct

• Hepatic artery proper

• Hepatic portal vein

Artery & Vein

• dual blood supply.

• (1) Hepatic artery proper (25%) – Derived from the coeliac trunk.

• (2) Hepatic portal vein (75%) – supplies the liver with partially deoxygenated blood, carrying nutrients absorbed from the small intestine. 

• Venous drainage of the liver is achieved through hepatic veins. These hepatic veins then open into the IVC