Liver, Gallbladder, and Pancreas Anatomy PDF

LIVER , GALLBLADDER and PANCREAS Prepared by : Dr.Abdinor Arab  LIVER  The liver is the largest visceral organ in the body and is primarily in the right hypochondrium and epigastric region, extending into the left hypochondri...

LIVER , GALLBLADDER and PANCREAS Prepared by : Dr.Abdinor Arab  LIVER  The liver is the largest visceral organ in the body and is primarily in the right hypochondrium and epigastric region, extending into the left hypochondrium.  Surfaces of the liver include: 1. A diaphragmatic surface in the anterior, superior, and posterior directions; and 2. A visceral surface in the inferior direction  Diaphragmatic surface The diaphragmatic surface of the liver, which is smooth and domed, lies against the inferior surface of the diaphragm. Associated with it are the subphrenic and hepatorenal recesses 1.The subphrenic recess separates the diaphragmatic surface of the liver from the diaphragm and is divided into right and left areas by the falciform ligament 2.The hepatorenal recess is a part of the peritoneal cavity on the right side between the liver and the right kidney and right suprarenal gland  Visceral surface The visceral surface of the liver is covered with visceral peritoneum except in the fossa for the gallbladder and at the porta hepatis (gateway to the liver) and structures related to it include the following: 1.Esophagus, 2.Right anterior part of the stomach, 3.Superior part of the duodenum, 4.Lesser omentum, 5.Gallbladder, 6. Right colic flexure, 7. Right transverse colon, 8. Right kidney, and 9. Right suprarenal gland. The porta hepatis serves as the point of entry into the liver for the hepatic arteries and the portal vein, and the exit point for the hepatic ducts. ASSOCIATED LIGAMENTS The liver is attached to the anterior abdominal wall by the falciform ligament and, except for a small area of the liver against the diaphragm (the bare area), the liver is almost completely surrounded by visceral peritoneum. The bare area of the liver is a part of the liver on the diaphragmatic surface where there is no intervening peritoneum between the liver and the diaphragm. Additional folds of peritoneum connect the liver to: 1.The stomach (hepatogastric ligament), 2.The duodenum (hepatoduodenal ligament), and 3.The diaphragm (right and left triangular ligaments and anterior and posterior coronary ligaments). 1.The anterior boundary of the bare area is indicated by a reflection of peritoneum—the anterior coronary ligament. 2.The posterior boundary of the bare area is indicated by a reflection of peritoneum—the posterior coronary ligament. 3.Where the coronary ligaments come together laterally, they form the right and left triangular ligaments.  LOBES The liver is divided into right and left lobes by the falciform ligament anterosuperiorly and the fissure for the ligamentum venosum and ligamentum teres on the visceral surface. The right lobe of the liver is the largest lobe, whereas the left lobe of the liver is smaller. The arterial supply to the liver includes: 1.The right hepatic artery from the hepatic artery proper (a branch of the common hepatic artery from the celiac trunk), and 2.The left hepatic artery from the hepatic artery proper (a branch of the common hepatic artery from the celiac trunk).  GALLBLADDER The gallbladder is a pear-shaped sac lying on the visceral surface of the right lobe of the liver in a fossa between the right and quadrate lobes. It has: 1.A rounded end (fundus of the gallbladder), which may project from the inferior border of the liver; 2.A major part in the fossa (body of the gallbladder), which may be against the transverse colon and the superior part of the duodenum; and The arterial supply to the gallbladder is the cystic artery from the right hepatic artery (a branch of the hepatic artery proper). The gallbladder receives, concentrates, and stores bile from the liver.  PANCREAS The pancreas lies mostly posterior to the stomach. It extends across the posterior abdominal wall from the duodenum, on the right, to the spleen, on the left. The pancreas is (secondarily) retroperitoneal except for a small part of its tail and consists of a head, uncinate process, neck, body, and tail. 1.The head of the pancreas lies within the C- shaped concavity of the duodenum. 2. Projecting from the lower part of the head is the uncinate process, which passes posterior to the superior mesenteric vessels. 3.The neck of the pancreas is anterior to the superior mesenteric vessels. Posterior to the neck of the pancreas, the superior mesenteric and splenic veins join to form the portal vein. 4.The body of the pancreas is elongate and extends from the neck to the tail of the pancreas. 5.The tail of the pancreas passes  The pancreatic duct begins in the tail of the pancreas.  It passes to the right through the body of the pancreas and, after entering the head of the pancreas, turns inferiorly.  In the lower part of the head of the pancreas, the pancreatic duct joins the bile duct.  The joining of these two structures forms the hepatopancreatic ampulla (ampulla of Vater), which enters the descending (second) part of the duodenum at the major duodenal. The arterial supply to the pancreas includes the: 1.Gastroduodenal artery from the common hepatic artery (a branch of the celiac trunk). 2.Anterior superior pancreaticoduodenal artery from the gastroduodenal artery. 3.Posterior superior pancreaticoduodenal artery from the gastroduodenal artery. 4.Dorsal pancreatic artery from the inferior pancreatic artery (a branch of the splenic artery). 5.Great pancreatic artery from the inferior pancreatic artery (a branch of the splenic artery). 6.Anterior inferior pancreaticoduodenal artery from the inferior pancreaticoduodenal artery (a branch of the superior mesenteric artery), and 7.Posterior inferior pancreaticoduodenal artery from the inferior pancreaticoduodenal artery (a  Duct system for bile The duct system for the passage of bile extends from the liver, connects with the gallbladder, and empties into the descending part of the duodenum. The coalescence of ducts begins in the liver parenchyma and continues until the right and left hepatic ducts are formed. These drain the respective lobes of the liver.  The two hepatic ducts combine to form the common hepatic duct, which runs near the liver, with the hepatic artery proper and portal vein in the free margin of the lesser omentum.  As the common hepatic duct continues to descend, it is joined by the cystic duct from the gallbladder. This completes the formation of the bile duct.  The bile duct continues to descend, passing posteriorly to the superior part of the duodenum before joining with the pancreatic duct to enter the descending part of the