liver seminar for medical and paramedical students

human anatomy of liver

1. ? By A.Shanmugam,Assistant professor of Anatomy, GVMCH.

2. ANATOMY OF LIVER I. Gross Anatomy II. Micro Anatomy(Histology)

3. I. Gross Anatomy of liver Definition Location Shape Size weight Colour coverings External features Lobes segments Supports Porta hepatis and bare areas Relations Blood supply Nerve supply Lymphatic drainage Surface anatomy Development Extra biliary apparatus Clinical Anatomy https://www.google.com/search?q=liver+anatomy&source

4. Definition Liver is the largest gland in the body. Both exocrine and endocrine gland. Primary metabolic and detoxifying organ of the body.

5. Location Right upper quadrant of the abdominal cavity. Right hypochondrial region-whole epigastric region-upper part left hypochondral region- upto mid clavicular line

6. shape Wedge shaped Broad base - right side Sharp edge-left side

7. Size , weight & colour Maximum size: Ap-14 cm Vertical -16 cm Transverse-18 cm Weight: in male 1.4-1.8 kg in female 1.2-1.4 kg ranges 1-2.5 kg At birth150 g Relation to body weight: 1/18 in child,1/36-50 in adult. Colour : reddish brown

8. coverings outer-Peritoneum inner - Glisson’s capsule

9. External features- Surfaces and borders Surfaces: Based on location-5 surfaces - anterior, posterior, superior, right and inferior surface. Based on relation-2 surfaces. diaphragmatic and visceral surface. Borders Sharp –inferior border Postero -superior and postero -inferior border.

10. Lobes and segments Lobes: Large lobes- right and left Small lobes-caudate and quadrate lobes Riedel’s lobe Pons hepatis Fibrous appendix of liver.

11. Segments( couinaud’s ) or physiological lobes Right lobe- anterior , posterior segments. Left lobe –medial and lateral segments. Then each segments divided into superior and inferior segments.

12. Supports of the liver 5 –peritoneal folds 2- embryological remanents . 2-vascular structures

13. Porta hepatis and bare areas

14. Relations 1. Diaphragmatic relations

15. Relations contd … 1. Visceral relations

16. Blood supply Arterial supply 20% by hepatic artery 80% by portal vein

17. Blood supply contd … Venous drainage Drained by hepatic veins. Upper group- right, left and middle. Lower group- many small veins.

18. Lymphatic drainage Superficial lymphatics - under the peritoneum – Posterior, right and superior surface-supra diaphragmatic nodes. Inferior and anterior surface-hepatic nodes. Deep lymphatics - follow the hepatic and portal veins- supra diaphragmatic and hepatic nodes.

19. Nerve supply By hepatic plexus- from coeliac ganglion –contains both sympathetic from T7-T9 and parasympathetic from vagus nerve.

20. Surface Anatomy Inferior border-1 st point on right 10 rib at mid clavicular line. 2nd-point- tip of right 9 th costal cartilage 3rd-point transpyloric plane at midline 4 th point –tip of 8 costal cartilage 5 th point left 5 th rib at mid- clavicular plane Superior border- 5 th point, xiphisternal joint, right 5 th rib at midclavicular plane. Right margin-connecting right end of both lines.

21. Development Hepatic bud arises from caudal end of fore gut. Pars cyctica , pars hepatica Parenchyma from –endoderm. Connective tissue from-septum transversum . Other cells from portal and umbilical sinusoids.

22. Extra biliary apparatus Right and hepatic duct Common hepatic duct Gall bladder, cystic duct Bile duct Sphincter of boyden Sphincter of oddi Calot’s triangle

23. II.Microanatomy (histology) Define Microanatomy? Subdivisions 1.Histology 2.cytology

24. Define micron?

25. Define Micron? One Millionth of a meter 1/1,000mm=0.001mm=10 -3 mm =1micron. 1/10,000cm=0.0001cm=10 -4 cm=1micron. 1/10,00,000m=0.000001m=10 -6 m=1micron. 1/1,00,00,00,000km=0.00000001km =10 -9 km=1micron.

