Questions and Answers
What are suprahepatic recesses?
The posterosuperior extension of the subhepatic space, lying between the right part of the visceral surface of the liver and the right kidney and suprarenal gland.
What is the relationship of the liver to the portal triad?
The portal triad passes between the layers of the hepatoduodenal ligament to enter the liver at the porta hepatis.
What is the primary function of the liver in terms of lymphatic drainage?
The liver is a major lymph-producing organ that contributes to lymph that enters the thoracic duct.
How many surgically resectable hepatic segments are there in the liver?
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Where does the blood and bile flow in the liver lobules?
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In which directions does lymph flow from the liver?
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Study Notes
Suprahepatic Recesses
- Hepatorenal recess, also known as Morison pouch, is located between the right liver surface and the right kidney/suprarenal gland.
- It serves as a gravity-dependent space for fluid in the supine position, receiving fluid from the omental bursa.
- Anteriorly connects with the right subphrenic recess.
- Normally contains minimal peritoneal fluid for lubrication.
Relationships of Liver to Abdominal Viscera
- Anterior sagittal cut at the gallbladder fossa; posterior cut at ligamentum venosum fissure.
- Coronal cut aligns with the porta hepatis, illustrating liver relations with intraperitoneal viscera.
- Portal triad enters the liver through the hepatoduodenal ligament layers.
- Coronal MRI images depict liver relations with retroperitoneal structures.
Lymphatic Drainage and Innervation of Liver
- The liver is a major source of lymph; 25-50% of thoracic duct lymph derives from it.
- Superficial lymphatics located in Glisson capsule, deep lymphatics follow the portal triad and hepatic veins.
- Major lymphatic drainage occurs in perisinusoidal spaces, guiding flow to hepatic nodes.
- Efferent lymphatics from hepatic nodes drain to celiac nodes, leading to the cisterna chyli.
- Innervation comprised of sympathetic and parasympathetic fibers from the hepatic plexus.
Hepatic Segmentation
- The liver divided into four vertical sections by right, intermediate, and left hepatic veins as reference.
- These sections are further subdivided into eight surgically resectable segments (I-VIII).
- Each segment has independent blood supply and biliary drainage, intersegmental drainage occurs via hepatic veins.
- Visualization of portal vein injections illustrates liver segmentation.
Flow of Blood and Bile in Liver
- Liver lobule has an interlobular portal triad with sinusoids and bile canaliculi.
- The hexagonal pattern of liver lobes is highlighted, showing structural organization.
- Extrahepatic bile passages, gallbladder, and pancreatic ducts connect to the hepatopancreatic ampulla leading to the duodenum.
Lymphatic Drainage and Innervation of Liver (Reiteration)
- Lymph from the upper liver drains to thoracic nodes; lower liver lymph drains to abdominal nodes.
- The hepatic plexus, largest celiac plexus derivative, transmits sympathetic and parasympathetic fibers to the liver.
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Description
Explore the intricacies of liver anatomy with these flashcards focusing on key terms such as suprahepatic recesses. Perfect for students preparing for BCS exams or anyone looking to enhance their understanding of liver structures. Dive into definitions and gain a solid grasp of essential anatomical concepts.
