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22 Cards in this Set

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What is the location of the liver (in terms of abdominal partitions)?
right hypochondrium, epigastrium, into left hypochondrium
Where does the liver lie in relation to the nipples?
just below nipple on R and about fingerbreadth below L
A penetrating wound to the liver can also penetrate what other structure? How can this be avoided on liver biopsy?
pleura

to avoid have patient breathe out fully (reduces costodiaphgramatic recess) and hold breath (no movement-related laceration of liver from biopsy needle)
if performed at 7th or 8th space patient requires monitoring in case of tension pneumothorax/haemothorax
Where do the diaphragmatic and visceral surfaces of liver meet?
anteriorly at a sharp inferior border (only palpable with deep inspiration or liver enlargement with emphysematous patient (diaphragm has lower resting level in this case)
What are the parts of the diaphragmatic surfaces of liver and how are they demarcated?
right, superior, anterior, posterior parts with no defined demarcation
The visceral surface of the liver lies on top of what structures?
oesophagus, stomach, duodenum, transverse colon, R colic flexure, R suprarenal gland, R kidney
Peritoneum lies on the anterior surface of the liver, what does it flex away as?
falciform ligament (Latin: sickle shaped)
Continuing distally to the falciform ligament is what other ligament? and what is it a remnant of?
the ligamentum teres, a remnant of the umbilical vein
What does the falciform ligament demarcate?
separate left and right lobes of liver
What are the two fissures separating left and right lobes of the posteroinferior liver?
fissure for ligamentum teres and fissure for ligamentum venosum
Describe the H-shape of structures on the posteroinferior liver
H:

left side - fissures for ligamentum teres and ligamentum venosum
right side - groove for IVC and fossa for gall bladder
cross-bar of H - porta hepatis (region where vessels, nerves and ducts enter or leave)
above cross-bar - caudate lobe
below cross-bar - quadrate lobe
What determines the functional lobes of the liver? How many sectors are there?
the distribution of branches of portal vein and then each sector (4 in total) is subdivided into segments (2) based on their supply by tertiary divisions of portal triad
What is the difference between left and right triangular ligaments?
peritoneum is closer together on left
What is the name of peritoneum superior to right triangular ligament?
anterior coronary ligament
Where does the lesser omentum attach to liver?
at fissure for ligamentum venosum and around porta hepatis
What is the most commonly infected space in the abdominal cavity?
hepatorenal recess (posteroinferior to liver)
What structures pass to the liver through the lesser omentum?
1. portal vein (posteriorly)
2. portohepatic artery (anterior and left)
3. bile duct (ant. and right)
How can bleeding be prevented with a lacterated liver?
put finger through epiploic foramen to complress portohepatic artery
Where does blood from the properhepatic artery and portal vein mix?
at the sinusoids of the liver
What is the dual blood supply to the liver and which supply is more oxygenated than the other?
proper hepatic artery (oxygenated blood to liver)
portal vein (poorly oxygenated blood, nutrients and toxins absorbed from GIT)
How many hepatic veins are there and where do they drain?
3 veins (right, left and middle)
they drain to IVC
Which structures drain into the portal vein of liver, and what are the two potential pathological consequences of this?
stomach, intestines, pancreas, spleen

problems:
1. tumour metastasis to liver from portal vein
2. portal hypertension may lead to oesophageal varices, splenic enlargement, caput medusae