26. Components of liver based on Micro-Anatomy 1.suporting tissue( stroma -fibrous tissue) 2.Cellular components(parenchyma) https://www.google.com/search?q=liver+anatomy&source

27. Components of liver 1.Fibrous tissue 1.Capsule 2.Trabeculae 3.Sheath around portal triad 2.Cells Hepatocytes Kupffer cells Natural killer cells(large granular lymphocytes or pit cells) stellate cells (Ito cells) Cholangiocytes  

28. Coverings of liver Glisson's capsule  - a collagenous capsule Named after Francis Glisson (1599 – 1677) a British anatomist. Coverings of the liver has two layers. 1.Serous layer- visceral peritoneum-outer layer. 2.Fibrous layer-inner layer https://www.google.com/search?q=liver+anatomy&source

29. Hepatic lobules Three types 1. classic hepatic lobule 2. portal lobule 3. portal acinus https://www.google.com/search?q=liver+anatomy&source

30. Hepatic lobules https://www.google.com/search?q=liver+anatomy&source

31. Concepts of liver lobules https://www.google.com/search?q=liver+anatomy&source

32. Hepatic lobule and acinus https://www.google.com/search?q=liver+anatomy&source

33. Spaces in the liver tissue 1.Portal canal or portal tract. 2. Hepatic canal. 3.Hepatic lacunae 4.Hepatic sinusoids 5.Canal of Herings 6.Space of Disse 7 .Space of mall. https://www.google.com/search?q=liver+anatomy&source

34. Fluid flow in liver tissue https://www.google.com/search?q=liver+anatomy&source

35. 1.Hepatocyte A  hepatocyte  is a cell of the main parenchymal tissue of the liver.   Hepatocytes  make up 55-65% of the liver's mass. These cells are involved in Protein synthesis and storage. Lifespan around 5 months. https://www.google.com/search?q=liver+anatomy&source

36. Kupffer cells Also known as stellate cells( kupffer – Browicz cells). Specilized macrophages- for phagocytosis . Discovered by Karl wilhelm von Kupffer . Lifespan 3.8 days https://www.google.com/search?q=liver+anatomy&source

37. Kupffer cells https://www.google.com/search?q=liver+anatomy&source

38. Kupffer cells https://www.google.com/search?q=liver+anatomy&source

39. Stellate cells(Ito cells) stellate cells  (Ito cells) - Named after Toshio Ito, a twentieth century Japanese physician. Also known as perisinusoidal cells. Earlier which is called as lipocytes or fat-storing cells. https://www.google.com/search?q=liver+anatomy&source

40. Stellate cells(Ito cells) It is the major cell type involved in the liver fibrosis. Lipid droplets in the cell body store the vit -A as retinol ester. https://www.google.com/search?q=liver+anatomy&source

41. Cholangiocytes Cholangiocytes  are the epithelial cells of the bile duct. They are cuboidal epithelium in the small interlobular bile ducts. but become columnar and mucus secreting in larger bile ducts approaching the porta hepatis and the extrahepatic ducts. https://www.google.com/search?q=liver+anatomy&source

42. Save liver https://www.google.com/search?q=liver+anatomy&source Donate liver

43. References 1. Gray’s anatomy-By Hentry Gray-38 edition. 2. Essentials of human Anatomy by A.K Datta-7 th edition. 3. wheater’s -text book of Histology 4. Histology-A text book and atlas-by Ross and Romrell-3 rd edition 5. Clinically Oriented Anatomy-by Keith.L.Moore . 6.Lang man’s Medical embryology-by T.W 7.text book of anatomy-by Vishram singh-4 th edition 8.clinical Anatomy –by Neeta V.kulkarni -2 nd edition 9.A text book of Human Anatomy by T.S. Ranganathan 10.Human Anatomy by B.D Chaurasia -6 th edition. 11.web:www.google.com

44. Thank you