Anatomy of Liver Circulation and Drainage

Anatomy of the Stomach, Liver, and Gallbladder

• The stomach, liver, and gallbladder are part of the digestive system.
• The stomach begins at the abdominal esophagus and ends proximal to the major duodenal papilla.
• The stomach is a muscular organ that receives food from the esophagus.
• It is located in the upper-left portion of the abdomen.
• The stomach has four main anatomical regions: cardia, fundus, body, and pyloric region.
• The stomach has two curvatures: lesser and greater.

Stomach

• Parts: Cardia, Fundus, Body, Pyloric region, Antrum, Canal, Sphincter
• Curvatures: Lesser curvature, Greater curvature
• Musculature: Outer longitudinal, Middle circular, Innermost oblique layers.
• Pyloric sphincter: A thickened ring of circular muscle that controls the release of food from the stomach to the small intestine.
• Arterial supply: Celiac trunk, Left gastric, Splenic, Short gastrics, L. gastro-omental, Common hepatic, Proper hepatic, Right gastric, Gastroduodenal, R. gastro-omental.
• Venous drainage: Short gastric, L gastro-omental, Splenic, Right gastric, R gastro-omental, Hepatic portal vein.
• Clinical correlations: Esophageal constrictions, including upper esophageal sphincter, arch of the aorta, left main bronchus, and diaphragmatic hiatus.
• Hiatal hernias: Sliding and paraesophageal forms.
• Blood Supply: Left and right gastric; short gastric; left gastro-epiploic and right gastro-epiploic arteries. Veins all drain into the portal system
• Imaging: X-rays for visualizing the different parts

Liver

• Location: Right hypochondrium and epigastric and (left hypochondrial) regions, enclosed in the rib cage.
• Surface Anatomy: Two: diaphramatic (anterior, superior, posterior) + visceral (inferior, covered with visceral peritoneum except the fossa for gallbladder and porta hepatis).
• Lobes: Anatomically, has 4 lobes: right, left, caudate, and quadrate.
• Functionally, consists of two portal lobes: a right lobe and a left lobe, which are subdivisions of the anatomic lobes. Divded into 8 segments.
• Blood Supply: Hepatic arteries, Portal vein.
• Lymphatic drainage: Commonly the celiac nodes
• Ligaments: Falciform, Round Ligament, Bare area of liver, Coronary ligaments, Triangular ligaments, Umbilical ligaments.
• Imaging: CT and X-rays used to visualize the liver.
• Surgical Anatomy: Porta hepatis (structures enter and leave the liver). Structures that enter/leave: Hepatic arteries, Portal vein. Structures that exit: Hepatic bile ducts (3).

Gallbladder

• Pear-shaped organ located in a fossa on the inferior surface of the liver.
• Parts: Fundus, Body, Neck.
• Function: Stores and concentrates bile produced by the liver.
• Biliary Apparatus: Pathway for bile in your body, including the cystic duct, hepatic ducts, and common bile duct.