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Liver

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Ram Modhvadiya
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5 views

Liver

Uploaded by

Ram Modhvadiya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Liver

• Hepatic
• Largest Gland
• Wedge Shaped
(Resemble 4 sided
pyramid & apex on
left

• Exocrine (secrete bile) as well as endocrine


• (Liberate Glucose from Glycogen , Pl. proteins ,
• heparin - Directly into blood stream
• Involved in metabolic , detoxification activities
• Occupy - Rt. Upper Quadrant
• Occupy Regions –
 Rt Hypochondrium,
 Epigastrium-upper part
 Lt. Hypochondrium – Partly up-to Lt. lateral plane
Liver
• Weight- 1.4 – 1.8 KG
- At birth – 150 gms.
Proportionate weight – Higher in children
Adult- 1/36th of body Wt
New Born- 1/18th of body Wt
Due to Haematopoietic Function
Liver
• Reddish brown
• Soft , solid
• Friable to touch
• Highly Vascular
• Bleed continuously
• Undergo rapid mitosis
• Move with respiration
• Essential for life
Liver
Factors keeping in position

Intra-abdominal pressure maintained by


tone of intra-abdominal muscles
Hepatic veins opening in IVC
Ligaments of Liver
Liver
 Surfaces
 Borders
 Lobes
 Fissures
 Porta Hepatis
 Bare area
 Ligaments & peritoneal
. reflections
2 Surfaces
 Parietal
 Visceral (Inferior)

Subdivisions of Parietal
Superior
Anterior
Rt. Lateral
Posterior
3 Borders

Postero-superior
Postero-inferior
Inferior
Borders
Inferior border
• Sharp
• Separate inferior surface
from Ant. & Rt. Lateral
Features
Interlobar notch –
Lodges Ligamentum Teres
( Left Umbilical Vein)
Cystic notch –
Lodge fundus of Gall bladder
Postero-Inferior Border
Separate Inferior From
Posterior surface
Extent – From Rt. To Lt.
• Lower layer of Coronary Lig.

• Lower end –Vena caval groove

• Tr. Line across caudate lobe


Above caudate & papillary process

• Ant.(Lt.) lip of fissure for


Lig. Venosum (Ductus Venosus)

• Lower end of Oesophageal goove

• Sharp post. Margin of Lt. lobe


Postero- Superior Border

Separate posterior
from superior surface
Demarcation
• Upper layer of coronary Lig.
• Vena caval groove (upper End)
• Lt. Triangular Lig.
Superior Surface
• Moulded with diaphragm ,Convex on sides
& depressed in middle (Cardiac impression)
Relation
• Corresponding lung & pleural sac above the
diaphragm
• Above central tendon – inferior surface of
heart separated by fibrous pericardium &
pericardial sac
Rt. Lateral surface
• Convex
• Covered with
peritoneum
Relation
• Undersurface of Rt.
Part of Diaphragm
• 7th – 11th Rib (Rt. side)
Rt. Lateral surface
Between ribs & Pleura
Upper 1/3rd
• Lower border of Rt. Lung
(Lung extend up-to 8th rib in
mid-axillary line)
• Rt. Pleural sac
Middle 1/3rd
• Costo-diaphragmatic recess of
Rt. Pleura (Pleura Extend up-
to 10th rib in mid-axillary line)
Lower1/3rd
No Lung , No Pleura
Diaphragm comes in contact
with 10th & 11th rib
Clinical Importance
Biopsy of Liver
• Done in forced expiration
• Liver approached through Rt. 9th or 10th
Intercostal space in mid axillary line to
avoid damage to lung
Anterior Surface
• Roughly Triangular in
outline
• Subdivided
Anatomically into Rt
& Lt lobes by the
attachment of
Falciform ligament
• Broad Rt part ,
narrow Lt. part &
intermediate
triangular portion
Anterior Surface

Relations of Right Part


Lie below Rt. Costal
margin
Diaphragm
6th – 10th rib – Rt. Side
Lower margin of Rt.
Lung & pleura
Anterior Surface
Relations of Left part
Lie below Left costal
margin
Diaphragm
7th & 8th left costal
cartilages
Intermediate part
 Xiphoid Process
 Ant. Abdo. Wall
Posterior Surface
• Lie b/w Postero-Sup. &
Postero – Inf. Border
• Deeply concave backward
(for V. Column)
Called vertebral groove
• Convex on Rt. Occupying
Rt. Para-vertebral gutter
Posterior Surface
Features from Right to Left
Largest bare area
Groove for IVC
Caudate lobe
Fissure for Ligamentum
Venosum
Groove for Oesophagus
Largest Bare Area
• On post surface of Rt.
Lobe
• Triangular shaped
• Apex – Rt. Triangular
Ligament
• Base – Groove for IVC
• Upper & lower limits –
Sup. & Inf. Layer of
coronary ligament
Groove For IVC
• Non peritoneal vertical
groove
• Floor pierced by Hepatic
veins
• Arranged in two groups ,
upper & Lower
• Devoid of valves
• Upper Gr.- Rt. ,
Intermediate & Lt.Veins
• Lower – usually two on
left & one on Rt.
Boundaries Caudate Lobe
• On Rt.-
Groove for Vena cava
• On Lt.–
Fissure for Lig. Venosum
• Above –
by Postero-Sup. Border
• Below –
by Porta Hepatis
Features
Caudate preocess (Rt.) &
Papillary process (Lt.)
Fissure for Ligamentum Venosum

• Deep Vertical Cleft


• Floor lodges
Ligamentum Venosum
(Remnant of Ductus
Venosus of Foetal life)
Inferior Surface
Impressions – Lt. To Rt.
• Gastric impression- fundus & body of stomach
• Tuber omentale
• Fissure for Ligamentum Teres
• Quadrate Lobe
• Porta Hepatis
• Caudate & papillary process
• Fossa for Gall bladder
• Duodenal impression (Junction Of Ist & Iind Part)
• Colic Impression ( Rt. Colic Flexture)
• Renal Impression – ant surface & upper part(Rt.
Kidney)
Porta Hepatis
• Transverse non peritoneal fissure – Gateway of
liver
• Extent
from neck of Gb to Fissure for Lig. Teres & Venosum &
intervene b/w –
Quadrate lobe in front &
Caudate process behind
Porta Hepatis
Structures Entering Liver
• Rt. & Lt. Branches of Hepatic
Artery
• Rt. & Lt divisions of Portal
vein
• Hepatic Plexus of Nerves
Structures Leaving
• Rt. & Lt. Hepatic ducts
• Lymphatics of Liver
Arranggement from before
backwards
Ducts , Arteries & Veins
Liver
Applied Anatomy
• Palpation
• Hepatitis
• Cirrhosis of Liver
• Amoebic Liver abscess
• Hepato-cellular Carcinoma

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