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LIVER(Page 182)Dr.Sherif Fahmy
Shape &Size
Dr.Sherif Fahmy
Site
Dr.Sherif Fahmy
Lobes of the liver:A- Anatomical:
- Left lobe.- Right lobe.- Caudate lobe.- Quadrate lobe.
B- Surgical & physiological:-Left lobe: Medial (superior & inferior) and lateral (superior & inferior) segments.-Right lobe: Anterior (superior & inferior) and posterior (superior & inferior) segments. Dr.Sherif
Fahmy
Anatomical DevisionsDr.Sherif Fahmy
Anatomical Lobes
Dr.Sherif Fahmy
Fissure of ligamentum venosum
Fissure of ligamentum teres
Left lobe
Dr.Sherif Fahmy
Surgical & Physiological Divisions
(Page 183)Dr.Sherif Fahmy
Lat. superior seg.
Lat. inferior seg.
Med. Superior seg.
Med. Inferior seg.
Ant. Superior seg.
Post. Superior seg.
Post. Inferior seg. Ant. Inferior
seg.
Line between gall bladder & inferior vena cava
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Surfaces, Border &
Relations(Page 187)Dr.Sherif Fahmy
Anterior, Superior and Right Relations
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Posterior & Inferior Relations
Dr.Sherif Fahmy
Posterior Surface
Dr.Sherif Fahmy
Dr.Sherif Fahmy
posterior
Inferior
Dr.Sherif Fahmy
Groove for esophagus
Fissure for lig. venosum
Caudate lobe I.V.C
.
Upper layer of coronary lig.
RT triangular lig.
Lower layer of triangular lig.
Gall bladder
Quadrate lobe
Fissure for ligamentum. teres
Omental tuberosity
Gastric area
Bare area
Porta hepatis
Papillary process
Caudate process
Inferior surface of RT lobe
Dr.Sherif Fahmy
Inferior (Visceral) Surface
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Esophagus
Stomach
Lesser omentum
Pyloro-duodenal junction
Area for transverse colon
Gall bladder
2nd part of duodenum
Rt. Colic flexure
Rt. kidney
Dr.Sherif Fahmy
Peritoneal Relations(page 191)
Dr.Sherif Fahmy
Areas not covered with peritoneum:1- Bare area of the liver.2- Fossae for gall bladder & for IVC.3- Porta hepatis.Peritoneal folds related to liver:1- Falciform ligament.2- Coronary ligament.3- Triangular ligaments.4- Lesser omentum (Page 82)Dr.Sherif
Fahmy
Falciform Ligament(Page 193)
Dr.Sherif Fahmy
Falciform ligament
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Coronary Ligament(Page 195)
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Triangular Ligaments(Page 195)
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Lesser Omentum
Dr.Sherif Fahmy
Fissure of ligamentum venosum
Lesser omentum
Porta hepatis
Dr.Sherif Fahmy
Lesser omentum
Dr.Sherif Fahmy
Subphrenic SpacesSubphrenic Spaces((Page 86Page 86))
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Fissures of the Liver(Page 185)
1- Porta hepatis.2- Fissure of ligamentum venosum.3- Fissure of ligamentum teres.
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Ligaments of the Liver:(Page 186)
A- Obliterated vascular ligaments:1- Ligamentum teres.2- Ligamentum venosum.
B- Peritoneal ligaments:1- Coronary ligament.2- Right & left triangualr
ligaments.3- Lesser omentum.4- Falciform ligament.Dr.Sherif
Fahmy
Surface Anatomy(Page 196)
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Blood Supply of Liver(Page 197)
Dr.Sherif Fahmy
Portal Vein
Dr.Sherif Fahmy
Hepatic Artery
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Lymphatic Drainage:(Page 197)A- Lymph vessels: Superficial & Deep.B- Lymph nodes:
1- Lateral diaphragmatic nodes.2- Paracardial nodes.3- Hepatic nodes.4- Coeliac nodes.Dr.Sherif
Fahmy
Dr.Sherif Fahmy
Factors supporting liver in position:(Page 198)1- Hepatic veins.2- Intra-abdominal pressure.3- Tone of anterior abdominal muscles.4- Peritoneal folds and ligaments.
Dr.Sherif Fahmy
Applied Anatomy of liver:1- How we stop bleeding from liver ?2- How we determine liver enlargement by examination ?3- Site of hepatic pain.4- Partial hepatectomy and partial liver transplantation.
Dr.Sherif Fahmy
Extra-hepatic Biliary Passage
(Page 199)Dr.Sherif Fahmy
Hepatic & Cystic Ducts
Dr.Sherif Fahmy
Hepatic Artery
CommonBile duct
Common hepatic duct
Gastro-duodenal art.
Cystic duct
Dr.Sherif Fahmy
Common Bile Duct(Page 200)
Dr.Sherif Fahmy
Hepatic Artery
CommonBile duct
Common hepatic duct
Gastro-duodenal art.
Cystic duct
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Gall BladderGall BladderPage 201Page 201
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy