LIVER ANATOMY.pptx

Liver Anatomy

1. Presentator : Dr. Vaishnavi Bhagat Class: BAMS First Year Subject: Anatomy Topic: Liver

2. LIVER

3. FEATURES The liver is the largest gland in body, which occupies the right upper quadrant of the abdominal cavity. Color: Reddish brown. Weight: M-1600g and F-1300g It consists of both Endocrine and Exocrine parts. Mainly liver performs a wide range of metabolic activities which are necessary for Hemostasis, Nutrition and Functions related to Immune System. It secrete Bile Juice and stores Glycogen. It also synthesize Serum proteins and Lipids.

4. Liver almost fully occupies Right hypochondrium , upper part of epigastrium and part of left hypochondrium up to left lateral line. Most of the liver is covered by ribs and costal cartilages, immediately below the diaphragm. It extend upwards under rib cage as far as 5 th rib anteriorly from right side. And at left 5 th intercostal space anteriorly from left side. LOCATION:

5. Shape and Size: Liver is Wedge Shaped and resembles with 4 sided pyramid laid on one side with base directed towards Right, and Apex directed towards Left Weight: In male: 1600g i.e 1.4-1.8 kg In Female: 1300g i.e 1.2-1.4 kg In New born : 1/18 th of body weight

6. EXTERNAL FEATURES: Wedge Shaped liver have two well defined surfaces(diaphragmatic) and visceral and well defined border i.e (inferior border). The diaphragmatic surface is convex and extensive. It faces upward, forward to right and backward. Viscera surface is relatively flat and faces inferiorly. At the inferior border- 2 Surfaces meet in front at the sharp.

7. PERITONIAL RELATIONS Most of the liver is covered by peritoneum. The areas which are not covered by peritoneum are: Base area of liver: It is triangular area on posterior aspect of right lobe. Fossa for gall bladder: On inferior surface of liver between Right and Quadrate lobes. Groove for 1VC: On posterior surface of right lobe of liver. Groove for “ ligamentum Venosum ”. Portal hepatis .

8. BLOOD SUPPLY

9. The liver is a highly vascular organ Liver receives — 20% BS through Hepatic Artery. 80% BS through Portal Vein. Before entering into the liver the both hepatic artery and portal vein divides into Right and Left branches. They redivides from segmental vessels, further divides from interlobular branches which opens into Hepatic Sinusoids. 6. Therefore hepatic arterial blood mixes with portal venous blood in sinusoid. No anastomoses between adjoining hepatic artery territory which means each branch is an end artery.

10. VENOUS DRAINAGE Hepatic Sinusoids drain into interlobular vein which joins from sublobular vein. Which unite to form hepatic vein which directly drain into the IVC; which provide support to liver besides intra - abdominal pressure.

11. Hepatic Vein UPPER LOWER Right vein Left Vein Middle Vein Number of small veins from lobe and caudate lobe. It emerges through lower part of caval groove and opens into vena cava. Which emerges through upper part of groove for IVC opens directly into vena cava. Microscopically, central veins are seen as separate channels from portal radicles.

12. LYMPHATIC DRAINAGE Superficial lymphatics of liver run on surface of organ beneath the peritoneum and terminate in caval , hepatic, paracardial and coeliac lymph nodes. Some vessels directly joins the thoracic duct from coronary ligament. Deep lymphatics ends partly in nodes around end of IVC and hepatic nodes.

13. NERVE SUPPLY Liver is supplied by both sympathetic and parasympathetic nerve fibres . Sympathetic fibres : Derived from coeliac plexus and they run along vessels in free margin of lesser omentum and enter into portal hepatis . Parasympathetic fibres : Derived from Hepatic branch , anterior Vagal trunk which reaches portal hepatis through lesser omentum . Nerves also reach liver through various peritonal ligaments.

14. HEPATIC SEGMENTS (8) Intrahepatic distribution of hepatic artery, portal vein and biliary ducts. The liver divided into Right and Left functional lobes. Right physiological lobe divided into anterior and posterior parts. Each parts divided into upper and lower which forms 8 surgically resectable hepatic segments. Thus there are 4 segments in liver as follows: 1) Right anterior (V & VIII) 2) Right posterior (VI & VII) 3) Left lateral ( II & III) 4) Left medial ( I & IV) The Hepatic vein tend to be intersegmental.

15. FUNCTIONS: Metabolism of carbohydrates, fats and proteins Secretes bile and prothrombin Excretion of drug, toxins, cholesterol, bile pigment and heavy metals Protects from conjugation, destruction, phagocytosis, antibody formation and excretive. Stores Glycogen,Iron , Fat, Vit A&D Liver is an indispensable gland of body

16. CLINICAL ANATOMY: Pringles Manoeuvre — Liver recieves blood from the hepatic artery and portal vein. These vessels are free marginal of lesser omentum and if bleeding from liver takes place it can be stopped by compressing the Fredge of lesser omentum . Inflammation in liver — Hepatatis ; infective Hepatatis or amoebic Hepatatis . Liver Transplantation — It done when patient is at end stage of liver disease. Impart of graft required inferior caval anastomeses which follows anatomis portal vein. And finally arterial and biliary anastomes performs. Liver Shrink and fibrosis while undergoes into “ Cirriohossis of liver”. Liver Cirriohossis cause — Caput Medusae at umbilicus. Liver Resection — Primary and secondary tumor is done 80% mass of liver remove safely and the liver grows to its original size within 12 months after resection.

17. THANK YOU !